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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 ] ~ ELECTRICAL <br /> <br /> [ [ [ i r'---'[ <br /> i ] DWELLING [ ,, [ BUILDING DEMOLITION [ [ MINOR EL LABEL <br /> <br /> I ! DWELLING LABEL i s SITE PLAN REVIEW [ ! PLUMBING <br /> [r---~M [ [ [ <br /> ANUFACTURED DWELLING ' , J SITE EVALUATION [ I MECHANICAL <br /> <br /> ; ; MANUFACTURED STORAGE ~ ; SITE EVALUATION/SEPTIC ~ ~ DRIVEWAY <br /> t ; PRE-FAB ] ; SEPTIC ~ t INFORMATION <br /> <br />NAME OF APPLICANT: ~ ~l~LL~,,~rr.~ca-/~ ~J PH# 7'~,y-~ <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />( ) <br />( )v~ I am a registered builder or the authorized representative of a registered builder. <br /> State of Oregon Construction Contractor's Board Registration # ~-..~-,~ <br /> FAX#. <br />(~"" I am the authorized representative of the property owner or contractor. <br /> <br />I am performing the work on property I own or occupy. <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~!!t-/~plicant <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 no, fled that your permit has been <br />issued and ready to be picked up. ~ (~L"'~, C~ <br /> <br />SUBOI'~aSlON: --"--'-(~--: '- ~ LOT# _ BLOCK, I. n <br /> <br />REV 8/3/95 <br /> <br /> <br />