Planning & Development <br />Planning Division <br />99 W. 10 <br />TH Avenue Suite 290, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail:planning@eugene-or.gov <br />Updated: May 2024 <br />Page 1 of 4 <br />Please complete the following application checklist. Note that additional information may be required upon further <br />review inorder to adequately address the applicable criteria for approval. If youhave any questions about filling out this <br />application, please contact Planning staff at the Permit and Information Center, phone (541)682-5377, 99 West 10th <br />Avenue, Eugene. <br />List all Assessor’s Map and Tax Lot numbers of the property included inthe request. <br />Assessor’s Map Tax Lot Zoning Acreage <br />Property Address:____________________________________________________________________________________ <br />Plans for FutureDevelopment & PermitNumber(if applicable): _______________________________________________ <br />Public Service Districts: <br />Name <br />Parks: <br />Electric: <br />Water: <br />SanitarySewer: <br />Fire: <br />Schools:Elementary:Middle:High: <br />Other: <br />Filing Fee <br />A filing fee must accompany all applications. The fee varies depending upon the type of application and is adjusted <br />periodically by the City Manager. Check with Planning staff at the Permit and Information Center to determine the <br />required fee or check website at www.eugeneplanning.org <br />WrittenStatement (Submit 5 copies) <br />Submit a detailed written statement describing how this request is consistent with all applicable criteria(Section 9.7825 of <br />the Eugene Code). <br />ANNEXATION <br />58/ <br />7/YDFDQW7/&REXUJ5G <br />(:(% <br />(:(% <br />:LOODNHQ]LH5XUDO)LUH3URWHFWLRQ'LVWULFW <br />*LOKDP &DO<RXQJ <br />6KHOGRQ <br />$UPLWDJH&UHVFHQW*LOKDP <br />([LVWLQJSXEOLFZDVWHZDWHUOLQHVLQ&REXUJ5G <br />$*8/