By signing below I am stating that I understand and agree to the statements.
1) Proposed application is authorized by the owner of record and I have been authorized by the owner to make this application as his/her authorized agent and we agree to conform to all applicable laws of this jurisdiction. 2) All information listed on this application is true and accurate, to the best of my knowledge and any misrepresentation may result in the denial or revocation of this permit. 3) I hereby agree to provide new information in the event any changes are made.
* Indicates a required field
Please attach a photo of your business/office/vehicle where work will take place. Along with any other documentation.