Aftk RECEIVED <br />• - -Planning ZONE VERIFICATION <br />a APR 2 4 2026 <br />Please complete the following form and provide th ir�f r�1 ation. I you have questions about filling out this <br />p g p �I'�1q �� UGEONE Y q g <br />application, please contact staff at the Permit and l:f9fR)q o , e r, 99 W St 10th Avenue, Eugene, OR 97401, phone <br />(541) 682-5377. <br />Location of Property: <br />Assessor's Map/Tax L, <br />Zoning of Property: --\I- - <br />Proposed Use of Property, if applicable: 1-N U 9- i V\ <br />Filing Fee <br />There is no initial filing fee. The fee for a Zone Verification varies depending on staff time to process the request and <br />will be charged once the request is complete. Check with Planning staff at planning@eugene-or.gov for an estimate of <br />the fee or for the current hourly fee check: www.eugene-or.gov/2040/Fees-and-Forms <br />Written Statement <br />Submit one paper copy and one digital copy (pdf or tiff format) of a written statement describing why the zone <br />verification is being requested. If applicable, include information describing the proposed use including operating <br />characteristics, building bulk and size, parking demand, and traffic generation per EC 9.1080. Please note that it is the <br />applicant's responsibility to make sure that the digital and paper copies are identical. <br />Note: to request a copy of a certificate of occupancy or building permit information, please complete a Request for <br />Reproduction of Copyrighted Materials form available here: https://www.eugene-or.gov/DocumentCenter/­ <br />View/25033/Reg uest-fo r-Re prod uctio n-of-Co Pyrighted- Mate ria Is, and email it to inspectionsupport@eugene-or.gov. <br />Contact Information <br />Name (print): A a XMV,\ �= eo� \S <br />Company/Organization: t�\ It� - 4jkr��'cgci 4 ' �r <br />v lr'�/�c' <br />Address: Sap, IZNQ. <br />City/State/Zip: & 0 q L - <br />Email (if applicable): Ad� \�. <br />Phone: <br />Fax: <br />I understand that staff time will be charged in 30 minute increments according to staff costs required to perform the <br />work. Please contact me if the fee reaches $ - UU <br />Signature: <br />Date: Z� /:��q 112�a <br />www. eupene-or. aov/planninp <br />Planning & Development Updated: January 2025 <br />Planning Division <br />99 W. 10T" Avenue Suite 290, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail: planning@eueene-or.eov Page 1 of 1 <br />