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(If land trust, give trust number, trustee and list all beneficiaries on separate sheet)
(If applicant is different than the landowner, applicant must have written landowner approval)
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Coop Dimensions (4 ft. sq. required per chicken):
Run Dimension (8 ft. sq. required per chicken):
Maximum number of chickens allowed (not to exceed six chickens):
Fees: $25 per chicken coop license; $10 for renewal; $25 per transfer
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