Business Directory Contact Form

Jonesborough Public Safety Department
123 Boone Street, Jonesborough, TN 37659
423.753.1053

The Contact Information on this form is shared between the Jonesborough Police Department and the
Jonesborough Fire Department to facilitate communication in an emergency situation. It is important that
Jonesborough officers and firefighters know who to call after hours if there is a fire or other emergency
situation related to your business.

IMPORTANT - This sheet must be completely filled out before Application is submitted

Date of Listing*

Business Name*

Business Phone Number*

Business Address*

Business Email*

Business Owner Name*

Building Owner Name (if different)

Key Holder #1 Name*

Key Holder #1 Phone number*

Key Holder #2 Name*

Key Holder #2 Phone Number*

Miscellaneous Information

Terms*

I have received a copy of the attached letter detailing Certificate of Occupancy, Sign Permit and Building Permits.

I have read and agree to the terms above.

Terms*

I have received a copy of and have read the Business License Applicant information sheet in the Business License Packet that details guidelines for a Certificate of Occupancy, Business Sign Permit and Building Permit. I also understand that I must have a Certificate of Occupancy to open a business and to obtain that certification, I must contact the Jonesborough Building Inspector 423.753.1035

I have read and agree to the terms above.

Date of Application*

Typed Name Signature*

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