Online Forms

Fee Refund Form

2. Fee Refund Form
   Please complete all fields.

   Please complete all fields.

4. Date

5. Permit Number

7. First Name

8. Last Name

10. Contact Phone Number*

11. Job Site Address

    Please enter the address of the job site you are wanting to request a refund for.

13. Mailing Address (If Different)

    If the mailing address for the job site differs from the physical address, please enter it here.

15. City

16. State

17. Zip

19. Who paid the fee?

    Please provide the name of the individual or organization who paid the fee in question,

20. Were SDC fees paid?

    1. Yes
    2. No

22. Detailed Request

    Please provide a detailed reason for the refund request and any additional information.

Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field