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ACTIVITY # <br /> <br />PLEASE FILL OUT THEtFOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. ~'~ <br /> <br /> APPLICATION SUBMITTAL <br /> <br />TYPE OF AFPL,OA,,O. C' g /ot 3 <br /> <br /> BUILDING ~ AG EXEMPT [~UILDING · * ELECTRICAL <br /> DWELLING ~ RUILDING DEMOLITION I I MINOR EL LABEL <br /> <br /> DWELLING LABEL L~ ~ITE PLAN REVIEW ~ PLUMBING <br /> MANUFACTURED DWELLING ~ SITE EVALUATION I ~ MECHANICAL <br /> MANUFACTURED ~TORAGE ~ SiTE EVALUATION/~EPTIC ~ DRIVEWAY <br /> PRE-FAB L~J SEPTIC <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br /> I am performing the work on property I own or occupy, <br /> <br />( ) I am a registered builder or the authorized representative of a registered builder, <br /> State of Oregon Construction Contractor's Board Re§istration # <br /> <br />( ) I am the authorized representative of the property owner. <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 met, you will be notified that your permit has been <br />issued and ready to be picked up, <br /> <br />SIGNATURE OF APPLICANT: --' <br />REV 211195 <br /> <br /> <br />