Edmonton Development Permit & Business Licence Application For Commercial Locations (Page 2 of 3) in pdf

9) Who is the owner of the business?

Last Name: ________________________________ First Name: _______________________ Middle Name: _______________________

The owner must also provide the following information if their business licence application is for one of the following types of businesses: Dance Club/Event,

Bingo, Carnival, Firearm/Ammunition Dealer, Gaming Establishment, Nightclub, Pawnshop, Public Market, Secondhand Store. These businesses require an Edmonton

Police Referral as part of their business licence application.

Date of Birth: (Month)____________________________ (Day) ___________________________ (Year) ____________________________

Home Address of Owner: ________________________________________________________City ________________________________

Prov. ____________________ Postal Code __________________ Phone Number: ( ________ ) _________________________

SECTION 2 – CHANGES to an Existing Business Licence (Section 1 must also be filled out)

Current Business Licence # ___________________________________________________________________________

___________________________________________________________________________________

Current Business Address:

____________________________________________________________________________________

Business Licence Name:

Please indicate what the change was:



Moved to a new location an existing business (no change in ownership or operations)

New address is:____________________________________________________________________________________

Phone number: ( _____ ) _____________________ FAX: ( _____ ) __________________________________________

E-mail address: ___________________________________________________________________________________

Contact person: ___________________________________________________________________________________



New Legal Entity: __________________________________________________________________________________



New Trade Name: _________________________________________________________________________________



Bought an existing business – If the previous company was operated as a ltd. or incorporated company

Did you buy the ltd. or incorporated company (Legal entity)? ________ Yes or ________ No

Did you only buy the equipment/assets of the business? ________ Yes or ________ No



Changed Operations: (please describe, i.e. was retail now restaurant) __________________________________

________________________________________________________________________________________________________________________________



Other: Please explain: ______________________________________________________________________________

The personal information on this form is collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy Act (FOIP) to assess all matters relevant to your application for this licence. The City may request input from

employees of other City of Edmonton departments, Alberta Health Services, Edmonton Police Service, and/or Alberta Gaming and Liquor Commission in order to properly assess your application for this licence or to determine appropriate conditions, if any, for this

licence. Therefore, the City requests your written consent to disclose the personal or other information provided in your application to other City employees or to the other named entities as may be required for these purposes, pursuant to section 40(1)(d) of

FOIP. If you have any questions regarding the collection, use, or disclosure of your personal information please contact the Licensing Advisor at 780-442-7197

OFFICE USE ONLY – Development Permit Information

Development Permit required? Yes  No 

Continuation of Use ____ Project No. ______________________

Zoning _____________________ Permitted Use _____ or Discretionary Use _____ Fees$ ___________________

Description: ____________________________________________________________________________________

___________________________________________ ____________________ Retail Store: Major _____ Minor _____

Reviewed by: ________________________________ ______________________ Date: ________________________

: Only processed after Development approval has been received

Business Licence Information

Business Licence Categories to be processed: _________________________________________________________

Reviewed by: ________________________________ ______________________ Date: ________________________

Payment Information

Licences are not issued until all licence fees are paid. Business licence fees vary depending on the category(s) your operations are classified into.

If applying in person, payment options are: cash, debit, cheque or credit card.

If applying by email or mail: we will call you at the time of application processing to advise you of the cost of your licence and you may pay by credit card.

Normal office hours are Monday to Friday, 8:00 a.m. – 4:30 p.m., with the exception of closures for holidays.

____________________________________________________________

___________________________

Applicant Signature:

Date:

Current Planning (HSBC Bank Place)

5th Floor, 10250-101 Street NW, Edmonton, AB T5J 3P4

Nov 2015

Phone: 311 or if outside Edmonton 780-442-5311 • Email: SDCurrentPlanning@edmonton.ca