www.eugene-or.gov/bps <br />Planning & Development <br />Building Permit Services <br />99 W. 10TH Avenue; Eugene, OR 97404 <br />P 541.682.5086 * F 541.685.5593 <br />www.euggene or.ggov//bpps <br />NOISE VARIANCE APPLICATION Page 2 of 3 <br />By signing, the undersigned certifies that he/she has read and understood the submittal <br />requirements outlined, and that he/she understands that omission of any listed item may <br />cause delay in processing the application. I (We), the undersigned, acknowledge that the <br />information supplied in this application is complete and accurate to the best of my (our) <br />knowledge. <br />OWNER (Also the Applicant? Yes / No): <br />Name (print): Phone: <br />Address: <br />City/State/Zip: <br />Signature: <br />APPLICANT / APPLICANT’S REPRESENTATIVE (Check one): <br />Name (print): Randi Staudinger <br />Company/Organization: Lane Transit District <br />Address: 3500 E 17th Ave <br />City/State/Zip: Eugene, OR 97403 E-mail (if applicable): randi.staudinger@ltd.org <br />Phone: 541-682-6184 Fax: <br />Signature: <br />APPLICANT’S REPRESENTATIVE / DESIGNATED CONTACT (Check all that apply): <br />Name (print): Nancy Thornton <br />Company/Organization: Chambers Construction <br />Address: 3028 Judkins Rd #1 <br />City/State/Zip: Eugene, OR 97403 E-mail (if applicable): nthornton@chambers-gc.com <br />Phone: (541) 868-8573 Fax: <br />Signature: <br />Note: This is not a complete list of requirements. Additional information may be <br />required after further review in order to adequately address the applicable <br />approval criteria. <br />Randi Staudinger Digitally signed by Randi Staudinger <br />DN: C=US, E=randi.staudinger@ltd.org, O=Lane <br />Transit District, CN=Randi Staudinger <br />Date: 2026.02.09 11:17:47-07'00'