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City / Township Approval Form

  1. County Logo

  2. City / Township Approval for Facility Applications

  3. ** All applicants are required to obtain local land use authority i.e. City or County completion of this section of the license application.

  4. Is a Conditional Use Permit (CUP) or other special zoning or land use regulation or permit required to operate this facility?

  5. If YES, is the subject location/facility currently in good standing and compliant with all applicable zoning and land use permit requirements?

  6. **Attach detailed compliance documentation and land use permit/zoning data as necessary.

  7. **Identification of non-compliant zoning or land use permit conditions may be cause for Conditional License status or license denial.

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