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 / ❑ No); <br />Name (print): Searr Living Trust <br />Address: PO Box 50563 <br />Clty/state/Zip: Eugene, OR 97405 <br />�oA�Signature: <br />APPLICANT ❑ / APPLICANT'S REPRESENTATIVE ❑ (Check one): <br />Name (print): <br />Company/Organization: <br />Address: <br />City/State/Zip: _ <br />Phone: <br />Signature: <br />Phone: 541.554.9998 <br />Martin Scarr, Trustee <br />E-mail (if applicable): <br />Fax: <br />APPLICANT'S REPRESENTATIVE ❑■ / DESIGNATED CONTACT PERSON K (Check all that apply): <br />Name (print): carol schlrrner <br />Company/Organization: Schirmer Consulting, LLC <br />Address: PO Box 10424 <br />City/State/Zip: Eugene, OR 97440 <br />Phone: 541.234.5108 <br />Signature: <br />E-mail (if applicable): Schirmer a@schi rmerconsulti ng.com <br />Fax: <br />www.euaene-or, aov/ulonnine <br />Planning & Development Updated: December 2024 <br />Planning Division <br />99 W.10TH Avenue Suite 290, Eugene, DR 97401 <br />Phone: 541.682.5377 or E-mail: planning@eugene-or.go Page 3 of 3 <br />