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Application for Residential Occupancy Permit (NOT FOR INSPECTIONS)

Steps

1. Step One This section is complete This section is incomplete
2. Occupant/Tenant Information This section is complete This section is incomplete
3. Signature This section is complete This section is incomplete

Step One

IT IS UNLAWFUL TO OCCUPY THE PREMISES BEFORE A PERMIT IS ISSUED.
Complete all requested information. List the names of all those who will occupy this residence and the relationships to the owner or principal leaseholder. City of Byrnes Mill Ordinance does not allow more than three (3) unrelated individuals to live in the same residence (Section 400.690). Any missing or incomplete information may delay issuance of the occupancy permit.
Applicant's First Name*
Applicant's Last Name*
Property Address*
Address 2
City*
State*
Zip*
Phone*
Email*
Is this a rental property?*
1. Yes
2. No
# of Bedrooms*
Byrnes Mill Occupancy Limit:
One (1) occupant per 200 sq ft living space
Property Owner
(only if different from applicant)
Property Owner Address
(only if different from applicant)
Owner/Leaseholder's Place of Employment*
Position*
Work Phone*
Continue

Occupant/Tenant Information

Owner/Principal Leaseholder*
Relationship*
2nd Tenant/Occupant
Relationship
3rd Tenant/Occupant
Relationship
4th Tenant/Occupant
Relationship
5th Tenant/Occupant
Relationship
6th Tenant/Occupant
Relationship
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Signature

THIS IS NOT A PERMIT. DO NOT OCCUPY THE PREMISES UNTIL A PERMIT IS ISSUED.
I hereby certify that the information contained in this application is correct,the premises will be used strictly for dwelling purposes only, and that I will conform to all applicable laws of the City of Byrnes Mill.
Copy of Driver's License
If you are unable to scan and upload a copy of your driver's license, please submit a copy to Byrnes Mill City Hall upon completion of this form.
Principal Leaseholder/Property Owner Signature*
By typing your name, you acknowledge understanding and completion of this form.
Date*
Date
Occupancy Permit Fee
The occupancy permit fee is $25.00 which can be paid online or in-person at City Hall. If paying online, you will be directed to the online payment portal immediately after submission.

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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