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Code Clearance Form

2. P.O. Box 1329
   Lake City, SC 29560
   Phone: 843-374-5421
   Fax: 843-374-1809
4. This form is required for all businesses located in the City of Lake City.
   Before a business license can be issued, you are required to obtain the necessary approvals for code compliance applicable to the location and nature of your business. Upon completion of this clearance form you may mail or bring it with the required license fee to the Finance Department.
   
   You may not lawfully conduct business until a license is issued.
6. Date
   Date
7. Name of Business
9. Name of Owner
10. Telephone
12. Address
14. City
15. State
16. Zip Code
18. Type of Business
19. Type of Building

    1. Residence
    2. Store
    3. Office Building
    4. Warehouse
21. Zoning Division
23. Compliance With Zoning Ordinance

    1. Approved
    2. Disapproved
24. Signature
25. Date
    Date
27. Inspection Division
29. Compliance With Buiding Code

    1. Approved
    2. Disapproved
30. Signature
31. Date
    Date
33. Fire Department
35. Compliance With Fire Code

    1. Approved
    2. Disapproved
36. Signature
37. Date
    Date
39. Health Department
41. Compliance With Health Regulations

    Will you be preparing food? If yes, attach a copy of the DHEC Inspection report to this form.

    1. Yes
    2. No
43. In the event of a change of location or ownership of a business, the same procedure shall be followed within 10 days of change. If you have any questions, please contact the Finance Department at 843-374-5421, option 2.
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44. Print Only

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