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2. License Application - Home Business
   $35 Annual Fee
4. Application Date*
   Application Date
5. Application Type*

   1. New

   1. Renewal
6. License Number
10. Business Information
12. Business Name*
13. Business Tax ID#*
15. Mailing Address*
17. City*
18. State*
19. Zip Code*
21. Business Phone Number*
22. Business Fax Number
24. Business Email Address
28. Business Owner Information
30. Name*
32. Address*
34. City*
35. State*
36. Zip Code*
38. Home Phone Number*
39. Cellular Phone Number*
41. Additional Business Owner
43. Name
45. Address
47. City
48. State
49. Zip Code
51. Home Phone Number
52. Cellular Phone Number
54. Notice
    For additional business owners beyond the fields provided, please attach a document containing the same information as the "Business Owner" fields:
    Name, Address, City, State, Zip Code, and Phone contact information.
    
    If you have any questions, please contact the City of Bel Aire at 316-744-2451, ext. 120.
58. Emergency Contact
    This information will be used by the Police Department in the event of an emergency.
59. Same as Business Owner*

    1. Yes
    2. No
61. Contact Name
    If you selected no, please add an emergency contact.
62. Home Phone Number
63. Cellular Phone Number
67. Description of Business
69. Days of Operation*
70. Hours of Operation*
    Hours of Operation Start Time

    —

    Hours of Operation End Time
71. Total Number of Employees*
73. Brief Description of Business Activities*
75. Signs

    A business related sign is currently installed or will be installed at the business address.

    1. Yes
    2. No
77. Traffic

    Business related traffic of more than 5 vehicles per day is expected at the business address.

    1. Yes

    1. No
79. External Storage

    There will be external storage of business related materials / products at the business address.

    1. Yes

    1. No
81. Business Income*

    The business income is, or is expected to be, more than $2,500 per year.

    1. Yes
    2. No
83. Hazardous Substances*

    Hazardous, combustible or flammable substances will be stored or used at the business address. (Hazardous substances are prohibited, except at the, “consumer commodity” level, as that term is defined in 49 C.F.R. Sec. 171.8.)

    1. Yes

    1. No
84. Hazardous Substances List
    Attach list.
86. Day Care for Children*

    This business is a home day care for children.

    1. Yes
    2. No
87. Day Care License
    Attach a current State of Kansas issued day care license for the business address.
89. Food Handling License
    Attach a current food handling license for all employees, if required.
91. I understand that:
    The submission of an application for registration and permit to operate will constitute permission, from applicant or their representatives, for inspection of the premises and/or business site by the Code Enforcement Officer or his/her designee for the express purpose of determining that the applicant has complied with the current incorporated Building Code, National Electrical Code , and all other relevant regulations of the city. Any business which the Chief of Police determines will overwhelm the City's law enforcement department, either through the actual operationsof such business or collateral effects directly associated with such business, will be denied a permit to operate until such business enters into an agreement with the City to underwrite all reasonable law enforcement costs brought about by the operation of such business. Such agreement will be subject to review and approval of the governing body. Any permit secured shall not be transferable. Failure to comply with all applicable codes, ordinances and regulations may result in the denial, revocation and/or restriction of the business license.
95. Business Chamber Information

    Indicate if you would like information on joining the Bel Aire Business Chamber. Annual Dues Apply.

    1. Yes

    1. No
99. Electronic Signature*
100. Date*
     Date
104. Date Received
     Date Received
105. Receipt Number
107. City Zoning Administrator recommendation:

     1. Approve
     2. Reject
108. Reviewed by City Zoning Administrator, Signature & Date
110. Chief of Police recommendation:

     1. Approve
     2. Reject
111. Reviewed by Chief of Police, Signature & Date:
113. Reject: Reason for Rejection
115. Date Issued / Denied
     Date Issued / Denied
116. Issue: Assigned License Number
Leave This Blank:


118. 1. Receive an email copy of this form.
119. Email address

     This field is not part of the form submission.

120. Submit

* indicates a required field