Change of Use & Occupancy Permit Aplication

We have recently made some changes to our Building applications & forms. This application can now be submitted online. You can also pay for the application in a few quick & easy steps. The two payment options are by check or credit card. Please note that for online credit card payments, a 2.80% processing fee will be added to the total review fee. Also, if paying by check, your application will not be processed until payment is received by our office.

Tenant:

Tenant Phone Number:

Tenant Email:

Property Owner Phone Number:

Property Owner Email:

Monitoring Agency Company Name:

Monitoring Agency Company Phone Number:

Monitoring Agency Company Email:

Type of Change:

New Building or Space

New Tenant with Use Change

New Tenant No Use Change

Prior Use of Premises:

Proposed Use of Premises:

Square Feet of Proposed Use:

Floor Level(s) of Proposed Use Location: (i.e. basement, 1st floor, etc.)

Proposed Number of Employees:

Proposed Number of Customers or Patrons:

Hours of Operation:

Do Cleaning, Maintenance, or Other Personnel Have After Hours Access to Building?

Yes

Number of Non-Accessible Off-Street Parking Stalls:

Number of Accessible Off-Street Parking Stalls:

Interior Emergency/Security Lights?

Yes

Exterior Emergency/Security Lights?

Yes

Fire Alarm?

Yes

Auto

Manual

Location of Fire Alarm Panel in Building:

Type of Heating System and Location of Equipment:

Location of Gas Shut Off:

Location of Electrical Distribution Panel:

Location of Building Main Electrical Disconnect:

Sprinklered?

Yes

If yes, Location of Sprinkler Main Shut-Off:

Hazardous Materials Present?

Yes

If yes, please list types of materials, quantities, and location of items below:

Firearms Present?

Yes

If yes, please list types of firearms, quantities, and location of items below:

Animals Present?

Yes

If yes, please list types of animals, quantities, and location of items below:

Knox Box Present?

Yes

If yes, a key to the business will need to be provided to the De Pere Fire Department to place in the Knox Box.

If no, a Knox Box will need to be purchased and installed and a key to the business will need to be provided to the De Pere Fire Department to place in the Knox Box.

Total Due:

Applicant Signature

First Name

Last Name

Choose how to sign

Draw Type

By continuing I agree that my electronic signature hereto creates a legally binding contract between the City of De Pere and myself, or the entity I am authorized to represent. I understand and acknowledge that I am authorized to complete this form and information about my user session may be stored.