Type Full Name :

Sign With Hand

Address

City, State, ZIP *

Email *

{[PNAME]}

Begin typing address and press enter or the magnifying glass to select from the populated dropdown *

Name

Fee Schedule

Property Owner

Type *

Mailing Address *

Agent Details

Fax #

Phone #

Number of Working Smoke Detectors *

Certification

Phone # *

I hereby agree to operate the above described business in accordance with all the regulations and conditions imposed by the State of Delaware and the laws, ordinances, and regulations of the Town of Millsboro.
I further consent to inspection of the premises by the Town of Millsboro, its agents and employees, for the purpose of verifying information on my application.

Under penalty of perjury, I swear or affirm that the information contained herein is true and correct. I understand that any false statements could result in revocation or denial of permit. The undersigned has complied with all of the laws and ordinances of the Town of Millsboro and paid all taxes and assessments due to the Town on the above described property.

$65.00 - Single Family, Townhouse, Air BNB
$35.00 - Apartment (per unit)
$25.00 - Hotel/Motel (per room)

Name *

Property Type *

Property Management *

* Cash, Check or Money Order made payable to the Town of Millsboro must be either mailed or dropped off at Town Hall.

Number of Bedrooms *

Fee Due

Phone # *

{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}

City, State, ZIP

Number of Units *

Emergency Contact Person Is *

Please state if other:

Application Type *

Name *

Address *

Applicant Signature *

Number of Rooms

Emergency Contact