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Liberty County Building & Licensing Department 100 Main Street Suite 7410 Hinesville, Georgia 31313 (912) 876-8454 (912) 876-9107 Fax Occupational Tax Certificate Application Date: Location (Street): Mailing Address: Type of Business: Business Name: Approved By: Zoning Classification: Tax Map & Parcel Number of Employees (Including Owners): Date: Description of work to be done from the Home Address: Applicant Signature: Federal ID Number: Telephone Number: Social Security Number: Owner's Name: This application must be approved by the Liberty Consolidated Planning Commission ***All building, electrical, mechanical, plumbing, well drilling contractors, mobile home dealers, mobile home installers and any other contractor that is required to have a State of Georgia License will be required to attach a copy of the license to this application before issuance. ***All commercially used buildings may be subject to an inspection for fire and safety code compliance prior to any certificate of occupancy for business license being issued. ---PAGE BREAK--- BOARD OF COMMISSIONERS LIBERTY COUNTY 100 Main Street, Suite 1320 HINESVILLE, GEORGIA 31313 (912) 876-2164 / FAX (912) 369-0204 www.libertycountyga.com DONALD LOVETTE CHAIRMAN MARION STEVENS, SR. DISTRICT 1 JUSTIN FRAISER DISTRICT 2 CONNIE THRIFT DISTRICT 3 PAT BOWEN DISTRICT 4 GARY GILLIARD DISTRICT 5 EDDIE J. WALDEN DISTRICT 6 JOSEPH W. BROWN COUNTY ADMINISTRATOR STATE OF GEORGIA COUNTY OF LIBERTY AFFIDAVIT VERFIFYING STATUS OF BENEFIT APPLICANT Pursuant to the Georgia Security and Immigration Compliance Act (O.C.G.A. 50-36-1 et seq.), every agency in Liberty County providing public benefits through any state or federal program is responsible for determining the immigration status of citizen applicants for said benefits. By executing this affidavit under oath, as an applicant for benefits, I am stating the following with respect to my application for benefits from Liberty County, Georgia (please initial one): I am a United States citizen or legal permanent resident 18 years of age or older; OR I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act 18 years of age or older and lawfully present in the United States. In making the above representation under oath, I understand that any person who knowing and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia. Signature of Applicant Date Printed Name Subscribed and sworn to before me this day of , 20 . Notary Public My Commission Expires: (NOTARY SEAL) ---PAGE BREAK--- State of Georgia Department of Revenue 1800 Century Boulevard Atlanta, Georgia 30345 An Equal Opportunity Employer Official Addendum to Business Occupancy License Application Required Fields Name of Business (Legal Name or Trade Name): Mailing Address if Different From the Physical Address: Actual Physical Address of Each Location of Such Business if Different From the Mailing Address: Sales Tax ID if Your Business is Required to Have One by Law: Applicable North American Industry Classification System Code Number (Please list all NAICS): NOTICE: Upon completion or refusal to complete this form by the taxpayer, the municipality or county shall provide written notice to the taxpayer that the above information will be submitted to the Georgia Department of Revenue. The failure or refusal to complete this form by the taxpayer shall not toll or extend the time of payment established for such occupation tax or regulatory fee under Code Section 48-13-20. In accordance with O.C.G.A. 48-2-15 and 48-7-60, all taxpayer information provided on this Form shall be confidential and privileged. In compliance with O.C.G.A. 48-1-2 and 48-8-33, the Commissioner of the Georgia Department of Revenue shall collect all sales tax remitted in Georgia. Any questions or comments regarding the collection of sales tax or this Form should be directed to the Georgia Department of Revenue at (404) 417-6605 or sent to Tax Law & Policy, 1800 Century Blvd., NE, Atlanta, GA 30345. ---PAGE BREAK--- Private Employer Exemption Affidavit Pursuant To O.C.G.A. 36-60-6(d) By executing this affidavit, the undersigned private employer verifies that it is exempt from compliance with O.C.G.A. 36-60-6, stating affirmatively that as of July 1, 2013 the individual, firm or corporation, employs fewer than ten (10) employees and therefore, is not required to register with and/or utilize the federal work authorization program commonly known as E-Verify, or any subsequent program, in accordance with the applicable provisions and deadlines established in O.C.G.A. 13-10-90. Signature of Exempt Private Employer Printed Name of Private Employer I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on , , 20 in (City) (State) Signature of Authorized Officer or Agent Printed Name and Title of Authorized Officer or Agent SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF , 20 . NOTARY PUBLIC My Commission Expires: ---PAGE BREAK--- Jeff Ricketson, AICP Executive Director Liberty Consolidated Planning Commission 100 Main Street Suite 7520 Hinesville, Georgia 31313 Phone: [PHONE REDACTED] Liberty County Zoning Overview of Type A Home Occupation Zoning Ordinance Applicant Name: Applicant Address: Current Zoning: Business Name: Business Location: In Type A home occupations residents use their home as a place of work, home office or business telephone or mailing address. Employees or customers are prohibited from coming to the site, and there is no visible indication of commercial activity. By way of illustration only, examples include artists, crafts people, writers and consultants. Type A home occupations may be approved administratively by the zoning administrator or his designee. General provisions and prohibited uses. All home occupations shall meet the following: 1. A home occupation shall be incidental and accessory to the use of a dwelling as a residence. No more than twenty (20) percent of the floor space of the dwelling unit (including attached garages) may be used for the home occupation. 