Type Full Name :
Sign With Hand
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Organization Name
Certification
Required Attachments
Type of Occupancy
Name of Property
Number of Rooms & Offices Contained in Premises
City, State, ZIP
Name of Business
Phone #
City, State, ZIP
Full Name
Building Owner Details
Size of Space to be Occupied
The fee for this application is:
Occupancy Use Details
Nature of Present Use or if Vacant
# of Parking spaces for Employees
Applicant Details
Email
Application Fee
# of Parking spaces to be Designated on Site
Lot
Address 2
Signature
Number of Employees that will Occupy the Premises
Type of Business and Brief Description of Operations
Block
NOTE: UPON APPROVAL, APPLICANT MUST APPLY FOR OCCUPANCY & BUILDING PERMITS FROM THE BUILDING DEPT.
By signing below, I the owner certify that all of the information provided in this application is true and accurate.
Total # of Parking spaces on Site
# of Parking spaces for Visitors
Full Name
{[PNAME]}
Email
Phone #
Address
Total # of Occupants
State
Qualifier
Location of Property
ZIP
Please attach a copy of the letter of intent.

Please note: The letter must be signed BY THE OWNER/LANDLORD of the property and not the applicant.

Certificate of Insurance is required.

Applicant should not sign lease or letter until use permit is approved.
Date Applicant Intends to Occupy
City
Will Cooking be done on Premises?
# of Parking spaces Provided in Lease
Address
Business Details
Nature of Proposed Alterations Intended, if any, be specific: