"Permit Application Form" - Virginia

Permit Application Form is a legal document that was released by the Virginia Department of Agriculture and Consumer Services - a government authority operating within Virginia.

Form Details:

  • Released on September 1, 2016;
  • The latest edition currently provided by the Virginia Department of Agriculture and Consumer Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Virginia Department of Agriculture and Consumer Services.

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Download "Permit Application Form" - Virginia

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VIRGINIA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES
OFFICE OF PLANT INDUSTRY SERVICES
102 Governor Street • Richmond, VA 23219
(804) 786-3515 • Fax: (804) 371-7793 • www.vdacs.virginia.gov
PERMIT APPLICATION FORM
• Please select the type of permit for which you are applying.
Please check one:
Fee
Revenue Code
Ginseng Dealer
$10.00
816-01-535-02199
Nursery Stock Dealer
$25.00
810-01-535-02141
Nursery Operation
$75.00
810-01-535-02191
• Complete the following:
The below named party makes application for this permit and agrees to comply
with all laws, rules and regulations applicable thereto.
Name of Business or Individual Dealer
Physical Address
City
State Zip Code
Mailing Address (if different than Physical Address)
City
State Zip Code
Contact Person (Last name, First name)
Phone number
Fax number
Alternate phone number
Email address
City or county of business location
Signature
Date
• Provide total amount of acreage (for Nursery Operation ONLY): ____________.
• Make a copy for your records.
• Send this application and the appropriate payment to the Virginia Department
of Agriculture and Consumer Services, PO Box 526, Richmond, VA
23218-0526.
• Payment in the form of a check or money order should be made payable to
“Treasurer of Virginia.”
(Revised September 2016)
VIRGINIA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES
OFFICE OF PLANT INDUSTRY SERVICES
102 Governor Street • Richmond, VA 23219
(804) 786-3515 • Fax: (804) 371-7793 • www.vdacs.virginia.gov
PERMIT APPLICATION FORM
• Please select the type of permit for which you are applying.
Please check one:
Fee
Revenue Code
Ginseng Dealer
$10.00
816-01-535-02199
Nursery Stock Dealer
$25.00
810-01-535-02141
Nursery Operation
$75.00
810-01-535-02191
• Complete the following:
The below named party makes application for this permit and agrees to comply
with all laws, rules and regulations applicable thereto.
Name of Business or Individual Dealer
Physical Address
City
State Zip Code
Mailing Address (if different than Physical Address)
City
State Zip Code
Contact Person (Last name, First name)
Phone number
Fax number
Alternate phone number
Email address
City or county of business location
Signature
Date
• Provide total amount of acreage (for Nursery Operation ONLY): ____________.
• Make a copy for your records.
• Send this application and the appropriate payment to the Virginia Department
of Agriculture and Consumer Services, PO Box 526, Richmond, VA
23218-0526.
• Payment in the form of a check or money order should be made payable to
“Treasurer of Virginia.”
(Revised September 2016)