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Specific Use Permit Application

  1. Specific Use Permit Application

  2. General Information

    • This application will not be scheduled for hearing until reviewed and deemed complete by the Public Works Director or designee.

    • Incomplete applications will not be reviewed.

    • The application fee is $325.00.
  3. Application Information

  4. Property Owner

  5. Authorized Representative

    (Notarized affidavit required including signature of legal owner(s))

  6. (Use attachment, if necessary)

  7. (Use attachment, if necessary)

  8. I hereby certify that I am the owner or duly authorized agent of the owner for the purposes of this application. I further certify that I have read and examined this application and know the same to be true and correct. If any of the information provided on this application is incorrect, the permit or approval may be revoked.

  9. Office use only

  10. Affidavit Attached?


  11. Affidavit attached?:


  12. Leave This Blank:

  13. This field is not part of the form submission.