City of Jeffersontown – Zoning Confirmation Application 20150301 Page 1 1of 1
City of Jeffersontown
Department of Permitting and Enforcement
10416 Watterson Trail
Jeffersontown, KY 40299
Phone: (502) 267-8333 Fax: (502) 267-
jeffersontownky.gov
FOR OFFICE
USE ONLY
Date:
________________
Zoning Confirmation Application
This is a Zoning Confirmation Application for the following (check one):
Motor Vehicle Dealer
Mobile Home Sales
Salon
Commercial Daycare
ABC License
Tattoo/Body Piercing Facility
Other:____________________________________
Name of Buisness: _______________________________________________________________________
Primary Address: ________________________________________________________________________
Primary Tax Block & Lot Number:__________________________________________________________
Contact Information
(Business Owner, Applicant, or Authorized Representative)
Name: ________________________________________________________________________________
Company (if applicable): __________________________________________________________________
Address: _______________________________________________________________________________
City: ________________________________ State: ________________________ Zip: ________________
Phone: __________________________________ Alternate Phone:________________________________
Email: ________________________________________________________________________________
Signature (required):____________________________________________________________________
