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MORGAN COUNTY PLANNING AND DEVELOPMENT Post Office Box 1357 150 East Washington Street, Suite 200 Madison, Georgia 30650 (706) 342-4373 Office (706) 343-6455 Fax Manufactured Home Permit Application (ALL APPLICATIONS HAVE TO BE FILLED OUT COMPLETELY IN ORDER TO BE PROCESSED) Property Owners Information Property Owner’s Name: Cell phone#: Address: Home phone#: City: State: Zip Code: Email Address: Property Location Property Address: City: State: Zip Code: Nearest Intersection or Address: Jurisdiction: Installation Contractor Information Contractor’s Name: Cell phone Contractor’s Address: Office Fax City: State: Zip Code: Email: Occupational Tax Issuing County: Level 1A Certification#: State Certification Expiration date: House Information Exterior Siding: Foundation Material: Roofing Material: Heat/Air: Number of Bedrooms: Bathrooms: Water Supply: Well Public Water Sewage: Septic Permit Sewer Power Company: Total Cost (including setup): Make/Model: Serial Number: Number of Sections: Square Footage: Year: Moving from: Dealer: New Used All information is true and accurate to the best of my knowledge. Applicant Date