HomeMy WebLinkAbout069-540-011MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
OROVILLE, CALIFORNIA — 534-4541
PERMIT NO.
Address or location of mobi lehome
Owner's name
Owner's address
Insignia or hud number
Manufacturer's name
Serial number of, V.I.N. Year of manufacture
(Offi ci a I Approving Installation) (Date)
IF THE AOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION
ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE
MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM.
L 513B White - Owner, Yellow - Installer, Pink - D.P.W.
TO: Building Department
FROM: Encroachment Permit Section
RE: Driveway Clearance
312 Z
owner lodation AP #
Driveway permi t Z2,3 has been iss'ued for the above property.
S ign,�p6ure
2 2 -
date