By signing, the undersigned certifies that he/she has read and understood the submittal requirements outlined, and that he/she <br />understands that omission of any listed item may cause delay in processing the application. I (We), the undersigned, <br />acknowledge that the information supplied in this application is complete and accurate to the best of my (our) knowledge. <br />OWNER (Also the Applicant? E] Yes / ® No): <br />State of Oregon Acting by and <br />through the Board of Trustees <br />Name (print): Attn: Mike Harwood Phone: 541.346.8267 <br />Address: University of Oregon 1585 E. 13th Avenue <br />City/State/Zip: Eugene OR 97403 <br />Signature: <br />APPLICANT❑ / APPLICANT'S REPRESENTATIVE ® (Check one): <br />Name (print): Karl Schulz <br />Company/Organization: inici group, LLC <br />Address: 4640 S Macadam Avenue, Suite 100 <br />City/State/Zip: Portland, OR 97239 E-mail (if applicable): kss@inicigroup.com <br />Phone: 503.972.2620 Fax: <br />Signature: <br />APPLICANT'S REPRESENTATIVE ❑ / DESIGNATED CONTACT PERSON ® (Check all that apply): <br />Name (print): Colin McArthur, AICP <br />Company/Organization: Cameron McCarthy Landscape Architecture and Planning <br />Address: 160 East Broadway <br />City/State/Zip: Eugene, OR 97402 E-mail (if applicable): colin@cameronmccarthy.com <br />Phone: 541.485.7385 Fax: <br />Signature: <br />Note: This is not a complete list of requirements. Additional information may be required after further review in order to <br />adequately address the applicable approval criteria. <br />Planning & Development <br />Planning Division <br />99 W. 10TH Avenue, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail: planning@ci.eugene.or.us <br />www. eugene-or. gov/plonning <br />Updated: March 2014 <br />Page 5 of 5 <br />