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2. Applicant Information
4. Name
5. Email Address
7. Address
9. City
10. State
11. Zip Code
13. Phone Number
14. Fax Number
16. Application Upload

    Upload the complete permit application. All applications are located here: https://www.martinsville-va.gov/369/Community-Development

18. Attachment 1
19. Attachment 2
21. Attachment 3
22. Attachment 4
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

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