J��It MCKEWMD <br />,► Planning JUN 08 2026 DDLE HOUSING LAND DIVISION, TENTATIVE PLAN <br />City of Eugene Planning Division <br />Please complete the following application checklist. Note that additional information may be required upon <br />further review in order to adequately address the applicable criteria for approval. If you have any questions <br />about filling out this application, please contact Planning staff at the Permit and Information Center, phone <br />(541) 682-5377, 99 West 10th Avenue Suite 290, Eugene, OR 97401. <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 <br />Tax Lot, <br />Zoning <br />Lot Area (square feet/acres) <br />17-04-16-34 <br />09800 <br />R 1 <br />15,745 <br />Name of Middle Housing Land Division: <br />Existing Use on Property: Residential <br />Jaffarian Land Division <br />Middle Housing Type (check one): ■❑ Duplex ❑ Triplex ❑ Fourplex ❑ Cottage Cluster ❑ Townhouses <br />Middle Housing Status: ❑ Developed (Existing): ❑ before OR ❑ after June 30, 2022 <br />Proposed (new): <br />❑■ To be developed later <br />❑ Permit Review/Issued - Permit No(s): <br />Does the project include Middle Housing Conversion (see definition at EC 9.0500)? ❑ Yes ❑■ No <br />Is site included on acknowledged Statewide Goal 5 Inventory? ❑ Yes ❑ No 0 Uncertain <br />Is this application running concurrently with another Land Use Application? <br />❑■ No ❑ Yes, type: <br />Adjustment Requested? ❑■ No ❑ Yes, section number(s): <br />Filing Fee <br />❑■ A filing fee must accompany all applications. The fee varies depending upon the type of application and is <br />adjusted periodically by the City Manager. Check with Planning staff at the Permit and Information <br />Center to determine the required fee or check website at: www.eugeneplanning.org <br />Application Procedures <br />I would like to follow the application procedures listed in EC 9.7900 - 9.7925; or <br />❑ I would like to follow the applications procedures listed under the Expedited Land Division procedures <br />listed in ORS 197.365, as amended by Enrolled House Bill 2138 (see next page for summary of <br />differences). <br />www. eugene-or. goy/planning <br />Planning & Development Updated: October 2025 <br />Planning Division <br />99 W. 1011 Avenue Suite 290, Eugene, OR 97401 <br />CA I C47 C?-7-7 C --N. <br />