Business Occupancy Application Form
Document Date unknown · 1 page(s) in the original
This is the document's text, extracted automatically. Headings and paragraphs are inferred from the original's layout, so the arrangement may differ from the published version — the words do not. Where it matters legally, the original governs.
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 or type). Please be advised that an incomplete application may result in the denial of an occupancy permit.
NOTE: $25.00 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):
Property Owner Address:
Street Address City State Zip Name of Business/Organization/Trade Name/DBA: ______
Alterations/renovations proposed to the building:
Materials/Equipment to be used:
Will deliveries be made to the business? (cid:1) Yes (cid:1) No Frequency:
Will business involve the use of hazardous materials? (cid:1) Yes (cid:1) No If yes, attach copy of MDE Permit.
Emergency contact person & phone number:
Applicant’s Signature:
**ANY SIGN REQUIRES A PERMIT**
**ANY ALTERATIONS / RENOVATIONS REQUIRE A PERMIT**
Signature – Zoning Administrator Date W:\0-PERMITS\APPLICATION Permit Forms\2015-Oct applications forms\Business Occupancy Application.doc Rev. 8/28/2015