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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.<br><br>You may not lawfully conduct business until a license is issued.

   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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