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Business License Application - Renewal

  1. Business Information *
    Provide local business & corporate information
  2. This number is provided to you in your renewal form.
  3. This number is provided to you in your renewal form.
  4. Do you own or lease the facility in which your business is located?*
  5. Type of Establishment*
  6. Business Activity - Select one or more of the following activities associated with your business.*
  7. Hazardous Material Storage?*
  8. Type of Food Service
  9. Days of Operation
  10. Preffered Mailing Address*
  11. Ownership – Principals, Sole Owners, Shareholders, Partners, etc.
    If you have additional, please attach the listing.
  12. Key Holders/Emergency Contacts
    A minimum of (2) two contacts are required. Do NOT provide ownership info. as listed above.
  13. Cannot be owner information. Please provide alternative contacts.
  14. Cannot be owner information. Please provide alternative contacts.
  15. Property Ownership
    Building Owner
  16. Execute*
    By selecting I agree option below you are giving your electronic signature.
  17. No False statements
    Your submission of this form certifies that the information provided is true and correct.
  18. Information for individual completing this form.
  19. Leave This Blank:

  20. This field is not part of the form submission.