Form Center

2. LEGAL DISCLAIMER
   I hereby certify that I have read and examined all application submitted at this time. and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. It is my responsibility to review the approved plans and any comments that are contained thereon and see that the structure and or project is built in compliance with all applicable codes. By submitting this application I agree to these terms and conditions.
4. Applicant Name*
5. Primary Phone Number*
6. Secondary Phone Number*
8. Email*
9. Date Submitted
   Date Submitted

   Date Submitted
13. Address2
15. City
16. State
17. Zip
21. Address of location or parcel numbers*
22. Nearest Intersection*
24. Description of proposed development*
26. any additional information
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field