;A.ga ft <br />WIPlanning <br />RECEIVEI�AIDDL� HOUSING LAND DIVISION, TENTATIVE PLAN <br />..ease complete the foll wing application checklist. Noe that additional information may be required upon <br />further review in order t adequately address the applicable criteria for approval. If you have any questions <br />about filling out this application, TyENS -lannin staff at the Permit and Information Center, phone <br />(541) 682-5377, 99 West 3�enue Suite 290, Eugene, OR 97401. <br />List all Assessor's Map and Tax Lot numbers of the property included in the request. Proposals are <br />required to include all property under contiguous ownership of the applicant. <br />Assessor's Map <br />Tax Lot <br />Zoning <br />Lot Area (square feet/acres) <br />lb 34 <br />4GG <br />Ss_t 71 _c <br />Name of Middle Housing Land Division: Z +(A �J ��v�c7cic� S,Ytt,t ftl�A �t»�"'�� 1 d 0 ,\ "Asio"\ <br />Existing Use on Property: �25� <br />Middle Housing Type (check one): 9 Duplex ❑ Triplex ❑ Fourplex ❑ Cottage Cluster ❑ Townhouses <br />Middle Housing Status: ❑ Developed (Existing): ❑ before OR ❑ after June 30, 2022 <br />f�j Proposed (new): <br />�] To be developed later <br />❑ Permit Review/Issued - Permit No(s): <br />Does the project include Middle Housing Conversion (see definition at EC 9.0500)? ❑ Yes ® No <br />Is site included on acknowledged Statewide Goal 5 Inventory? ❑ Yes 0 No ❑ Uncertain <br />Is this application running concurrently with another Land Use Application? <br />No ❑ Yes, type: <br />Adjustment Requested? K No ❑ Yes, section number(s): <br />Filing Fee <br />KJ A filing fee must accompany all applications. The fee varies depending upon the type of application and is <br />adjusted periodically by the City Manager. Check with Planning staff at the Permit and Information <br />Center to determine the required fee or check website at: www.eugeneplanning.org <br />Application Procedures <br />❑ I would like to follow the application procedures listed in EC 9.7900 - 9.7925; or <br />I would like to follow the applications procedures listed under the Expedited Land Division procedures <br />listed in ORS 197.365, as amended by Enrolled House Bill 2138 (see next page for summary of <br />differences). <br />www.eugene-or.gov/planning <br />Planning & Development Updated: October 2025 <br />Planning Division <br />99 W. 1011 Avenue Suite 290, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail: planning@eugene-or.gov <br />Page 1 of 5 <br />