Planning Building & Development 215 Church Ave., SW, Room 170 Roanoke, VA 24011 Phone: (540) 853-1090 www.roanokeva.gov permitcenter@roanokeva.gov DateBusiness License Zoning Verification Permit # Business Address Tax Map # Applicant Name (if different) Owner Contractor AgentRelationship to Property Owner Applicant Address City State Zip Code Phone # Cell # Email Address Initial Here I understand that all applications for permits, along with all additional required information, must be provided to the Permit Center prior to processing of this application. All information submitted will be reviewed prior to issuance of a permit. Should information be missing or additional information be required, the review process may be delayed. I also understand that I am required to conform to all applicable requirements of the Virginia Uniform statewide Building Code, the Zoning Ordinance for the City of Roanoke and all other applicable laws and ordinances. Design Professional Detailed Description of business activitiesOct 2016 Business/Trade Name Business Owner Business Owner Address Cell # Phone # Zip Code State City Email Address American LegalNet, Inc. www.FormsWorkFlow.com