Form Dr-1 - Business Application Page 3
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4DR-1
SOLID WASTE
Page 3
Do you sell tires or batteries or rent/lease motor vehicles to others?
23.
--------------------------------------------------- Yes
No
If yes, answer the questions in this block.
24.
Do you make retail sales of new tires for motorized vehicles (either separately or as a part of a vehicle)? --------------------- Yes
No
25.
Do you make retail sales of new, used, or remanufactured lead-acid batteries sold separately
or as a component part of another product? ----------------------------------------------------------------------------------------------- Yes
No
26.
Are you in the business of renting or leasing motor vehicles that transport less than nine passengers
to individuals or businesses? ---------------------------------------------------------------------------------------------------------------- Yes
No
DRY CLEANING
Do you own or operate a dry-cleaning plant in Florida?
27.
-------------------------------------------------------------------- Yes
No
If yes, answer the questions in this block.
28.
Do you use perchloroethylene in the dry-cleaning process? ---------------------------------------------------------------------------- Yes
No
If you use perchloroethylene, enclose $30 dry-cleaning registration fee.
29.
Do you produce or import perchloroethylene? ------------------------------------------------------------------------------------------- Yes
No
If yes, complete an Application for Florida License to Produce or Import Taxable Pollutants (Form DR-166).
MOTOR FUEL
Do you sell any type of fuel or use off-road diesel fuel? ---------------------------------------------------------------
30.
Yes
No
If yes, answer the questions in this block.
31.
Do you (or will you) make retail sales of gasoline, diesel fuel, or aviation fuel at posted retail prices? ------------------------- Yes
No
If yes to # 31, do you expect the sales of diesel fuel (as measured in gallons) to exceed the sales of gasoline? ---------------- Yes
No
If yes to # 31, does this business exist as a marina? ------------------------------------------------------------------------------------- Yes
No
If yes to # 31, what is your seven (7) digit Florida Department of Environmental Protection Facility
Registration Number for this location? _____________________________________________________________
32
Do you use diesel fuel for non-highway purposes? -------------------------------------------------------------------------------------- Yes
No
CONTRACTORS
Are you a contractor who improves real property?
33.
-------------------------------------------------------------------------- Yes
No
If yes, answer the questions in this block.
Do you most frequently operate as a
prime contractor
subcontractor? List the type of construction you perform (e.g., building,
painting, electrical) _________________________________________________________________________________
_________________________________________________________________________________________________
34.
Do you operate under formal written contracts? ....................................................................................................................... Yes
No
If yes, what type of contracts do you operate under?
Lump Sum
Cost Plus
Fixed Fee
Other
If other, please explain _______________________________________________________________________________________________
35.
Do you purchase any materials or supplies from vendors located outside of Florida? --------------------------------------------- Yes
No
36.
Does your company have a current occupational license in any Florida county? --------------------------------------------------- Yes
No
If yes, please list all the counties in which you are licensed and the corresponding license numbers __________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
37.
Do you fabricate/manufacture any building components at a location other than contract sites? --------------------------------- Yes
No
TELECOMMUNICATION/ENERGY
Do you provide telecommunication services, electrical power, or gas? --------------------------------------------
38.
Yes
No
If yes, answer the questions in this block.
Do you sell:
a.
Electrical power ---------------------------------------------------------------------------------------------------------------------- Yes
No
b.
Natural or manufactured gas -------------------------------------------------------------------------------------------------------- Yes
No
c.
Pay phone service -------------------------------------------------------------------------------------------------------------------- Yes
No
d.
2-way cable television service ------------------------------------------------------------------------------------------------------ Yes
No
e.
Telex, telegram, teletype service --------------------------------------------------------------------------------------------------- Yes
No
f.
Cellular or pagers service ----------------------------------------------------------------------------------------------------------- Yes
No
g.
Long distance (inter-exchange service) ------------------------------------------------------------------------------------------- Yes
No
h.
Shared tenant utility service --------------------------------------------------------------------------------------------------------- Yes
No
i.
Telephone service (local exchange) ------------------------------------------------------------------------------------------------ Yes
No
j.
Alternative access vendor service -------------------------------------------------------------------------------------------------- Yes
No
k.
Other telecommunication services (By-Pass provider, etc.) -------------------------------------------------------------------- Yes
No
Describe ____________________________________________________________________________________
39.
Do you provide billing services to telecommunication service providers? ----------------------------------------------------------- Yes
No
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Parent category: Financial