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Business License Application - New

  1. Business License Application Form - New
  2. Business Information *

    Provide local business & corporate information with supplemental documents.

  3. For sole proprietors ONLY: Please attach documentation of your "Assumed Name Certificate" from the County. Or in the interim, you may submit a receipt as proof that you have complied with the County's requirement to publish the notice in a local newspaper.
  4. Do you own or lease the facility in which your business is located?*
  5. Type of Establishment*
  6. Business Information*
  7. Work to be Performed on the Building*
  8. Business Activity - Select one or more of the following activities associated with your business.*
  9. Tests Offered
  10. Method of Specimen Collection
  11. How are Test Results Handled?
  12. Upload a map showing the location the food vending vehicle will be parked.

  13. Food Vending Vehicle Duration

    How many days will the vehicle be vending at this location?

  14. Is the Business Veteran-Owned?*
  15. Hazardous Material Storage?*
  16. Type of Food Service
  17. Days of Operation*
  18. Preffered Mailing Address*
  19. Ownership – Principals, Sole Owners, Shareholders, Partners, etc.
    If you have additional, please attach the listing.
  20. Key Holders/Emergency Contacts
    A minimum of (2) two emergency contacts are required. Do NOT provide ownership info. as listed above.
  21. Cannot be owner information. Please provide alternative contacts.

  22. Cannot be owner information. Please provide alternative contacts.


  23. Property Ownership

    Building Owner

  24. Execute*
    By selecting I agree option below you are giving your electronic signature.
  25. No False statements
    Your submission of this form certifies that the information provided is true and correct.
  26. Information for individual completing this form.
  27. Leave This Blank:

  28. This field is not part of the form submission.