Licensing Eligibility Forms - City Of Mesa, Arizona - 2012 Page 4
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4RESIDENTIAL BUSINESS LOCATIONS
COMPLETE THIS FORM IF YOUR BUSINESS ADDRESS IS IN A MESA RESIDENTIAL
AREA. DO NOT COMPLETE THE COMMERCIAL BUSINESS LOCATION FORM
(REVERSE SIDE) IF YOU ARE IN A RESIDENTIAL AREA.
You have applied for a Transaction Privilege (Sales) & Use Tax License for your business which is located in a
residential zoning district within the City of Mesa. Businesses located in a residential district must meet
guidelines limiting the impact of uses in residential districts. Please complete the following questionnaire. It will
be used to determine if your request for a license in a residential district fits within the guidelines of a residential
zoning district.
Business Name __________________________________________________________________
Business Address ________________________________________________________________
Please answer all the follow questions in regard to your home based business with a check mark in the ‘yes’ or
‘no’ box supplied.
1.
Yes
No
Will this business be the main use of the residence?
2.
Yes
No
Will employees come to the home? (Other than people that live in the home)
3. Yes
No
Will there be any storage of business materials or supplies outside of
the main residence?
4. Yes
No
Will customers of the business come to the residence?
5. Yes
No
Will there be any commercial vehicles with a gross weight rating exceeding
13,000 lbs and/or dual rear wheels exceeding 17 inches in diameter kept at
this residence?
6. Yes
No
Will any business related work be performed outside of the residential
structure, in either the front or back yards?
Provide an explanation for any “Yes” answers:_________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
I certify that the statements made on this questionnaire are true and complete to the best of my knowledge.
_________________________________________
Signature of Applicant (REQUIRED)
May 2011
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