M-8 - Draft of Urban Chicken Application

CITY OF TIFFIN URBAN CHICKEN PERMIT APPLICATION ATTACHMENT D (Cont.) FOR CITY USE ONLY Initial Permit Application Fee Paid $50: _____________ Renewal Permit Fee Paid $25: _____________ City Inspection Date: ____/___/_____ City Official: _______________________ Applicant Meets Requirements: Yes No Approval Date: ____/___/____ Denied ____/___/_____ Reasons For Denial: ______________________________________________ Permit Number: ______ Issue Date: ____/___/_____ Expiration Date: ____/___/_____ Issued By: _______________________