Onaf'-major & Minor Partiti Application <br />Planning <br />& Development <br />Planning <br />Please complete the following required information. If any of this required information or material is <br />missing or incomplete, the application will not be .processed. If you have any questions about filling out <br />this application, please contact the Planning Staff at the Permit and Information Center, phone 61 -5086 . <br />99 West 10th Ave Eugene Also please note the information required on the attached application <br />information sheet. <br />Assessor's Map(s) and Tax Lot(s) of the property in the request. <br />(Please indicate if only a portion of a lot is included in the request and attach any additional <br />map and lot numbers for the property.) <br />Map # 11-p y _33. << Lot # o c, Map # 11-o4 -33 - `j Lot # <br />Area of Request: l 9 ,'"1 acres OR - square feet <br />Number of lots to be created: Z F--fisting zoning: 2- <br />I (We) the undersigned acknowledge that the information in this application is complete and accurate to <br />the best of my (our) knowledge. <br />OWNER Phone: Sys 'L((o zg <br />SURVEYOR Phone: 4 gS -45 o S <br />Addr: O ~-0'v' Zy `i Addr: 0.30 ZSZ.'1 <br />City/ City/ <br />State: State: ii=0GF=tj 1=, Z:Z C:) (Z <br />Zip: 01-74-0 Z Zip: 4`l`t o Z <br />CL "Z <br />EOWNER SIGNATURES P <br />T SIGNATURE <br />9~ Pftl <br />JA MEeb L6 A DDar K w ~ 0 , o 3 <br />NOTE: Please attach the name, phone number, address, and signature of any additional owners <br />of the property. <br />CITY OF EUGENE <br />8111H)ING & PERMIT SERAMCES <br />ADNI9 2001 <br />BUILDING & PERMIT SEIMCES <br />RECEiVED~Im.- CEIVED <br />!v o 0 <br />