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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling in your Petitioner/Licensee Information. Enter your name, address, city, state, and zip code in the designated fields.
  3. If applicable, provide the name of your agent who is filling out the petition on behalf of a corporation.
  4. Specify the Board and License information by entering the appropriate details in the provided fields.
  5. Select whether you are requesting a Variance or Waiver by checking the corresponding box.
  6. In the subsequent sections, provide detailed information regarding any representatives assisting you, specific rules from which you seek variance or waiver, and explain how strict application of these rules would cause substantial hardship.
  7. Outline alternative standards you agree to meet and how they will protect public health and safety.
  8. Finally, sign and date the form before submitting it to ensure your petition is processed correctly.

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