<br />Annexation Completeness Review Form Last Revised 9/2024 Page 2 of 2 <br /> <br />Comments 1) Please provide a north arrow and standard engineer’s scale. <br />7) Show existing structures on the site. <br />8) Submitted documents in the packet may indicate a permanent drainage easement exists on one of the <br />parcels. If so, it needs to be shown on site plan. <br /> <br />General Requirements <br />Submitted Missing Incomplete N/A <br />☒ ☐ ☐ ☐ 9. Petition for Annexation listing all owners, including partial owners, and <br />electors. <br />☒ ☐ ☐ ☐ 10. Certification of Electors form signed by the Lane County Elections/Voter <br />Registration Department. <br />☒ ☐ ☐ ☐ 11. Verification (Certification) of Property Owners form signed by the Lane <br />County Department of Assessment and Taxation. <br />☒ ☐ ☐ ☐ 12. Notarized Consent to Annex. <br />General Requirements (continued) <br />Submitted Missing Incomplete N/A <br />☐ ☐ ☒ ☐ <br />13. A legal description of the land proposed for annexation, including any <br />public right of way prepared by a registered land surveyor. These <br />descriptions must be typed on an 8-1/2 x 11" white sheet of paper (no <br />letterhead) so that it is suitable for recording. <br />☐ ☒ ☐ ☐ 14. Certification of Description signed by a registered land surveyor. <br />☒ ☐ ☐ ☐ 15. Summary of Urban Service Provision. <br />☐ ☒ ☐ ☐ 16. An 8½ x 11 county assessor’s cadastral map. <br />☐ ☐ ☐ ☒ 17. Census Information Sheet <br />Comments 13 &14) See attached from City Surveyor. <br />16) Please provide a county assessor’s cadastral map. <br /> <br />Yes No For Staff Use Only <br />☐ ☒ 1. Confirm zoning and designation and if /ND & /WQ overlays will be automatically applied upon <br />annexation. (Check OnTrack and Metro Plan to verify if property is designated for Nodal <br />Development. Check OnTrack for /WQ after June 10, 2009.) <br />☐ ☐ 2. Is this within a special district? (Check RLID). If so, add info item to findings regarding need for <br />withdrawal by the City – see previous findings for example. <br /> <br /> <br /> <br />Yes No For Staff Use Only - Referral Information <br />☒ ☐ 3. Is the right-of-way county maintained? If yes, route land use referral to Lane County <br />Transportation and Lane County Road Maintenance Planning. <br />☐ ☒ 4. Does the resulting change create or eliminate a split zone or split overlay zone? If Yes, please send <br />referral to Thea Evans or Planning GIS Specialist <br />☐ ☐ 5. Other: <br /> <br /> <br /> <br /> <br />