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ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NI~ <br /> <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br /> APPLICATION SUBMITTAL <br /> 90-11-1'~ A'IU:16 OUT <br /> <br />TYPE OF APPLICATION <br /> O*'.' <br /> [] BUILDINO [] AG EXEMPT ~UILDtNG [] ELECTRICAL <br /> [] OWELUNG [] BUlLOING DEMOLITION [] MINOR EL LABEL <br /> [] DWELLING LABEL [] SITE PLAN REVIEW [] PLUMBING <br /> [] blANUFACTURED DWELLING [] SITE EVALUATION [] MECHANICAL <br /> [] MANUFACTURED STORAGE [] SITE EVALUATION/SEPTIC [] DRIVEWAY <br /> [] PRE-FAB [] SEPTIC {~ INFORMATION <br /> <br />NAME OF APPLICANT: <br /> <br />WORK DESCRIPTION: <br /> <br /> P.# <br /> <br />I am pe,e ing the <br /> <br />I am a r~te~ builder or ~e auto.ed represen~five of a register~ D~der. <br />State of Oregon Cons~on Con~o~s Boa~ Regis~fion ~ . ~ ~ , <br /> <br />lam <br /> <br />I will be hidng a general ~or r~istar~ w~ ~e Cons~on Con~cto~ B~rd. <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 permiL It is ~he responsibility of the applicant <br />to assure that all necessary infommtion 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 />I certify that I have read this application and state that the Information given Is correcL I agree to <br />comply with all state laws and county ordinances relating to building construction. I will authorize <br />a representative of Building Inspection to enter on the property for the purpose of making <br />Inspections for mis permiL <br /> <br />SIGNATURE OF APPLICANT: <br />FOROFFICEUSEOHI. Y: GEODISTRICT:R. OOOPLAIN SLIDE___ HISTORIC WE77_a~DS <br /> <br />MAP PAGE: ZONE: CJ~OSS STREET: <br /> <br /> LAND USE CASE.~ <br />TA,~ ACCr# <br /> <br /> <br />