The undersigned hereby makes application for a license as indicated below:
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1 BUSINESS LICENSE APPLICATION (Staff Use) Application received by: Date Received: Permit # : BL- Applicant Instructions/Guidelines: 1. Application: The following information (which includes the A. Business License Application, B. Information for the City of Columbia Emergency Disaster File, and C. Communications Emergency Contact List must be completed and submitted to the City Clerk s Office at Columbia City Hall. 2. Inspection of Business Location: After application has been received and reviewed by the appropriate staff at City Hall, inspections of the proposed business location will be scheduled with the applicant/representative. This process is to confirm the proposed location is meeting all code requirements regarding zoning, building, fire and electrical, as well as insuring sufficient parking for employees and customers will be provided. 3. Approved/Disapproved Business License: After all inspections have been completed, you will be contacted by the City Clerk s office and informed of the permit status. If a business license has been approved, the Clerk s Office will inform the applicant of the appropriate fees. 4. Approved Permit: The approved business license may be picked up at the City Clerk s Office upon receipt of fee payment. 5. How long will it take to receive a business license? If the business and proposed location meet all requirements, the license should be ready for the applicant to pick up from the City Clerk s Office within approximately five (5) working days. 6. Questions: If you have any questions or need help completing this application, please call the Columbia City Hall - Building Permit Office at (618) ext The undersigned hereby makes application for a license as indicated below: Applicant: Phone #: Applicant DOB: Driver s License #: Proposed Business Phone #: No. Street Zoning District: # of Employees: Full Time - Part Time -
2 Legal Owner of Proposed Business: Phone #: DOB: Driver s License #: Legal owner of proposed business property: Phone #: Contact person for building, electrical & fire inspections: Phone #: Type of Business (explain in detail): Number and type of coin operated devices (i.e.: games, food & cigarette vending machine, etc.) # Type: Illinois Business ID Tax #: Illinois kind of Business #: Applicant Signature (mandatory) Date Property Owner Signature (mandatory) Date (Do not write in this space - For office use only) Annual License Fee for Fiscal Year Beginning May 1 (Except as otherwise noted) TOTAL LICENSE FEE License due and payable at the: Office of the City Clerk 208 S. Rapp Avenue, P.O. Box 467 Columbia, IL May 1 Other City Clerk
3 INFORMATION FOR THE CITY OF COLUMBIA EMERGENCY DISASTER FILE Applicant: Business Phone #: ( ) The following information is being requested for the Emergency Disaster File of the City of Columbia: 1. Will your require more than: 20,000 gallons of water per month? 40,000 gallons of water per month? 60,000 gallons of water per month? 100,000 gallons of water per month? 2. Do you recycle any water? 3. Do you provide, serve or sell potable water to the public? (i.e. day care centers, restaurants, etc.) 4. Are you a medical office or dentist office? 5. Are you a legal office (Law or Title)? Thank you for your help. YES NO cc: Police Communications Office Public Works Department
4 February 1, 2004 Reference: Update Emergency Contact Person / Telephone Numbers Dear Business Owner: The Columbia Police Department Telecommunicators provide dispatch services for Police, Fire and Emergency Medical Services twenty-four hours a day, seven days a week for the City. In the evening and on weekends we make contact for the Public Works Department as problems arise in the City. We will assist Illinois Power, Harrisonville Telephone or other utilities as needed. During certain times it may be necessary to contact someone from your business related to the services we provide or on behalf of these other entities if a problem arises. That is the purpose of this letter. We would like to update our after hours contact list for your business. We have enclosed a form requesting information for the employees you would like contacted first in the event of an after hours alarm, fire, water system problem or other situation at your business. The form is enclosed with this letter. Please mail, fax, drop off or call and a police officer will pick up your contact form. If you have any questions, please call the Telecommunication center, (618) Thank you, Sergeant Jerald Paul Communications Supervisor Columbia Police Department JP
5 COLUMBIA POLICE DEPARTMENT COMMUNICATIONS EMERGENCY CONTACT LIST Business: Phone #: ( ) Fax #: AFTER HOURS CONTACT PERSON(S): FIRST CONTACT: SECOND CONTACT: THIRD CONTACT: FOURTH CONTACT: FIFTH CONTACT: Please list additional contacts on a separate piece of paper and attach.
6 Business License Application Check List: The following information has been completed and submitted to Columbia City Hall, Clerk s Office: - Business License Application (2 pages) Applicant & Property Owner signature mandatory. - Information for the City of Columbia Emergency Disaster File (1 page) - Columbia Police Department Communications Emergency Contact List (1 page) Application is reviewed by City of Columbia staff. Applicant/representative will be contacted by City of Columbia staff member to schedule inspections. Business license will be approved if all requirements are met and fee will be determined. City Clerk s office will inform applicant of approved or disapproved business license status. Approved business license may be picked up by applicant at the City Clerk s Office.
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