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E First Name M.I. Business Name Business phone E-mail address Address City State P.E. R.A. D.O.B. ID No. : Zip License No. 2 Property Details Borough Block Lot House No. Street Name 3 Issue Impacting Issuance of Certificate of Occupancy: 4 List Attached Documents a. b. c. d. 5 Comments: 6 Applicants Signature Date If needed, please attached separate sheet(s) to provide additional information Internal Use Project Advocate: Case ID # : Date : Comments: Reviewed and.

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  • Applicants
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