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~ -- ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL: BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN, <br /> <br /> APPLiCation SUBMITTAL / <br /> <br />TYPE OF APPLICATIO. N_ <br /> I AG EXEMPT BUILOINn ~..-- ELECTRICAL <br /> <br /> ~ BUILDING DEMOLITION I ~ MINOR EL LABEL <br /> <br /> . ~ I ~ANUFA~US~D ~WELLI~ g SITE EVALUATION ~ J ~EaHANI~AL <br /> <br /> I J ~A~UFAOTU~E~ ~TO~A~E ~ ~ ~FE EVALUATJO~I~EPTI~ ~ ~ D~IVEWAY <br /> ~ r PRE-FAB ~ r SEPTIC <br /> <br />NAME OF A~PPUCANT: <br /> <br />PROJECT ADDRESS: <br /> <br /> · WORK DE$CRI.PTIDN: /~ 3~,~ ~ - <br /> <br />' (')0 I am performing the wore on property I own or occuoy. LJ <br /> <br />I am a registered builder or the authorized representative of a registered builder. <br />State of Oregon Construction Contractor's Board Registration # <br />FAX# <br /> <br />I am the authorized representative of the property owner or contractor. <br /> <br />I will be hiring a general contractor registered with the C0n'struction Contractors Board. <br /> <br />This application may go through a simultaneous review process' where .zoning', septic (if applicable) and <br />construction requirements are checked prior to issuance of a permit. It is the responsibility of the applicant <br />to assure that all necessary information has been provided. <br /> <br />As soon as all requirements of the review.have been me[, you will be notified that your permit has been <br />issued and ready to be picked up. <br /> <br />SIGNATURE OF APPLICANT: ~ <br /> <br />SEBflfVISIOB: L~'# BLOCK/ <br /> <br />REV 5tI~95 <br /> <br /> <br />