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2. Business License Application Form - New
6. Business Information *

   Provide local business & corporate information with supplemental documents.

   1. Incorporated- Secretary of State (Certificate of Good Standing)
   2. Sole Proprietor- County (Attach Assumed Name Certificate)
7. Corporate Name/ Sole Propietor*
8. Assumed Business Name/DBA*
9. Attach Document of Assumed Name Certificate
   For sole proprietors ONLY: Please attach documentation of your "Assumed Name Certificate" from the County. Or in the interim, you may submit a receipt as proof that you have complied with the County's requirement to publish the notice in a local newspaper.
11. FEIN Number*
12. IBT No./Retailer's Occupational Tax No. *
16. Do you own or lease the facility in which your business is located?*

    1. Own
    2. Lease
17. Estimated Opening Date*
    Estimated Opening Date
19. Upload a Copy of the Lease or Proof of Ownership*
21. Area of Business in Square Feet*
23. Type of Establishment*

    1. Food Establishment
    2. Service Establishment
    3. Retail and Wholesale Sales
    4. Multiple
25. Percent Food Establishment
    -- Select One --0%10%20%30%40%50%60%70%80%90%100%
26. Percent Service Establishment
    -- Select One --0%10%20%30%40%50%60%70%80%90%100%
27. Percent Retail and Wholesale Sales
    -- Select One --0%10%20%30%40%50%60%70%80%90%100%
29. Business Information*

    1. New Business
    2. Existing Business - Relocation
    3. Existing Business - Ownership Change
30. Work to be Performed on the Building*

    1. New Building Construction
    2. Addition to Existing Building
    3. Expansion into Adjacent Space
    4. Remodeling Existing Space
    5. Cleaning and Painting Only
    6. Move-In Ready
32. Business Activity - Select one or more of the following activities associated with your business.*

    1. COVID-19 Testing
    2. Tobacco and/or Alternative Nicotine Product Sales
    3. Video Gaming/Gambling
    4. Alcoholic Beverage Sales
    5. Circus (no mechanical rides)
    6. Carnival (includes mechanical rides)
    7. Live Entertainment
    8. Animal Exhibition
    9. Billiards / Pool Tables
    10. Vendor - Nonpermanent Location
    11. Fuel Service Station
    12. Taxicab
    13. Automobile Sales
    14. Cannabis / Drugs - Items designed for or marketed for use with
    15. Vending Machines
    16. Amusement Devices
    17. Automatic Music Devices
    18. Public Dance

    1. Dealers of Secondhand Items
    2. Food Delivery Vehicles
    3. Food or Beverage Vending Vehicles
    4. Dry Cleaning Machines
    5. Theaters
    6. Bus Services
    7. Solicitors
    8. Coin-Operated Amusement
    9. Horse Stable
    10. Sidewalk Sale
    11. Rabbitry
    12. Tent Sales
    13. Hobby Kennels
    14. Massage
    15. Private Outdoor Pay Telephone
    16. Hotels and Motels
    17. NO ADDITIONAL ACTIVITIES
34. Tests Offered

    1. Rapid
    2. Laboratory
    3. Rapid and Laboratory
35. Method of Specimen Collection

    1. Staff administers test to collect specimen
    2. Patient self-collects specimen
37. How are Test Results Handled?

    1. Staff interpret and report test results
    2. Staff receive specimen and send to laboratory for interpretation and reporting of results
    3. Patient self-interprets their own results
39. Provide a copy of your CLIA Certificate or Proof of Application
41. Provide the Name of the Testing Laboratory Used
43. Tobacco License Required
    New Tobacco License

    A separate tobacco license is required.  These licenses are issued by the Village Clerk.  Please follow the above link to open a separate window to apply for a tobacco license in addition to your business license.

45. Gaming License Required
    Contact the Clerk's Office

    A separate gaming license is required.  These licenses are issued by the Village Clerk.  Please follow the above link to open a separate window with contact information for the Clerk's Office.

47. Liquor License Required
    Contact the Clerk's Office

    A separate liquor license is required.  These licenses are issued by the Village Clerk.  Please follow the above link to open a separate window with contact information for the Clerk's Office.

49. Circus - Start/End
    Circus - Start/End Start Date

    —

    Circus - Start/End End Date
50. Carnival Start/End
    Carnival Start/End Start Date

    —

    Carnival Start/End End Date
51. Animal Exhibition Start/End
    Animal Exhibition Start/End Start Date

    —

    Animal Exhibition Start/End End Date
52. Billiards - Number of Tables
54. Vendor Start/End
    Vendor Start/End Start Date

    —

    Vendor Start/End End Date
55. Fuel - Number of Hoses
56. Taxicab - Number of Cabs
57. Vending Machine - Type
    -- Select One --CigaretteFoodBoth
59. Number of Food Machines
60. Public Dance Start/End
    Public Dance Start/End Start Date

