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PL,ASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BEDIRECT,D TO THE N,X1- <br />A ¥ A,L^g£, C ODE TEC.N,C,A . RECE E , <br /> <br /> APPLICATION SUBMITTAL ,iLl!,. O ;; I795 <br /> ~ARIOH CO L~NT",t' <br />TYPE OF APPLICATION ~_t~UILDI~G I~S~TIGN <br /> ~ ~ BUILDING ~ AG EXEMPT BUILDING L ~ ELECTRICAL <br /> <br /> ~ DWELLING ~ ~ BUILDING DEMOLITION I , J MINOR EL LABEL <br /> <br /> ~ ~ DWELLING ~BEL ~ , I SITE PLAN REVIEW t , ,,I PLUMBING <br /> ~ ~ MANUFACTURED DWELLING ~ SITE EVALUATIQN ~ ~ MECHANICAL <br /> <br /> MANUFACTURED STORAGE L. SITE EVALUATION/SEPTIC I ~ DRIVEWAY <br /> <br /> I I PRE-~A~ ~ ~ SEPTIC <br /> <br />NAME OF APPLICANT: ~.~/,/~//~-S' ~.~/~/v~¢~p~--~ PH# ~ --~? <br /> <br />PROJECT ADDRES~27''/-~. ~7, ~,¢~/~. ,~7~....~,7--/~/~,-~/ /_~.~ c~_-;~.__ <br /> <br />WORK DESCRIPTION: ~ ~ ~ ,~c~. ~/~-/~-~'./~/'D,,~.~ <br /> w,NS <br /> p O 'gthe o Konprope~lownoroccupy. <br /> <br /> I am a registered builder or the authorized representative of a registered builder, <br /> State of Oregon Constru~ion Contractor% Board Registration <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 />FOa Ot~Tr~ USE OILY: ~" <br />MaP PAGE__ ZONE __ Ir~TOSS 5'11~: T~X A[;~'T ~. <br /> <br />BLOC[/ <br /> <br />REV $11 GI95 <br /> <br /> <br />