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City of Burley 2020 Park Avenue P.O. Box 1090 Burley, Idaho 83318 Phone: (208)878-2538 Fax: (208)878-2539 ***Note: There will be a $25.00 application fee for all applications*** APPLICATION FOR COMMERCIAL BUSINESS LICENSE BUSINESS NAME: PHONE: BUSINESS LOCATION: (City, State, Zip Code) BUSINESS MAILING ADDRESS: (City, State, Zip Code) APPLICANT NAME: PHONE: EMAIL: PERMISSION TO CONTACT VIA EMAIL YES NO IF APPLICANT IS A PARTNERSHIP OR CORPORATION, LIST NAMES OF PARTERNERS OR OFFICERS NAME: ADDRESS: NAME: ADDRESS: NAME: ADDRESS: TYPE AND DESCRIPTION OF BUSINESS: Applicant Signature Date Note: When applicable- before a license will be issued, a copy of the Central District Health Department Certificate must accompany this application. Note: Issuance of a License is not intended as a determination that the applicant has met or complied with any or all of the applicant’s legal obligations or requirements of operating the applicant’s business. The issuance of a license shall in no way waive or reduce any legal obligation or responsibility of Licensee. Required Signatures of Approval Building Department (if applicable): Date Burley Rural Fire District: Date ***OFFICE USE ONLY*** Date Fee Paid: Receipt No.: APPROVED DENIED LICENSE NUMBER: City Clerk $25.00 SIGN ---PAGE BREAK--- [EMAIL REDACTED] EMERGENCY AFTER HOURS CONTACT AND KEY HOLDER INFORMATION REQUEST We are requesting this information to update our records. Should we respond to your business/facility and there is a problem, our office will need a way to contact someone. This information is for Law Enforcement Purposes only. Please return to our office via email, fax, or mail. Business Name: Business Physical Address Business Number: After Hours Key Holders: Name (Last and First) Cell Number House Number Other Phone _ Is there any other information you feel would be helpful for Law Enforcement should an emergency arise? UPDATED 02-11-2021 JPowell CASSIA COUNTY SHERIFF 129 East 14th St. * Burley, ID 83318 * [PHONE REDACTED] * Fax [PHONE REDACTED] George E. Warrell III, Sheriff * Jarrod Thompson Undersheriff