Planning & Development <br />Planning Division <br />99 W. 10TH 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 in order to adequately address the applicable criteria for approval. If you have 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 in the request. <br />Assessor’s Map Tax Lot Zoning Acreage <br />Property Address: ____________________________________________________________________________________ <br />Plans for Future Development & Permit Number (if applicable): _______________________________________________ <br />Public Service Districts: <br />Name <br />Parks: <br />Electric: <br />Water: <br />Sanitary Sewer: <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 />Written Statement (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