2. There shall be no exterior evidence of the home occupation or alteration of the residence and/or accessory buildings to accommodate the home occupation. Internal or external changes which will make the dwelling appear less residential in nature or function are prohibited. Examples of such prohibited alterations include construction of parking lots, paving of required setbacks, or adding commercial-like exterior lighting. 3. There shall be no outside operations or exterior storage of inventory, equipment, or materials to be used in conjunction with a home occupation. 4. Off-site employees of the resident shall not congregate on the premises for any purpose concerning the home occupation nor park their personal vehicles at the location. ---PAGE BREAK--- Additional requirements. The foregoing requirements for home occupation shall be in addition to those requirements for business licenses generally, and any violation of these requirements shall be grounds 5. No more than one vehicle associated with the home occupation (no larger than a standard van or pick-up truck and with minimal commercial markings as approved by the zoning administrator) may be parked at the site. Such vehicle is limited to one-ton carrying capacity and must be used exclusively by the resident and parked on a valid improved surface constructed of materials common in conventional residential development (e.g. concrete, pavers, etc.) and which is otherwise compatible with the surrounding neighborhood. 6. No use or activity may create an offensive noise, dust, glare, vibration, smoke, smell, electrical interference or any fire hazard, or unhealthful condition, or other nuisance or disturbance. 7. All home occupations shall be subject to periodic inspections by the department of planning and zoning. 8. Any type of repair or assembly of vehicles or equipment with internal combustion engines (such as autos, marine engines, lawn mowers, chain saws and other small engines) or of large appliances (such as washing machines, dryers, and refrigerators) or any other work related to automobiles and their parts is prohibited. 9. Accessory home occupations may not serve as headquarters or dispatch centers where employees come to the site and are dispatched to other locations. Specific criteria for Type A home occupations. In addition to the general criteria established in subsection Type A home occupations are subject to the following restrictions: 1. No clients, nonresident employees or customers are allowed on the premises. 2. Pickups from and deliveries to the site in regard to the business shall be restricted to vehicles which have no more than two axles and shall be restricted to no more than two pickups or deliveries per day between the hours of 9:00 a.m. and 6:00 p.m. 3. No signage regarding the home occupation is permitted on the property. 4. No advertisement shall be placed in any media (including flyers soliciting business) containing the address of the property. 5. Retail sales are prohibited. ---PAGE BREAK--- for denial, suspension or revocation of the subject business license, and vice versa. Upon any violation of this ordinance, the home occupation may be suspended, denied or terminated as with business licenses generally. Renewal application. All persons wishing to renew their home occupation from the previous year shall make application for such renewal at the same time as provided for renewals of business licenses generally on such forms as may be prepared by the zoning administrator. Notwithstanding any terminology used in this section or any other provision herein to the contrary, the granting of a home occupation for one year shall in no way vest any rights or privileges whatsoever to any renewal or subsequent permit, and such person must satisfy in full the requirements for such business license established by ordinance at the time of such renewal; provided, however, that if there is no change in the home occupation and the operations connected. Property Landowner & Identification Business Owner & Identification Date of Signature Date of Signature Above Signature(s) Attested to and Witnessed By LCPC Staff Member Date ---PAGE BREAK--- If your business will be a seasonal business, make sure seasonality is reflected in your narrative. Description of the business: Answer as many of the following questions as you can. Business Narrative What type of business are you opening? Describe how your company's day-to-day operations work: What other kinds of businesses are in the neighborhood? What is the nature of the product(s) or service(s)? Take your time, be very specific! What group of customers are you going after? What hours/days will you be open? How many employees will you need and when? Do you have any company cars or trucks for this business? What furniture, fixtures, equipment, tools, inventory, etc. do you need? Include a brief description of who does what. What other licenses or permits will you be required to obtain? County? City? State? Health Dept.? How will you store the business inventory?