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ACTIVITY # <br /> <br />PLEASE fILL OUT THE FOLLOWING INFORMATION AND YOU WiLL BE DIRECTED TO THE NEXT <br /> <br />APPLICATION SUBMITTAL <br /> <br /> BUILDING · ~ AG EXEMPT BUILDING ~ ELECTRICAL <br />~ · DWELLING ~ EUILDING DEMOLITION L--J MINOR EL LABEL <br />~ DWELL}NG LA~EL SITE pLAN REVIEW [ ~., ~ PLUMEING <br />~ MANUFACTURED DWELLING ~ SITE EVALUATION ~ MECHANICAL <br /> <br />~ ~ MANUFACTURED STORAGE ~ SITE EVALUATION/SEPTIC ~ DRIVEWAY <br /> · PR~-FAB t ~ <br /> <br />NAME OF APPLICANT: ~'£Dy~/' ,~ ~//~7'~'~/)/'~ 5~,7T <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 Registration # <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 Construction Contractors Board, <br /> <br />This application may go throu§h 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~ave been met, you will be notified that your permit has been <br />issued and ready to be picked up.~/ <br />S I'GNATURIE OF APPLICANT://~~/~ ~'~"~ <br /> <br />REV 3/GI9S <br /> <br /> <br />