Planning & Community Development Department

Duchesne County
Removal of Old Mobile Homes

APPLICATION

Name of Applicant: _________________________________		Phone # ________________________________
Mailing Address: __________________________________________________________________
Location of Trailer: (Physical Address)_____________________________________________________________
Section___________	Township________	Range_________	U.S.B.&M.
Detailed description of trailer: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

 

SIGNATURE OF APPLICANT:	__________________________________
DATE:	__________________________________

Please provide the following for a complete application:
_____	Proof of ownership (title of trailer or property tax notice if attached to property)
_____	Waiver Form
_____	Detailed site location map
_____	Photo(s) of trailer

 ______________________________________________________________________