BUSINESS REGISTRATION LICENSE APPLICATION
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1 Cashier Validation Code 01 BUSINESS REGISTRATION LICENSE APPLICATION Return Completed Application and Fees to: City Clerk s Office 215 W. Main St. rthville, MI Make Checks Payable To: City of rthville Registration Fee: $40 (Annual Renewal Required by Ordinance) ichat fee: $10 per owner, manager, and applicant [You must include the ichat fee for each owner, manager, and applicant listed on this form] BUSINESS INFORMATION Business Name Address, rthville, Michigan Mailing Address City State Zip List all assumed, trade or firm names with which you intend to do business Which name will be used on business sign Address Website Address Phone Number Fax Number Hours of Operation: MON to TUES to WED to THUR to FRI to SAT to SUN to Number of Employees Planned Opening Date Business Category Code: Primary Secondary (See attachment for categories) Nature of Business: (Describe in detail) What is the Zoning for this location? Zoning Map and Zoning Ordinance available on the City website at (go to Services / Building Department / Zoning Ordinance) Is your business a permitted use in that zoning district? Yes Contact the Building Official at with questions pertaining to Zoning and permitted uses. 1
2 Business located in Historic District? Yes If yes, you must apply to the Historic District Commission for sign approval and for improvements to your building, including paint, roof, windows. Contact the Building Official at with questions. Are you required to have a State of Michigan License or Permit for this type of business (Sec )? Yes If yes, a copy of your State license must be attached to this application Are hazardous materials stored on site? Yes If yes, type of materials Exact location where materials are stored BUSINESS OWNER INFORMATION If there are additional Business Owners to list, please attach a separate sheet. 1. Business Owner Name Driver License (required) ATTACH COPY Home Phone Cell Phone (Disclosure required under Chapter 18 of the rthville Code of Ordinances) 2. Business Owner Name Driver License (required) ATTACH COPY Home Phone Cell Phone (Disclosure required under Chapter 18 of the rthville Code of Ordinances) 2
3 FORM OF BUSINESS Is this business a Corporation? Yes If yes, provide the following: Corporation: Date Incorporated Where Incorporated Name of Corporation, Association, or Club 1. On a separate sheet, list the name, address, and phone number of each officer and director 2. Attach COPY OF DRIVER S LICENSE for each BUSINESS MANAGER INFORMATION 1. Manager Name Driver License (required) ATTACH COPY Home Phone Cell Phone (Disclosure required under Chapter 18 of the rthville Code of Ordinances) 2. Manager Name Driver License (required) ATTACH COPY Home Phone Cell Phone (Disclosure required under Chapter 18 of the rthville Code of Ordinances) 3
4 BUSINESS EMERGENCY CONTACT INFORMATION Name Address City State Zip Home Phone ( ) Cell Phone ( ) LANDLORD CONTACT INFORMATION Landlord Name Address City State Zip Home Number Business Phone Number Cell Phone ( ) Address AFFIDAVIT (applicant and all listed owners must sign this application) The following is included with this application: Copy of State of Michigan License or Permit (if required to operate this type of business) Copy of Driver s Licenses (for all business owners and business managers noted on application). $40 registration Fee (payable to City of rthville) $10 ichat per applicant, owner, manager ( x $10= ) I (We) hereby affirm that the above information is complete and correct to the best of my knowledge and belief. Further, as the business owner/applicant, I (we) have read and understand the business license ordinance as outlined in Chapter 18 of the City of rthville Code of Ordinances. I (we) understand that annual renewal of the business license is required. I (we) further understand that this business shall not permanently close or go out of business without notifying the city clerk at least two weeks in advance of such closing or going out of business. 1. Applicant/Owner Signature Date Print Name: 2. Applicant/Owner Signature Date Print Name: 3. Applicant/Owner Signature Date Print Name: 4
5 OFFICE USE ONLY Police Department Approved Denied Signature Date Fire Department Approved Denied Signature Date Building Department Approved Denied Signature Date City Clerk Copy of Approved Application Forwarded to Assessor / Date DDA Date UB /Date Comm/Date Bus Clk /Date Signature Date Business License Clerk Entered into BS&A Date Registration issued and mailed Business no longer in the City/Out of Business: Date: 5
6 rthville Business Categories 8/24/2007 Category Code C03 R04 R05 C59 R06 C07 R08 S41 S09 F39 C51 R42 H45 S10 S57 F40 C52 R53 S37 C65 S50 D03 H44 R11 C13 E14 S15 R16 R17 S19 R54 R20 R56 H61 R21 C22 S66 R23 S64 M24 M58 S46 H36 C25 R47 H48 Category Name ACCOUNTING & TAX SERVICES ANTIQUE SHOPS APPAREL ARCHITECT AND PLANNERS ARTS & CRAFTS ATTORNEYS & LEGAL SERVICES AUTOMOTIVE SALES AUTOMOTIVE SERVICE BARBER & BEAUTY SHOPS BARS BUSINESS CONSULTANTS CAMERA SALES AND SERVICE CHIROPRACTIC CLEANERS & LAUNDRIES CLOCK AND WATCH SHOP COFFEE SHOP COMPUTER CONSULTANTS COMPUTER SALES CONTRACTORS CORPORTATE HEADQUARTERS COUNSELING DANCE STUDIO DENTISTS DRUG AND HEALTH STORES ENGINEERING & SURVEYING FAMILY ENTERTAINMENT FINANCIAL INSTITUTIONS AND INVESTMENT SERVICE FLORISTS FOOD SALES FUNERAL SERVICES GALLERY GIFT AND CARD SHOPS HARDWARE HEALTH FACILITY HOME AND GARDEN INSURANCE INTERIOR DESIGN JEWELRY SALES & REPAIR LODGING MANUFACTURING AND FABRICATING MANUFACTURING REPS AND BROKERAGE MASSAGE THERAPY MEDICAL SERVICES NEWSPAPERS OPTICAL SALES OPTOMETRISTS 1
7 rthville Business Categories 8/24/2007 Category Code R26 S27 S28 H49 H43 S29 S30 E38 C31 F32 S60 S62 R60 H63 R55 D10 S33 S34 S35 X01 X02 X12 X18 Category Name PARTY STORE PET SERVICES PHOTOGRAPHY PHYSICAL THERAPY PHYSICIANS PLUMBING PRINTING, PUBLISHING AND PACKAGING RACETRACK REAL ESTATE RESTAURANTS SEWING AND TAILORING SHOE REPAIR SHOES / ACCESSORIES SPA AND TANNING SPORTING OUTDOOR SALES THEATRE TRANSPORTATION TRAVEL AGENCIES WHOLESALERS 2
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