Natrona County Development Department
200 North Center, Room 205
Casper, WY 82601
307 235-9435 Fax 307 235-9436
CONTRACTOR’S LICENSE APPLICATION
GENERAL CONTRACTOR
FOR BUILDING DEPARTMENT USE ONLY
APPROVED NOT APPROVED
Building Official: _____________________________
Type of Ownership
Sole Proprietor Limited Liability
Partnership Corporation
Class I
Class II
Class III
Demolition
Subcontractor/Trades
Electrical
Wyoming State License #
Plumbing
Mechanical
Other (specify):
tower erector, roofing, utility, etc.
Licenses are not prorated and will expire
at the end of each calendar year
PLEASE PRINT LEGIBLY
Trade Name
License Issued To:
Business Address:
Mailing Address:
Phone No: Fax No:
Authorized person(s) to pull permits:
OTHER LICENSES AND TRADE CERTIFICATIONS
City/State Licenses and No.
Must retain copies in file
General Liability Insurance Policy No
Policy Period: to
(Must have copy of Certificate of Liability Insurance in file)
Certificate Holder:
Natrona County Development
200 North Center Street, Room 205
Casper, WY 82601 FAX 307 235-9436
I declare under penalty of perjury that this application has been examined by me and the statements made herein are
made in good faith, pursuant to Natrona County laws and regulations and to the best of my knowledge and belief are true,
correct and complete.
SIGNATURE: ____________________________________________________ DATE: ______________________
