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ACTIVITY # <br /> <br />P~LEASE' FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br /> <br /> APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br />L/~F~" BUiLDiNG~ L.~ AG EXEMPT BUILDING <br /> DWELLING L.~ BUILDING DEMOLITION <br /> <br />DWELLING LABEL ~ BiTI~ pLAN REVIEW <br />MANUFACTURED DWELLING ~ SiTE EVALUATION <br />MANUFACTURED STORAGE L.__J BITE EVALUATION/SEPTIC <br />PRE-FAB ~ SEPTIC <br /> <br />ELECTRICAL <br />MINOR EL LABEL <br />PLUMBING <br />MECHANICAL <br />DRIVEWAY <br />INFORMATION <br /> <br />NA.ME O~,F APPLICANT: <br />PROJECT ADDR~ESS;, <br /> <br />~'~ c~'~' PHi <br /> <br />WORK DESCRIP_TION <br />( ) <br /> <br />I am a registered builder or the authorized representative of a registered builder. <br />State of ©re,~on Construction Contractor's 8oard Registration # ~'~3 ! O ~ <br />FAX¢ <br /> <br />( ) J am the authorized representative of the property owner or contractor, <br /> <br />( ) I will be hiring a general contractor registered with the Construction 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 permiL It is the responsibility of the applicant <br />to assure that all necessary information has b~en provided. <br /> <br />As soon as all requirements of the review have been met you will be notified that your p~mJt.-has.-been .... <br />issued and ready to be picked up. ~ , ....... ..-. ~.~.. <br /> <br />SIGNATUR[ OF APPLICANT. ~-~.~.~,'C~c.~- - ~ ~ '-] ~ ~_ ) <br /> <br />REV 813195 <br /> <br /> <br />