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? ❑ Yes / x❑ No): <br />Americo Real Estate <br />Name (print): COMDanv Phone: 541.514.8260 <br />Address: 2727 N. C <br />p:,, Pho9i)ix, AZ 85004 <br />Signature <br />Ian Goralewski <br />APPLICANT x❑ / APPLICANT'S REPRESENTATIVE ❑ (Check one): <br />Name (print): Ian Goralewski <br />Company/Organization: Uhaul Company of Southern Oregon <br />Address: 4400 Franklin Blvd <br />Eugene, OR <br />City/State/Zip: 97403 E-mail (if applicable): ian_goralewski@uhaul.com <br />Phone: 541.514.8260 Fax: <br />Signature <br />Ian Goralewski <br />APPLICANT'S REPRESENTATIVE ❑x / DESIGNATED CONTACT PERSON ❑x (Check all that apply): <br />Name (print): Carol Schirmer <br />ny/Organization: Schirmer Consulting, LLC <br />Address: PO Box 10424 <br />Eugene, OR <br />City/State/Zip: 97440 E-mail (if applicable): schirmer@schirmerconsulting.com <br />Phone: 541.234.5108 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 />Www. euaene-or. goy/plan n inq <br />Planning & Development Updated: March 2014 <br />Planning Division <br />99 W. 101" Avenue, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail:planning@ci.eugene.or.us Page 3 of 3 <br />