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ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br /> <br />TYPE OF APPLICATION <br /> <br /> ~ BUILDING ~ AG EXEMPT BUILDING <br /> ~ DWELLING ~ BUILDING DEMOLITION <br /> <br /> ~ r DWELLING LABEL [ ~ BITE PLAN REVIEW <br /> [ I MANUFACTURED DWELLING [ ~ SiTE EVALUATION <br /> I ~ MANUFACTURED STORAGE ~ ~ BITE EVALUATION/SEPTIC <br /> I I PRE-FAB SEPTIC <br /> <br />ELECTRICAL <br />MINOR EL LABEL <br />PLUMBING <br /> <br />DRIVEWAY <br /> <br />P, ROJECTADDRESS: .,8t B:' YAm- H u/ <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 # ,5-~;ff~/o <br />FAX# <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 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 /> <br />FOR OIFRCE USE OBLY: <br />MAP PAGr~.~ <br />BUEDIVIS30~ <br /> <br />LOT# aLICICI' <br /> <br />REV 5115195 <br /> <br /> <br />