    —

    Public Dance Start/End End Date
61. Dealer - Type
    -- Select One --ItinerantDealer and/or PawnbrokerLimited Sales Dealer
63. Itinerant Dealer Start/Stop
    Itinerant Dealer Start/Stop Start Date

    —

    Itinerant Dealer Start/Stop End Date
64. Food Delivery - Number of Vehicles
65. Food Vendor - Number of Vehicles
66. Dry Cleaning - Number of Machines
68. Theater Number of Seats
    -- Select One --1 to 600 seats601 to 1,000 seatsOver 1,000 seatsDrive-In Theater
69. Bus Service - Number of Buses
70. Solicitors - Number of Solicitors
71. Coin-Operated Devices/Centers
    -- Select One --Coin-Operated Amusement DeviceCoin-Operated Amusement CenterCoin-Operated Amusement Center-Restaurant
73. Coin-Operated Devices - Number of Machines
74. Sale - Duration
    Sale - Duration Start Date

    —

    Sale - Duration End Date
75. Rabbitry - Location
    -- Select One --Inside a DwellingInside an Accessory Structure
76. Pay Phone - Number of Phones
78. Hotel/Motel - Number of Rooms
79. Hotel/Model - Total Area of all Rooms in Square Feet
80. I certify that my business does not contain any additional activities
    -- Select One --Yes - I have read the full list
82. Food Vending Vehicle Location

    Upload a map showing the location the food vending vehicle will be parked.

83. Food Vending Vehicle Duration

    How many days will the vehicle be vending at this location?

    1. One day only
    2. Regularly, but not daily
    3. Daily
85. Provide a full description of your business and all related activities. Be specific! Insufficient answers may delay your registration*
87. Total Number of Employees*
88. Total Number of Parking Spaces*
90. Check all that Apply*

    1. Minority Owned Business
    2. Women Owned Business
    3. Veteran Owned Business
    4. LGBTQ+ Owned Business
    5. Disability Owned Business
    6. None of the above apply to this business
91. Do you have a business plan?

    1. Yes
    2. No

    You can use the attached template to create your business plan.  While not required by the Village, business plans are typically required when you apply for loans and grants.

    Business Plan Template

    Plan de Negocios

93. What Percentage of Employees are Veterans?
95. Hazardous Material Storage?*

    1. Yes
    2. No
97. Attach a list of all hazardous materials stored on site
98. Type of Food Service

    1. Pre-Packaged Foods
    2. Beverages
    3. Counter Service

    1. Sit-Down Dining
    2. Food Packaging or Processing
100. Days of Operation*

     1. Sunday
     2. Monday
     3. Tuesday
     4. Wednesday
     5. Thursday
     6. Friday
     7. Saturday
     8. By Appointment Only
102. Sunday Open
     Sunday Open
103. Sunday Close
     Sunday Close
104. Monday Open
     Monday Open
105. Monday Close
     Monday Close
107. Tuesday Open
     Tuesday Open
108. Tuesday Close
     Tuesday Close
109. Wednesday Open
     Wednesday Open
110. Wednesday Close
     Wednesday Close
112. Thursday Open
     Thursday Open
113. Thursday Close
     Thursday Close
114. Friday Open
     Friday Open
115. Friday Close
     Friday Close
117. Saturday Open
     Saturday Open
118. Saturday Close
     Saturday Close
122. Preffered Mailing Address*

     1. Business Address
     2. Corporate Address
124. Business Address*
125. Phone Number *
127. City*
128. State*
129. Zip Code*
131. Corporate Address
132. Phone Number
134. City
135. State
136. Zip Code
140. Ownership – Principals, Sole Owners, Shareholders, Partners, etc.
     If you have additional, please attach the listing.
142. 1. Business Owner*
143. Email Address*
145. Address*
147. City*
148. State*
149. Zip Code*
151. Phone Number*
152. Cell Number*
154. 2. Business Owner
155. Email Address
157. Address
159. City
160. State
161. Zip Code
163. Phone Number
164. Cell Number
168. Key Holders/Emergency Contacts
     A minimum of (2) two emergency contacts are required. Do NOT provide ownership info. as listed above.
170. 1. Key Holder*

     Cannot be owner information. Please provide alternative contacts.

171. Title*
172. Phone Number*
174. 2. Key Holder*

     Cannot be owner information. Please provide alternative contacts.

     
     

175. Title*
176. Phone Number*
180. Property Ownership

     Building Owner

182. Building Owner / Landlord*
183. Email Address
185. Address*
187. City*
188. State*
189. Zip Code*
191. Phone Number*
192. Cell Number
194. Execute*

     1. I agree

     By selecting I agree option below you are giving your electronic signature.
195. No False statements
     Your submission of this form certifies that the information provided is true and correct.
197. First Name*
     Information for individual completing this form.
198. Title*
200. Phone Number*
201. Email Address*
Leave This Blank:


203. 1. Receive an email copy of this form.
204. Email address

     This field is not part of the form submission.

205. Submit Submit and Print

* indicates a required field