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www.eugene-or.gov/planning Planning & Development Updated: January 2025 Planning Division 99 W. 10TH Avenue Suite 290, Eugene, OR 97401 Phone: 541.682.5377 or E-mail: planning@eugene-or.gov 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. criteria of approval. Jose Garduno (for Walmart REBT)479-273-4000 PO Box 8050, MS 0555 Bentonville, AR 72716 Jeffrey Davis PB2 Architecture + Engineering 4886 W Pauline Whitaker Parkway Suite 200 Rogers, AR 72758 jeff.davis@pb2ae.com 479-878-3663 Jeffrey R. Davis Digitally signed by Jeffrey R. Davis DN: C=US, E=jeff.davis@pb2ae.com, O="pb2 architecture + engineering", CN=Jeffrey R. Davis Date: 2025.12.17 09:43:46-06'00' Docusign Envelope ID: B6FB714A-E65C-4A73-96BA-7555F4A75E49