Temporary Long Term Business License Application (Page 2 of 2) in pdf

SECTION III: BUSINESS DESCRIPTION - SPECIFIC

(Outline the use of the business location, storage of materials, etc.)

SECTION IV: OWNERSHIP & CONTACTS

Contact Role(s):

(mark all that apply)

Contact Name:_________________________________________________________________________

o Application Contact

o Ownership

o Agent

Home Address:______________________________________________________________________________________________

o Local Manager

Street Address (include unit #) / PO Box

City, State, Zip

o After-Hours

Emergency Contact

o Licensing Rep /ie. Accounting

Contact Ph 1:__________________________________________ Contact Ph 2:__________________________________________

o Other Officer or Employee

Date of Birth:_______________________ and, Driver Lic. #:_____________________________(State:____) or, US Passport #:_______________________________

Contact Role(s):

(mark all that apply)

o Application Contact

Contact Name:_________________________________________________________________________

o Ownership

o Agent

o Local Manager

Home Address:______________________________________________________________________________________________

After-Hours Emergency Contact

Street Address (include unit #) / PO Box

City, State, Zip

o Licensing Rep /ie. Accounting

o Other Officer or Employee

Contact Ph1:__________________________________________ Contact Ph2:___________________________________________

Date of Birth:_______________________ and, Driver Lic. #:_____________________________(State:____) or, US Passport #:_______________________________

See attached page(s) for additional contacts

SECTION V: IDENTIFICATION / BCI BACKGROUND CHECK

Provide proof of identity: (a) Valid Driver’s License issued by any state, (b) a U.S. Passport, or (c) U.S. Military ID.

All applicants must submit a BCI Background Check that has been done within 180 days of the application date.

Contact the Bureau of Criminal Identification at (801) 965-4445 or

Proof of Identity: o

BCI Background Check: o

Yes

SECTION VI: NOTIFICATIONS and VERIFICATION of AUTHORITY

1) Mandatory review process - This application does not constitute a business license. All applications are subject to the review process mandated by Title 5 of

the Municipal Code. Incomplete applications will not be processed. Decisions on applications will take 15 business days (minimum), and are made based on:

(i) the information provided on the application materials, and

(ii) reviews inspections performed, as required.

2) Additional Requirements - Under the Municipal Code, additional Business License application requirements are necessitated for some business types.

3) Denial of License - Application denial or subsequent license suspension or revocation are most often the result of:

(i) an inaccurate or incomplete application, or failure to update information with the division, and/or

(ii) non-compliance with the Municipal Code, Land Development Code, and/or applicable building, fire, and environmental codes.

4) Other regulatory bodies - It is the applicant’s responsibility to determine and comply with any requirements from other regulatory agencies.

5) Signage - Permanent signage requires a separate Sign Permit application, which is administered by the Division of Planning and Zoning (435-716-9023).

6) Building alterations - All alterations to buildings or spaces, including electrical, plumbing, and mechanical alterations, require a separate building permit and

compliance inspection as established by Logan Municipal Code. Building permits are administered by the Division of Building and Safety (435-716-9030).

7) Officer background checks - The application process includes a Logan Police local background check for each business principal or officer.

I affirm that: (i) I am an authorized agent of the business for which application is being made, and (ii) the information on this form and on all application materials

is both complete and accurate to the best of my knowledge.

________________________________________ _____________________________________ _________________________

Signature

Printed Name

Date

FEE: $75.00

Payment will not be accepted after 4:30 p.m. on business days.