City of Mildred, Texas Mobile Home/Mfg. Home Application for Permit Date of Application: ______________ Name of Applicant or Owner: _____________________________________________ Address:_____________________________________ Phone: __________________ Sub-Division/where to be located: ________________________________________ 911 Address: _________________________________ Lot No.: __________________ Block or Section: ________________________ Description Make: ______________________________ Year: ___________ Size: _____________ Cost: $__________________ When is home to be moved? ______________________ What type of foundation will home be set on? ________________________________ ________________________________________________________________________ How soon after home is installed will it be skirted or closed in? __________________ Does the building comply with the sub-division restrictions? ___Yes ___No (If not in sub-div. Omit)ATTACH:NOTICE: _____________________________ _____________________________ Signature Owner Signature of Applicant if made by Agent Application without complete information will not be approved. copy of legal description of lot & if in a sub-division a copy of the restrictions two (2) snapshots of the home. a drawing showing set backs (IN FEET) from sides, front & back. Application fee of $75.00 and a Administrative fee of $25.00 Fee Paid: $ _______ cash_______ check _________Money Order Approved _____Yes ___No _____________________________ Date: __________________ City Official/Title
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