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BAHE OF AFPLXCA~T: ~ <br /> <br />petlteatou to ~p~e~tatt~a o~ ~ttee ~ty to enter the a~e ~e9cttbed <br />pr~rCy at te~o~ble tt~S ~or the Furpooe of ~nitotln8 rioter water <br />~ll. ~e applicant ~derstands C~t vtnter rater checks are ~de during <br />~e ~t~ o[ Jae~ oF Febr~. a~d durtn8 a vtntet tn ~ich no~l <br />~ainfmll has ~cutted. <br /> <br /> ~leaee ratut~ Chis ·ppllcati~ tn ltarlou ~otmty Oept, of Buildin8 <br />lns~ctt~, Senator l~ldlng, no. 225, 220 Rish St. ~, Sat~, Or. 97~!, <br /> <br />SIG.~ATURE OF OI,'I. iER, IF OTHER ~ AI'PLIC~'~r <br /> <br /> <br />