Town of Kippens


Permit No.: _____

Name of Applicant: ______________ Address: _______________

Telephone No.: _________________

Business Name: __________________________________________________________

Property Owner: ________________ Telephone No.: ___________

(If you do not own the dwelling, you must obtain a letter of permission from the property owner)

Application to operate a home based business occupation from a:

______ Single Detached ______ Duplex ______ Apartment ______ Other

Describe your Business: ____________________________________________________


Where will you perform your business or sell your product? ______________________________

What part of your dwelling will you use for your business? ______________________________

What equipment/material will you use for your business? ________________________________

Where will equipment/material be kept? _____________________________________________

Will you use your garage for your business? __________________________________________

How often will people be coming to your home for your business? Never ___________________

Number of visits per day ____

How many employees/people will be involved in your business? ____ Work on property? _____

How many off street parking places are available now? _________________________________

What type/size of vehicle may be involved in your business? _____________________________

What hours will your business be in operation? ________________________________________

I/We hereby make application under the provisions of the Town of Kippens Development Regulations to develop in accordance with the information submitted, which form a part of this application. I/We understand and acknowledge the conditions and limitations applying to the issuance of a development permit.

Signature: ________________________ Date: _____________________

2 Juniper Avenue, Kippens, NL, Canada A2N 3H8

T: 709-643-5281 * F: 709-643-9773 * E: *