Specific Use Permit Application
(Notarized affidavit required including signature of legal owner(s))
(Use attachment, if necessary)
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.
This field is not part of the form submission.
* indicates a required field