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Home My WebLink About4. Application_Attach_Forms_1-4 Revised 04/17/2023 slm 13 of 16 FORM 2 OWNERSHIP WORKSHEET (This form is NOT the petition) (Please include the name and address of ALL owners regardless of whether they signed an annexation petition or not. OWNERS Property Designation (Map/lot number) Name of Owner Acres Assessed Value Imp. Y / N Signed Yes Signed No TOTALS: TOTAL NUMBER OF OWNERS IN THE PROPOSAL NUMBER OF OWNERS WHO SIGNED PERCENTAGE OF OWNERS WHO SIGNED TOTAL ACREAGE IN PROPOSAL ACREAGE SIGNED FOR PERCENTAGE OF ACREAGE SIGNED FOR TOTAL VALUE IN THE PROPOSAL VALUE CONSENTED FOR PERCENTAGE OF VALUE CONSENTED FOR Revised 04/17/2023 slm Page 14 of 16 FORM 3 SUPPLEMENTAL INFORMATION FORM (Complete all the following questions and provide all the requested information. Attach any responses that require additional space, restating the question or request for information on additional sheets.) Contact Person: E-mail: Supply the following information regarding the annexation area. • Estimated Population (at present): • Number of Existing Residential Units: • Other Uses: • Land Area: total acres • Existing Plan Designation(s): • Existing Zoning(s): • Existing Land Use(s): • Applicable Comprehensive Plan(s): • Applicable Refinement Plan(s): • Provide evidence that the annexation is consistent with the applicable comprehensive plan(s) and any associated refinement plans. • Are there development plans associated with this proposed annexation? Yes No If yes, describe. • Is the proposed use or development allowed on the property under the current plan designation and zoning? Yes No • Please describe where the proposed annexation is contiguous to the city limits (non-contiguous annexations cannot be approved under 5.7-140, Criteria). Revised 04/17/2023 slm Page 15 of 16 Does this application include all contiguous property under the same ownership? Yes No If no, state the reasons why all property is not included: • Check the special districts and others that provide service to the annexation area:  Glenwood Water District  Rainbow Water and Fire District  Eugene School District  Pleasant Hill School District  Springfield School District  McKenzie Fire & Rescue  Pleasant Hill RFPD  Willakenzie RFPD  EPUD  SUB  Willamalane Parks and Rec District  Other __________________ • Names of persons to whom staff notes and notices should be sent, in addition to applicant(s), such as an agent or legal representative. (Name) (Name) (Address) (Address) (City) (Zip) (City) (Zip) (Name) (Name) (Address) (Address) (City) (Zip) (City) (Zip)