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ACTIVITY #. <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILAgLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION ' <br /> <br /> ~ ] I~U~LD{NG ~ AG EXEMPT BUILDING <br /> ~,.~ DWELLING L~J BUILDING DEMOLITION <br /> <br /> ~ t DWELLING LABEL ~ SITE PLAN REVIEW <br /> <br /> MANUFA~TURt~D DW!=LLI~G L__.J SITE EVALUAT(ON <br /> <br /> ~ MANUfACTUReD ~TORAGE ~ ~ITE EVALUATIONI~EPTIC <br /> <br />N~ME O~ APPLICANT: ~ -" <br /> <br />PROJECT ADDRESS: <br /> <br /> LECTR,OA <br /> <br />MINOR EL LABEL <br /> <br />MECHANICAL <br /> <br />DRIVEWAY <br /> <br />WORK DESC~RIPTION: <br /> <br />( ) I am performing the work on property I own or occupy, <br /> <br />( ) ( am a registered builder or the authorized representative of a registered builder, <br /> State of Oregon Construction Contractor's Board Registration # <br />(~(~ I am the authorized representative of the property owner or contractor, <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 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 ~2~ve been met, you will be notified that your permit has been <br /> <br />SIGNATURE OF APPLICANT: X~,/~'/ ~ ~ <br />FOR OFF1C~ USE ONLY: / <br /> <br />PAGE: ZOt~E: --. CI~OSS S'13~"t: T/~( ACC~-~': <br /> <br />REV 316195 <br /> <br /> <br />