Fillable CertificateofOccupancy Certificate of Occupancy.pub

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CertificateofOccupancy Certificate of Occupancy.pub

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APPLICATION FOR A CERTIFICATE OF OCCUPANCY
INSPECTIONS AND
CODE
COLUMBUS, GEORGIA
Ap
plication is hereby made for a Certificate of Occupancy for the use of the building, structure or prem-
ises as identified and described herein. It is agreed that all the laws, ordinances and regulations enforced
by Inspections and Code Enforcement of Columbus, Georgia , shall be complied with in pursuit of grant-
ing of this Certificate whether or not specified herein.
FEE $ __
________________________
Date issued ______________________
Certificate of Occ. No. _____________
Reference Case No. _______________
MAP ______ BLK ______ LOT_____
_____
___________________________________________________
NAME
________________________________________________________________________
ADDRESS
________________________________________________________________________
CITY STATE
________________________________________________________________________
PHONE
_____
_____________________________________
LOCATION
_____________________________________________________________
ZONING
CLASSIFICATION_____________________________________________
To be used
for ______________________________________
___________________________________________________
___________________________________________________
Firm or
Business Name______________________________________
___________________________________________________
Last Occupancy
In Building _________________________________
Business
Name______________________________________
License Holder ______________________________
License Date
No. ______________________ Issued ________
Verified
By ________________________________________
License Dept.
Conforming Non-conforming
_____
______________________________________
Name
_______________________________ ___________________________________
DATE APPLICANT’S SIGNATURE
Application Denied Because
_______________________________________________________________________________
_______________________________________________________________________________________________________
Date ______________________________ Building Official ______________________________________________________
I ha
ve read and understand the regulations from the Zoning Ordinance that applies to operating a business from my home and
hereby certify that I will comply with those restrictions.
_______________________________ ______________________________________
DATE APPLICANT’S SIGNATURE
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Completed 12 July 2020

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