HomeMy WebLinkAbout069-240-012MOBILEHOME INSTALLATIONACCEPTANCE
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
OROViLLE, CALIFORNIA — 534-4541
5 -
PERMIT NO.
0 AL 0
11 Xddress or location of mobilehome 6C)? 7 q L /*
Owner's name
Owner's address
Insignia or hud number 9-3 Ll 92 V F
Tyaridfa6turer's name
Seri"al 6
rfiber, of V I N Year of manulacture
(Uttj.Cj'al�Appro
z, ving ln;talla!ion) (Date),
IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION
,�.,ACCEPTANCE SHALL BECOME INVALID'. THIS FORM . SHALL NOT BE USED WHEN -THE
M OBILE I HOME -IS I NSTALLEDON A FOU NDA TION
SYSTEM.
513Q� WhitL_ Owner, Yellow -'lrio
TO: Building De par tml,-�,Crt—ZY�.S-
FROM: Encroachment Permit Section
Rlt: Driveway Clearance
7 7
owner location AP
Driveway permit, has been isssmed� 7f� the above property.
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i . Aat�� -If'— -
-d
ignature.- date