2. Home Occupation Fee
   Home Occupation Fee
3. Price
4. Quantity
5. Shipping Cost
7. Taxable
9. Inspection acknowlegement

   Submitting this permit application to Perry Township establishes the property owner’s consent for and authorization of Township staff member(s), including, but not limited to, the Township Zoning Inspector or his/her designee, to enter upon the project property and inspect the property and structure(s) in order to determine whether to issue a Zoning Certificate of Compliance.

11. Applicant Name*
13. Business Name
14. Number of Employees
16. Address of Property*
18. City
19. State
20. Zip
22. Phone (999-999-9999)*
26. Mailing Address*
28. City
29. State
30. Zip
32. Work Phone (999-999-9999)
33. Email
37. Please complete if you are leasing the property of the proposed home occupation
39. Name of Property Owner if Other than Applicant
41. Owner Phone (999-999-9999)
42. Owner Email Address
44. Owner Mailing Address
46. Address2
48. City
49. State
50. Zip
52. Description of Occupation*
56. Zoning Department Use
    Permit Number _________________________
    
    Receipt # _________________________
    
    Approved By _________________________
    
    Date _________________________
    
    
58. 12/28/16
Leave This Blank:


59. Calculate Totals Proceed to Checkout

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