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Application for Permit

Permit Number
Type of Permit
Status
Desc.
Value
Area in Sq. Foot
Zone
Requester Details
Name of Contact
Address
City
State
ZIP
Phone
Email
Date applied (mm-dd-yyyy)
Date of Issue (mm-dd-yyyy)
Date of Expiry (mm-dd-yyyy)
Fee
Reference Item Type
Reference Item Number
Date (mm-dd-yyyy)
Fee Amount
Payment Method
Payment ID
Reversed Date (mm-dd-yyyy)
Reversed Amount
Description
Inspection Number
Attach Document (PDF, JPG, PNG, GIF, TIFF Only)


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