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(Where the work is being performed)
(Date the work begins)
Attach a plan or sketch depicting exact location, dimensions, type of installations, and details. Issuance of the permit will be considered following a review by the Director of Public Works.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. I hereby agree to all terms, conditions and restrictions so far as they apply to work to be done under the permit as issued. (Refer back to information portion of this form).
(This fee is usually $25 or $50)
This field is not part of the form submission.
* indicates a required field