Building & Permit Services NOISE VARIANCE APPLICATION <br />Please complete the following application checklist. Note that additional information maybe required after further <br />review in order to adequately address the applicable approval criteria. If you have any questions about completing <br />this application, please contact Planning staff at the Permit and Information Center, phone (541) 682-8336, 99 West <br />10th Avenue, Eugene. <br />List all Assessors' Map and Tax Lot numbers of the property included in the request. Please indicate if only a <br />portion of a lot is included in the request. <br />Assessor's Ma Tax Lot Zonin <br />17-03-32-00 00100 Public Land <br />Site address(es) Ofworksite: 1580 A ate St. Eugene, OR 97403 <br />Site address(es) of sound source (if different): <br />Dates and times sound will exceed code provisions: 9/23/19 - 12/31/19 from 7:OOPM to 12:OOAM <br />Noise V ie pingu: <br />X Consideration for a variance for sounds that otherwise do not comply with City requirements EC 6.755(2). <br />Filing Fee <br />X A filing fee must accompany all applications. Check with Planning staff at the Permit and Information Center to <br />determine the required fee or check the City website at 3u weug <br />Written Statement <br />Provide 1 copy of the time of submittal, <br />X Submit a detailed written statement describing the sound and sound source, dates and times of sound disturbance, <br />reason for seeking a noise variance and any other information that could be helpful for City evaluation. Applicable <br />code criteria is found under EC 6.755 <br />General SitPlan Reauirements <br />Provide 1 copy at the time ofinitial submittal. ton,submit one co <br />py of the set of site plans reduced to 8-112 x 11 "for <br />Public notice purposes. (All site plans must be [ 1 I 6 ll" ] 7') ess ~.I Show the Assessor's Map and Tax Lot numbers on the site plan. <br />X Show a vicinity map on the site plan (vicinity map does not need to he drawn to sea RECEIVED <br />SEP - 2019 <br />CITY OF EUGENE <br />WW <br /> <br />Planning & Development <br />99 W. LoTo Avenue, Eugene, OR 97401 Form qF-214 <br />P 541.682.5086 " F 541.685.5593 Updated: April 2014 <br />