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Business Occupancy Application

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THE TOWN OF CENTREVILLE 101 LAWYERS ROW CENTREVILLE, MD 21617

410-758-1180 FAX 410-758-4741 WWW.TOWNOFCENTREVILLE.ORG

BUSINESS OCCUPANCY APPLICATION

Applicant must complete ALL of the following information (please print clearly). Please be advised that an incomplete application may result in the denial of an occupancy permit. NOTE: $50.00 application fee is due at time of application.

Applicant/Business Owner: Home Phone:

Mailing Address: Business Phone:

Cell Phone:

Email address:

Location of Business/Organization:

Street Address City State Zip Property Owner (if different from applicant, must attach letter of permission for use):

Property Owner Address:

Street Address City State Zip Name of Business/Organization/Trade Name/DBA:

Proposed Use:

Previous Use:

Alterations/renovations proposed to the building Floor plans must be submitted with application.

Materials/Equipment to be Uued:

Will deliveries be made to the business?  Yes  No Frequency:

Will business involve the use of hazardous materials?  Yes  No If yes, attach copy of MDE Permit.

Emergency contact person & phone number:

Applicant’s Signature:

**ANY SIGN REQUIRES A SIGN PERMIT**

**ANY ALTERATIONS OR RENOVATIONS REQUIRE A BUILDING PERMIT**

Rev. 03-2025

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