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BROWN COUNTY AREA PLAN COMMISSION P.O. BOX 401, NASHVILLE IN Phone: (812) 988-5490 APPLICATION FOR A HOME OCCUPATION PERMIT PLEASE RETURN THIS FORM WITH A CHECK OR MONEY ORDER FOR $15.00 TO: THE BROWN COUNTY AREA PLAN COMMISSION. PLEASE DO NOT SEND CASH THROUGH THE MAIL THANK YOU! PLEASE PRINT NAME OF STREET MAILING OWNER OF NAME OF TYPE OF NUMBER OF PRODUCTS OR SERVICES SPECIAL EXCEPTION REQUIRED__________YES SPECIAL EXCEPTION # I AFFIRM THAT MY HOME OCCUPATION HAS NOT EXPANDED BEYOND THE USE FOR WHICH THE ORIGINAL PERMIT WAS ISSUED: SIGNATURE OF APPLICANT DATE THIS PERMIT MUST BE RENEWED EACH YEAR IN JANUARY. PLEASE CONTACT THE PLAN OFFICE IF YOU HAVE ANY QUESTIONS. THANK YOU IN ADVANCE FOR YOUR COOPERATION! OFFICE USE ONLY PERMIT STAFF SIGNATURE FEE $15 Check # Cash ( )