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2. Applicant Name
4. Address
6. City
7. State
8. Zip Code
10. Zoning
11. Phone Number
13. Type of Request

    Please check all that apply.

    1. Building Permit
    2. Business License
    3. Plat Approval
    4. Other
14. If other please explain
16. Type of Business

    Please check all that apply.

    1. Retail
    2. Wholesale
    3. Service
    4. Restaurant
    5. Other
17. If other please explain
19. If this request is for a business license - do you plan to have a sign for your business? If yes, please complete a sign permit application as well.

    1. Yes
    2. No
21. Written Explanation of Request
23. Signature
24. Date
    Date
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25. Print Only

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