❑ Submit a copy of all recorded easements, including the legal description, for each easement or right-of-way to <br />be vacated. <br />❑ if any parcel or lot was created through a previous land use application, provide evidence that the proposed <br />vacation will be consistent with the original conditions of approval. <br />❑ For public utility easement vacations, provide written statements of concurrence for the proposed vacation <br />from affected utility providers. <br />For any vacation request under the Type I or II process, provide signatures of all owners of property subject to <br />the easement and the owners of abutting properties. For vacations of right-of-way or public ways, consent of <br />surrounding property owners shall be provided, as required by Oregon Revised Statute (ORS) section 271.1380. <br />Forms are available from the Planning Department or online at: www.eugeneplanning.org <br />By signing, the undersigned certifies that he/she has read and understood the submittal requirements outlined, <br />and that he/she understands that omission of any listed item may cause delay In processing the application. I <br />(die), the undersigned, acknowledge that the information supplied in this application is complete and accurate <br />to the best of my (our) knowledge. <br />OWNER (Also the Applicant? ❑ Yes / ® No): <br />Name (print) A Phone: <br />Address: ~ Q )t- _5'd 0tii'~ S <br />City/State/Zip: r eJ C 0-VJ vL <br />Signat <br />APPLICANT / APPLICANT'S REPRESENTATIVE ❑ (Check one): <br />Name (print): Elliott Pelfre <br />Company/Organization: Neiqhborly Ventures, Inc <br />Address: 2925 River Road S <br />City/State/Zip: Salem, OR 97302 E-mail (if applicable): elliottp@theneighborlyway.com <br />Phone: 503-373-312 Fax: <br />Signature: NOTE: This is n6t a c6mplete list of requirements. Additional information may be required after further review in <br />order to adequately address the required criteria of approval. <br />tvwtv.e gene-ongovlyionnino <br />Planning & Development Updated: March 2014 <br />Planning Division <br />99 w. 1018 Avenue, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail: planning@ci.eugene.or.us Page 3 of 3 <br />