100 N King St
HENDERSON COUNTY PERMITS & INSPECTIONS Hendersonville, NC 28792
UREQUEST TO REMOVE LICENSE FROM PERMIT
the __________________________Contractor on record for the work
associated with Permit #_______________________ for the property located at_______________________________
______________________________________________, Have ceased all work for the project at this location.
Upon this cancellation I understand that my NC state license will be removed from this permit.
_______________________________________________ of ________________________________________
(Contractor Signature) (Name of Business)
License # :________________ Date:______________