Fillable 119 APPLICATION FOR OCCUPANCY (Libertyville)

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119 APPLICATION FOR OCCUPANCY (Libertyville)

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The 119 APPLICATION FOR OCCUPANCY (Libertyville) form is 1 page long and contains:

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  • 7 check-boxes
  • 29 other fields

Country of origin: US
File type: PDF

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The Village of Libertyville reserves the right to request any additional information necessary for the review process
APPLICATION FOR OCCUPANCY
VILLAGE OF LIBERTYVILLE
Community Development Department
Phone: (847) 918-2020 200 E. Cook Avenue, Libertyville, IL 60048 Email: building@libertyville.com
www.libertyville.com/building Fax: (847) 918-9439
Location Address
Business Name
Would you like to be contacted via email? Yes No
Provide email address below for more efficient communication.
Name
Street Address, City, State, Zip
Contact Numbers
Property Owner
Phone
Fax
Email
Applicant
Phone
Fax
Email
Business Information
Contact Name & Position
Contact Numbers
Phone
Fax
Email
Intended Use
(Business Description)
Square Footage to be Occupied
Number of Employees
Days/Hours of Operation
Number of Parking Spaces
Would You Like to be Listed on the Village Business Directory?
□ Yes □ No
Business Website
Owner's Representative Legal Statement
All information provided herein is true and correct and all provisions of the
ordinances of the Village of Libertyville shall be complied with. I hereby
certify that the proposed use is authorized by the owner of record and that I
have been authorized by the owner to submit this application as his/her
agent.
This Box For Office Use Only
Print Name of Applicant
Property Owner
Occupant
General Contractor
Signature of Applicant
Date
FOR OFFICE USE ONLY:
S:\Building\mac\Forms Procedures & Labels\Application for
Occupancy 2020 Fillable
Existing Use Group
vs. New Use Group
Zoning Approval
Approval Date
Building Approval
Approval Date
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signature
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119 APPLICATION FOR OCCUPANCY (Libertyville)

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Completed 12 July 2021

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