Business Information

Business Name*

Street Address*

City State Zip*

Phone Number*

Email Address*

Website

Mailing Address*

City State Zip*

Owner's Name*

Phone Number*

Home Address*

City State Zip*

FEIN or SSN*

Sales Tax Number

No Retail Sales

Description of Business (Check all that apply)

General Business

Auto Dealership Auto Salvage Yard Auto Sales / Repair General Contractor Electrical Contractor Plumbing Contractor Mechanical Contractor Roofing Contractor

Financial Institution Insurance Manufacturer Professional Service Real Estate Agency Restaurant Retail Other- Specify Below

Kansas Roofing Registration Number

Home Occupation (in city limits)

Hair Salon Day Care

Office Other -Specify Below

If 'Other', please specify

Number of Employees*

Emergency Contact Information

Name*

Phone*

Address*

City State Zip

Fee Payment

I understand that the Occupational License fee must submitted before this application can be processed. Fees may be submitted by mail (check or money order) to City of Bonner Springs, P.O. Box 38, Bonner Springs, KS 66012 or paid in person (cash, check or money order) to 200 E. Third St., Bonner Springs, KS 66012.*

Mail

In Person

Applicant certifies all applicable taxes paid or current?*

Yes

No

For Office Use Only

CL

Restrictions

Planning

Codes

City Clerk

License Number

Fee