Francis, Utah

 

FRANCIS TOWN

2317 South Springhollow Road

P. O. Box 668

Francis, Utah  84036

(435) 783-6236    FAX (435) 783-6186

E-Mail:  lhallam@allwest.net

 

BUSINESS LICENSE APPLICATION

 

 

Section I:  Business Information

 

Is this application a:    New Application      Renewal      Change of ownership or location

 

Name of Applicant­­­­­­­­­­­­­­­ ­­­­­____________________________________________ Date ­­­­­­­­­­­­­­­­­­­­­­_____________

                                                                                                         Is this name registered with the

Business Name _______________________________________ State of Utah    Yes    No

 

Type of Business (be specific)_____________________________________________________

 

Physical Address ______________________________________  Phone No. (    )­­­­­­­­­­­____________

 

Mailing Address ­­­­­­­­­­­­­­­­­­­­______________________________________  Business Start Date ________

 

Applicant's Address (if different) ­­­­­­­­­­­­­­­­­­­­_______________________________ Phone _____________

 

Manager's Name (if applicable) __________________________  Phone No. (    ) ____________

 

Federal License (if any) _________________________________  Expires _________________

 

Federal ID:   SSN     or    EIN __________________ Utah Corp. LP or LLC # ___________

 

Sales & Use Tax No.  (if not applicable, please sign here) _______________________________

 

DBA File No. ____________________________

 

Professional License/State Contractors Number (if applicable) _____________________

 

 

Section II:  Check all that apply

 

 Approximate number of employees _________

 

 Commercial                           Home Occupation                             Sole Proprietorship

 General Partnership               Limited Partnership                            Limited Liability Co.

 Profit Corporation                 Non-Profit Corporation                     Sexually-Oriented

    Business or Employee

Section III:  Describe Business

 

______________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Where will your equipment, tools, supplies to conduct you business be stored?_______________ ______________________________________________________________________________

If storage is located at home what will be stored and where?_____________________________ ______________________________________________________________________________

 

Section IV:  Verification of Accuracy - Acknowledgment of Responsibility

 

Under penalty of perjury, I hereby certify that the information provided for this entire application is complete, accurate and in accordance with Francis Town Ordinances.  I further certify that updated information will be provided in writing, as required, to Francis Town within ten (10) days of any change to the business, name, organization or location.  I hereby acknowledge that that illegal or fraudulent business practices are grounds for revocation of the business license, as is delinquent payment of the business license fee.  This form is an application for a business license.  The receipt for payment of license fees thereof does not constitute being approved to operate a business; the actual license will be issued only when approval is given.  It is the responsibility of the licensee to be familiar with the ordinance(s) under which the license is applied for.  All business licenses are to be renewed yearly.  The application and fees provided herein shall be due and payable by the 31st of January of each year, or before commencing a new business, trade, service or profession.  All license fees not paid by that shall be considered delinquent and assessed a $25.00 late penalty.  Failure to renew by the last day of February of each year shall result in revocation of the business license.  Responsibility of renewal is that of the licensee.  Failure to receive a renewal notice does not excuse this responsibility.

 

____________________________________________             _________________________

    Signature of Authorized Business Agent/Owner                         Date

______________________________________________________________________________

For office use only:

 

Conditional Use Permit Required:   Yes      No     If yes, give date approved by:

                   Planning Commission ___________   Town Council ______________

 

Inspection required:   Yes      No     If yes, date inspected _____________

 

Property zoned appropriately:   Yes      No

 

Health Department Inspection required:   Yes      No     If yes, date inspected ____________

 

Approval of Business License Administrator:

 

 

_______________________________________________              Date ___________________

 

License Fee ___________       Date Paid __________  Rec'd by ________  Receipt #________

Hosted by Identity Design, LLC