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PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br /> <br /> APPLICATION SUBMITTAL// EJ4 <br />TYPE~OF APPLICATION ~ i m m ~ ~'~ ~ <br /> <br /> ~ ~ BUILDING ~ J AG ~XEMPT BUILOING ~ ~ ELECTRIC <br /> <br /> ~ ~ DWELLING [ I BUILOING DEMOLITION [ ~ MINOR EL LABEL <br /> I I DWELLING LA I I SITE PLAN REVIEW L.. ~ PLUMBING ~ <br /> <br /> MANUFAcTUE~.DwEL~ING,/ I ,~ sITE EVALUATION ~ ~ MEcHANIcAL <br /> '~ '~ ma.uFActU~EO sTO~A~ [, '~ s~T~ ~vaLuAT~On/sEP~Ic: '~ [ DmvewaY <br /> <br /> PROJECT ADDRESS: /~'q'~'7.~ ~'"/¢~,~-," ~ /A~-''''~, <br /> <br />  ) I am performing the work on prope~y I own or occupy. <br /> ( I am a registered builder or the authorized representative of a registered builder, <br /> SFka~;of Ore,on Construction Contractor's Board Registration ~ O B~ <br /> , em the authorized representative of the prope,~ owner or contractor ql <br /> <br />~" ~ '~This application may 8o through a simaltaneous review process where zonin, , septic (if a~SleS'X ~ <br /> construction requirements are checked prior to issuance of a ~rmit. It is the responsibiliW of the <br /> to assure that all necessa~ intormation 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 ~nd ready to ~ picked <br /> <br /> FOE OFR~ USE <br /> $~S]O~ - L~l BLO~ <br /> <br />5116195 <br /> <br /> <br />