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❑ Submit a copy of all recorded easements, including the legal description, for each easement or right-of-way to be vacated. ❑ If any parcel or lot was created through a previous land use application, provide evidence that the proposed vacation will be consistent with the original conditions of approval. ❑ For public utility easement vacations, provide written statements of concurrence for the proposed vacation from affected utility providers. ❑ For any vacation request under the Type I or 11 process, provide signatures of all owners of property subject to the easement and the owners of abutting properties. For vacations of right-of-way or public ways, consent of surrounding property owners shall be provided, as required by Oregon Revised Statute (ORS) section 271.080. Forms are available from the Planning Department or online at: www.eugeneplanning.org By signing, the undersigned certifies that he/she has read and understood the submittal requirements outlined, and that he/she understands that omission of any listed item may cause delay in processing the application. I (We), the undersigned, acknowledge that the information supplied in this application is complete and accurate to the best of my (our) knowledge. OWNER (Also the Applicant? Yes / No): Name (print): utv-Zo L- aF EIJ~ yC Phone: S01 J Ca J ~l t Address: 3q 21 13 QcLyd L V-%) ac, V 3l'*- Signature: APPLICANT[ / A~P'FLICANT'S REPRESENTATIVE E] (Check one): Name (print): Elliott Pelfrey Company/Organization: Neighborly Ventures, Inc Address: 2925 River Road S City/State/Zip: Salem, OR 97302 E-mail (if applicable): elliottp@theneighborlyway.com Phone: 503-373-312 Fax: Signature: L{~7rf-• NOTE: This is not a c6implete list of requirements. Additional Information may be required after further review in order to adequately address the required criteria of approval. www. eog ene• on uo ylplan ninrr Planning & Development Updated: March 2014 Planning Division 99 W. 107H Avenue, Eugene, OR 97401 Phone: 541.682.5377 or E-mail: planning@cl.eugene.or.us Page 3 of 3