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2. Client / Party
4. Primary Contact
6. First Name
7. Last Name
9. Address
11. City
12. State
13. Zip Code
15. Phone Number
16. Email Address
18. Additional Attendees:
20. Meeting Time, Date and Location
22. Date
23. Time:
25. Location
    -- Select One --LDS OfficeRoom 100Room 230Other
27. LDS Staff
    -- Select One --Jim Squires, ext. 291Amy Stonebreaker, ext. 293Steve Stallings, ext. 118Sam Bennett, ext. 200Chris Gay, ext. 132Pattie Talley, ext. 275
29. Note to Reception: If no answer, please contact the Permits Clerk at Extension 275.
31. Topic:

    1. Building Permit
    2. Grading Permit
    3. Occupancy Permit
    4. Mapping
    5. Rezoning

    1. Subdivision (Lot Creation)
    2. E911 Location Address
    3. Zoning Certification
    4. Board of Zoning Appeals
    5. Building Code

    1. Floodplain Management
    2. Document Requests
    3. General Assistance
    4. Code Enforcement
    5. Other
33. Additional Comments:
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

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