CA -US-03 <br />�LD <br />AFFIDAVIT OF ELECTRONIC SUBMISSION OF NOTICE TO DLCD <br />I, Sc-%✓ , hereby certify that I am an employee of the <br />Ij <br />City of Eugene. I further certify that on � C'I /­?-D-Z-� , I electronically submitted <br />the notice of post -acknowledgment plan amendment indicated below, as well as the <br />documentation attached as Exhibit A, to the Department of Land Conservation and Development <br />(DLCD) using DLCD's "PAPA Online" electronic submission tool. <br />❑ New Proposal <br />- Revision <br />❑ Adoption <br />❑ Withdrawal/Denial <br />c' Dated this ` day of <br />�- <br />[Emffoyee Signature] <br />State of Oregon <br />ss. <br />County of Lane ) <br />Signed and affirmed before me on 011 A v �at S by <br />OFFICIAL ST <br />�.•:c SALINA i0 LDE-DICKENS <br />�: O• �C. 1040378 <br />MY COMMiSS+CN :X?'R:S SEPTEMBER 07, 2027 <br />;Sr <br />10--, <br />OFFICIAL STAMP <br />SAL!NA JOANN WILDE-PICKENS <br />NOTARY PUBLIC - OREGON <br />COM,MiSS ON NO. 1040378 <br />Y CY,yMISS:Cv :X?'RES SEPTEMBER 07, 2027 <br />Notary Public for Oregon <br />My Commission Expires: <br />