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Applications WIII Be Processm,l When Submitted Properly Completed. Be Sure .Sign The AddIl atlon.'5v` <br /> OFFICE USE ONLY r I <br /> i �� <br /> For Calendar Year� Area <br /> Multiple Years (Permanent Housing Camps) APPLICATION <br /> Conditional Permit Date Approved <br /> I.D. No. > -' -- �'. ' (For Non-Transferable, Revocable, Suspendable) Permit <br /> ENVIRONMENTAL HEALTH PERMIT <br /> Date Mailed <br /> TO OPERATE <br /> EMPLOYEE HOUSING OR LABOR CAMP New_ Existing <br /> c <br /> I FEE IS DUE WITH APPLICATION Change c x07 / ���• <br /> Location -L Cv cf - M t4 , Ct +m Q <br /> Operator <br /> Address yf ' 1 Telephone <br /> Legal Owner New Owner Yes No <br /> Address 36,'l 7 MT, U,AiL RhipTelephone No. 47/(77 .)f33 -�1.111u <br /> No. Employees Housed - 5Occupancy Dates From akar. To I kc- Crop ri <br />