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ACTIVITY # <br /> <br />Pi'EASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO TIlE NEXT <br />AVAILABI-E BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br /> TyPE OF APPLICATION <br /> qs ts 4 <br />._.- BUILDING ~ i . i AG EXEMPT BUILDING <br /> <br /> ~ I DWELLING ~ i BUILDING DEMOLITION <br /> i I MANUFACTURED DWELLING ~ SITE EVALUATION <br /> <br />ELECTRI <br /> <br />PLUMBING [ <br />MECHANICA <br />DRIVEWAY ~ ...... <br />INFORMATION <br /> <br />PROJECT ADDRESS: <br /> <br />W_ ORK DESCRIPTION: <br /> <br /> .... ', <br /> <br />State of OreBo. Construction Contra~or s Board Registration ~ . <br /> <br /> cL6 Lc <br /> <br />~ will be hirin8 a ~eneral contractor registered wi~h the ~onstrucfion 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 necessan/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:~.~Z:f ~'~ ~ <br /> <br />FOR OFFICE ~ ONLY: <br />SU~DIVISIOfl: '~ LOT~ EII.OCK,~ <br /> <br /> <br />