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APPLICATION FOR STREET TREE AGREEMENT E.C. 7.280 <br />MW <br />E U G E N E <br />POPI►S and <br />Open Space <br />Date <br />City Plant, Option A. Developer pays City to assume responsibility <br />for requirements under E.C. 7.280 related to this development <br />Developers Name E,' <br />Developer Plant, Option B. Developer contracts with City to meet <br />Mailing Address J1 b K <br />3 <br />requirements of E.C.7.280 related to this development <br />V 40C <br />Phone: (Home) <br />q'2 Clio I <br />(Work) <br />) ✓� /flips <br />Name of Representative <br />Name of Corporation <br />G Jj <br />Mailing Address ��� �7 v V&yLe i yd <br />Name of Partnership L <br />L <br />V /Z' C�Qr <br />Phone: <br />Name of Individual <br />!r f <br />Special Notes <br />Applicants signature <br />CITY USE ONLY <br />Date received <br />Fees paid: <br />Z $300 Application Fee + 0.01 /ft <br />Account # 131- 9650 -45790 <br />S $100 City Plant, Option A • <br />Account # 131 - 9650 -45790 <br />❑ $200 Developer Plant, Option B <br />Account # 131 - 9650 -45790 <br />Comments: <br />Authorizing Signature <br />Title Date Signed <br />Please note that this is an application form, not alpermit. <br />Questions regarding completion of this application form or the application review process may be directed to: <br />City of <br />January 2004 <br />Eugene, Office of Urban Forestry - Phone 682 4800 <br />1820 Roosevelt Blvd. Eugene, OR 97402 WHITF/PROPERTY OWNER <br />YELLOW /FILE <br />