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Alkh WPlanning MIDDLE HOUSING LAND DIVISION, FINAL Please complete the following application checklist. Note that additional information may be required upon further review in order to adequately address the applicable criteria for approval. If you have any questions about filling out this application, please contact Planning staff at the Permit and Information Center - Phone: (541) 682-5377; Address: 99 West 101" Avenue Suite 290, Eugene, OR 97401 Tentative Middle Housing Land Division File Number: Approval Date: Expiration Date: MHT 25-4 April 4, 2025 3 years after effective approval date List the Assessor's Map and Tax Lot number(s) of the property included in the request. Please indicate if only a portion of a lot is included in the request and attach any additional map and lot numbers for the property. Assessor's Map Tax Lot Zoning Number of Middle Housing Lots 18 03 05 42 05400 R-1 2 Name of Middle Housing Land Division Plat: Middle Housing Type (check one): ❑■ Duplex ❑ Triplex ❑ Fourplex ❑ Cottage Cluster Filing Fee ❑■ A filing fee must accompany all applications. The fee varies depending upon the type of application and is adjusted periodically by the City Manager. Check with Planning staff at the Permit and Information Center to determine the required fee or check website at: www.eugeneplanning.org Stage 1 Submittal Requirements: Provide 2 paper copies and one digital copy (CD, USB Drive, or Other) of all application materials (i.e. written statement, site plans, etc.). Digital files must be in PDF file format. Please note that it is the applicant's responsibility to make sure that the digital and paper copies are identical. Following completeness review, an updated digital and paper copies may be required. All paper site plans must be folded to a size equal or less than 11" x 17". ■❑ Written statement that indicates how the final application addresses the final plat approval criteria and the conditions of approval (informational items identified during the tentative approval may be applicable during the final plat stage). ❑■ Draft of the final site plan to be attached to the Performance Agreement in accordance with EC 9.7025. The final site plan should depict, and a layout consistent with the approved Tentative Middle Housing Land Division including, but not limited to, required site plan notes and details identified during the Tentative Middle Housing Land Division approval, the proposed middle housing lots, easements, landscaping, and other requirements of the Tentative Approval. ❑■ Plat signed by an Oregon licensed land surveyor. A list of plat requirements subject to City Survey staff review is available at the City of Eugene Public Works offices, at 858 Pearl Street, Eugene, OR 97401. N/A ❑ As required, include the following: ❑ Delineation of the flood plain or floodway boundaries. ❑ The community number, map/panel number and effective date of the relevant FIRM map. ❑ A note including the Base Flood Elevation for each lot. www. eugene-or. qov/planninq Planning & Development Planning Division 99 W. 10T" Avenue Suite 290, Eugene, OR 97401 Phone: 541.682.5377 or E-mail: planning@eugene-or.gov Updated: December 2024 Page 1 of 3