Skip to Main Content
Do Not Show Again
Information about OR22, Eugene Riverfront Festival, and transportation around town.
I Want To...
Select a Category
Canines for Clean Water
Equity and Human Rights
Eugene Sunday Streets
Family and Medical Leave
Fire and EMS Services
Parks and Open Space
PDD - BPS - Public Passenger Vehicles
PDD - Community Development
PDD - Recycling and Solid Waste
PDD Business and Economic Development
PDD Waste Prevention Sustainable Event Bins Reservation Form
Planning - Zoning and Land Use Forms
Planning - Zoning and Land Use Forms 3
Planning - Zoning and Land Use Forms 4
Planning- Zoning and Land Use Forms 2
Request Tracker Form
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Downtown Core Smoking Prohibition Opt-Out Request
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Please use this form to request smoking locations on public rights-of-way adjacent to private establishments located inside the downtown core.
*There are no fees associated with this request.
1. Requester Information
Name of Downtown Core Private Establishment
2. Requested Smoking Location
Please attach a map, photograph, or diagram showing the right-of-way area(s) adjacent to your private establishment where you are requesting that people be allowed to smoke.
3. Opt-Out Request
After 9:00 p.m.
4. Electronic Signature
I certify that I am an authorized representative of the above-referenced private establishment. I acknowledge that the City approving my request to allow smoking within the downtown core on adjacent rights-of-way does not alleviate my responsibility to comply with all other applicable local and state laws, including Eugene Code 6.225 – 6.240 and Administrative Order No. 21-18-07. I understand that, in addition to the penalties provided in City Code, any violation of the applicable regulations may result in the City revoking the permission granted me to allow smoking within the downtown core adjacent to the above-identified property. I agree to encourage patrons to use any cigarette disposal receptacle near the property provided by the City and I agree to work cooperatively with the City in placing the cigarette disposal receptacle in an optimum location for maximum usage.
Leave This Blank:
Receive an email copy of this form.
This field is not part of the form submission.
* indicates a required field
Meeting Materials and Webcasts
Mayor and City Council
Slideshow Left Arrow
Slideshow Right Arrow