City of Leon Automobile Rebuilding Permit

City of Leon Automobile Rebuilding Permit

Application for authorization to rebuild an automobile within the City of Leon. Please complete all required sections.
Applicant Information
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Vehicle Information
Vehicle Year
Vehicle Make
Vehicle Model
Vehicle Identification Number (VIN)
License Plate Number
Current Title Status
Project Location

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Description of Rebuilding Work
Estimated Start Date

MonthDayYear
Date
Estimated Completion Date

MonthDayYear
Date
Estimated Value After Rebuilding (USD)
Zoning and Compliance
Will the rebuilding work be conducted in a:

Other
Will any hazardous materials be used or stored on site?
Will the project create significant noise or parking impacts?
Please describe any anticipated noise or parking impacts (if applicable):
Certification and Agreement
Applicant Signature

I understand that I must renew this permit by the expiration date. I understand that if in violation I can receive a citation. I have received a copy of the ordinance. I understand that this permit can be terminated at any time by the City without notice..
Date Signed

MonthDayYear
Date
City Approval (For Office Use Only)
Approved by City Clerk On:____________________________________________

__________________________________________________________________

Jodie Laidler, City Clerk
-1st (90) Day Permit Issued By:________________________ Fee Paid _____

Application Date:________________ Renewal Date:___________________

-2nd (90) Day Permit Issued By:________________________Fee Paid _____

Inspected By:_______________________________________________________

Renewal Date:____________________

Improvements Made: _________________________________________________

__________________________________________________________________

-3rd (90) Day Permit Issued By: _________________________ Fee Paid _____

Inspected By:_______________________________________________________

Renewal Date:_______________________

Improvements Made:_________________________________________________

__________________________________________________________________

-Final (90) Day Permit Issued By:________________________ Fee Paid_____
Should be Empty:

City of Leon Automobile Rebuilding Permit

Applicant Information

Vehicle Information

Zoning and Compliance

Certification and Agreement

City Approval (For Office Use Only)