Notes: Include any access instructions.
I hereby certify that I am authorized to make this request on behalf of the permit applicant. I certify that all information is true and complete to the best of my knowledge. I understand that this form is used only to request an inspection, and does not mean that an inspection has actually been scheduled. I understand that if I do not receive a confirmation it is my responsibility to follow up and confirm that an inspection has been scheduled.
I have read, understood, and agree with the above statement.