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 />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. | (We), the undersigned, acknowledge <br />that the information supplied in this application is complete and accurate to the best of my (our) knowledge. <br />OWNER (Also the Applicant? [_] Yes / [lll] No): <br />Haven and Mallory Beebe <br />Name (print): Phone: <br /> <br />Address: <br /> Eugene, OR 97402 <br />City/State/Zip: <br /> <br />Signature: <br /> <br />APPLICANT [_] / APPLICANT’S REPRESENTATIVE [M] (Check one): <br />See below. <br />Name (print): <br /> <br />Company/Organization: <br /> <br />Address: <br /> <br />City/State/Zip: E-mail (if applicable): <br /> <br />Phone: Fax: <br /> <br />Signature: <br /> <br />APPLICANT'S REPRESENTATIVE [Ml] / DESIGNATED CONTACT PERSON [ll] (Check all that apply): <br />Zack P. Mittge <br />Name (print): <br /> Hutchinson, Cox <br />Company/Organization: <br />940 Willamette St., Ste 400 <br /> <br /> <br /> <br />Address: <br />Eugene, OR 97401 zmittge @ eugenelaw.com <br />City/State/Zip: E-mail (if applicable): <br />(541) 686-9160 (541) 343-8693 <br />Phone: Fax: <br /> <br />Signature: Cf-— O <br />www.eugene-or.gov/planning <br />Planning & Development Updated: January 2025 <br />Planning Division <br />99 W. 10™ Avenue Suite 290, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail: planning@eugene-or.gov Page 3 of 3 <br />