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www.eugene-or.gov/planning Planning & Development Updated: September 2022 Planning Division 99 W. 10TH Avenue, Eugene, OR 97401 Phone: 541.682.5377 or E-mail:planning@ci.eugene.or.us Page 3 of 3 By signing, the undersigned certifies that he/she has read and understood the submittal requirements outlined, and that he/she understands that omission of any listed item may cause delay in processing the application. I (We), the undersigned, acknowledge that the information supplied in this application is complete and accurate to the best of my (our) knowledge. OWNER (Also the Applicant? Yes / No): Name (print): Phone: Address: City/State/Zip: Signature: APPLICANT / APPLICANT’S REPRESENTATIVE (Check one): Name (print): Company/Organization: Address: City/State/Zip: E-mail (if applicable): Phone: Fax: Signature: APPLICANT’S REPRESENTATIVE / DESIGNATED CONTACT PERSON (Check all that apply): Name (print): Company/Organization: Address: City/State/Zip: E-mail (if applicable): Phone: Fax: Signature: Note: This is not a complete list of requirements. Additional information may be required after further review in order to adequately address the applicable approval criteria. Anthony J. Favreau The Favreau Group, LLC 3750 Norwich Ave., Eugene, OR 97408 favreaugroup@msn.com 541-683-7048 KSK Investment, LLC 541-554-7377 93271 Bear Creek Ranch Road Junction City , OR 97448