Apfth, <br />WPIanning <br />ADJUSTMENT REVIEW <br />Please complete the following application checklist. Note that additional information may be required upon further review in order <br />to adequately address the applicable criteria for approval. If you have any questions about filling out this application, please contact <br />Planning staff at the Permit and Information Center, phone (541) 682-5377, 99 West 10th Avenue, Eugene. <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 Tax Lot Existing Zoning <br />Code Sections Proposed for Adjustment Review <br />List specific code sections for which adiustment review is pr000sed. <br />Check if the Adjustment Review is for any of the following: <br />❑ Large commercial facility <br />❑ Large multi -tenant commercial facility, or <br />❑ Multiple -family housing <br />Does adjustment request affect at least 2 of the following: ❑ Yes ❑ No <br />(If yes, this application will be processed as a major adjustment review.) <br />(a) Maximum front yard setbacks <br />(b) Building orientation, <br />(c) Building entrances <br />(d) On-site pedestrian circulation, <br />(e) Block requirements or street layout: <br />Does adjustment request include stormwater drainage facilities: ❑ Yes ❑ No <br />(If request includes Pollution Reduction/Flow Control, submit approved alternative design. If request includes Source Control, submit <br />DAR form.) <br />Does request include an adjustment of internal vehicle stacking at Eugene Code Section 9.6703(3)(a): ❑ Yes <br />❑ No <br />If yes, submit an Alternative Traffic Safety Study (ATSS). <br />Associated pending Land Use Application or Building Permit numbers: <br />Planning & Development <br />Planning Division <br />99 W. 10Th Avenue, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail: planning@ci.eugene.or.us <br />www. eugene-or. goy/planning <br />Updated: March 2014 <br />Page 1 of 3 <br />