Conditional Use Permit Form

All applications shall be submitted (Renewable Yearly) by the first of the month.

Applicant must be at Hearing

Name(Required)

First Last

Address(Required)

Street Address Address Line 2

Phone(Required)

Email(Required)

Description of variance requested(Required)

Attorney Involvement?

My attorney will be present at the hearing

My attorney will handle this matter at the hearing

Attorney Name(Required)

First Last

Attorney Address(Required)

Street Address Address Line 2 City State ZIP Code

Attorney Phone(Required)

Attorney Email(Required)

Permit Type(Required)

NEW INTERNET SWEEPSTAKE CONDITIONAL USE PERMIT ($1,500.00)

RENEWAL INTERNET SWEEPSTAKE CONDITIONAL USE PERMIT ($750.00)

NEW SHOOTING RANGE CONDITIONAL USE PERMIT ($500.00)

RENEWAL SHOOTING RANGE CONDITIONAL USE PERMIT ($250.00)

NEW TOWING AND STORAGE CONDITIONAL USE PERMIT ($500.00)

RENEWAL TOWING AND STORAGE CONDITIONAL USE PERMIT ($250.00)

Total

Payment Method(Required)

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name