Full Text
BUSINESS LICENSE APPLICATION INFORMATION AND CHECKLIST Failure to Submit Required Items or to Complete Forms May Delay Processing of Your Application All businesses that conduct business within the limits of the Town of Monument are required to obtain a business license. This includes contractors, retail sales and service-based businesses located inside or outside of town limits. Please use the checklist below to assist you in the completion of your application. If you have any questions call Tina Erickson at (719)884-8047 or email [EMAIL REDACTED]. Additional information may also be found at Please check all that apply: Local or Non-local Business Local Business (Business address is physically located within the town limits.) o Complete page 1 and page 2 of the business license application and the Business Premise Form. Non-local Business (Business address is not located within the town limits.) o Complete page 1 of the business license application. Required Items Business License Application (All applicable fields must be filled out to avoid delays in processing.) $75.00 Application Fee (Annual Renewal Fee is also $75 and due at time of license expiration.) Business Premise Form (Required for all local businesses.) Home Occupation Agreement (Required for all businesses based out of a home in Monument.) Non-Profit Organizations 501(c) organizations must submit copies of their IRS determination letter or other proof of non-profit status. Application fee will be waived for qualified non-profit organizations. Mobile Vendors “Mobile Vendor” is a person or persons selling products or services from, or out of a motorized vehicle or other mobile device, such as a trailer. Mobile Vendors, mobile food carts, kiosks and seasonal uses located outside a permanent structure may require a temporary use permit. Municipal Code 15.16.020 (REQUIRED) All applications for a license pursuant to this title shall be written statements upon forms provided by the Town Clerk's office. In the event any person knowingly makes any false statement or omits any pertinent information on any application, such act or omission shall be grounds for denial of such application or suspension and revocation of any license issued upon the basis of such false statement and shall be grounds for prosecution for perjury. Email List Check this box if you would like to receive emails with Town of Monument news and information. Applicant Affirmation: I, as the applicant, affirm under penalty of perjury, have read and understand the Business License and Application information and checklist. I also affirm that I have not engaged in false or misleading advertising, falsified any business records, or participated in any unlawful business practices in a similar business, nor have I had a similar type business license revoked or suspended in this or any other locality in the twelve (12) months immediately preceding the date of the application. APPLICANT’S SIGNATURE PRINTED NAME DATE ---PAGE BREAK--- (For local businesses located within the Town of Monument, please complete page 2 of the application) Page 1 Business Information (all fields are required) NAME OF BUSINESS TRADE NAME / DBA (if different from Name of Business) BUSINESS LOCATION ADDRESS (No PO Box) CITY STATE ZIP+4 MAILING ADDRESS CITY STATE ZIP+4 OWNER NAME OWNER PHONE OWNER OR BUSINESS EMAIL OWNER’S RESIDENTIAL ADDRESS CITY STATE ZIP+4 FEIN OR EIN (Tax ID COLORADO SALES TAX NUMBER (or write “service industry” if applicable) PLEASE ENTER DETAILED BUSINESS DESCRIPTION: (I.E RESTAURANT, BREWERY, LANDSCAPER, DECK CONSTRUCTION, MOBILE VENDOR ETC.) PLEASE LIST A MANAGING AGENT RESPONSIBLE FOR THE LICENSEE’S COMPLIACE WITH TITLE 5 OF THE MONUMENT MUNICIPAL CODE (REQUIRED): Non-Local Business License Applicant Signature (Business is not located within the town limits.) I, as the applicant, affirm under penalty of perjury, the business, premises, building or land use complies with the requirements of the Town codes or the close of entities having jurisdiction over activities conducted within the Town limit. I, as the applicant, declare under penalty of perjury, that this application has been examined by me; that the statements made herein are made in good faith and, to the best of my knowledge and belief, are true, correct and complete. I further state that I am qualified under Federal or State law to engage in the activity authorized by the license and I have read and understand the Business License Application information and checklist attached to this application. NON-LOCAL BUSINESS APPLICANT’S SIGNATURE PRINTED NAME DATE FOR TOWN USE ONLY Application For One of the Following: (check 1) New Business License ($75 Annual Fee) Renewal of Existing Business License ($75 Annual Fee) Non-profit Organization (Proof of Non-profit Status Required) Address Change for Existing License (No Fee) Supplemental Documents: (check if applicable) Business Premise Form (Required if physically located in Town) Home Occupation Agreement (Required for all home occupations) Local or Non-local Business: (check 1) Non-local Business (Complete page 1) Local Business (Complete page 1 and page 2) Mobile Vendor: (check if applicable) Temporary Use Permit Required (Please contact the Planning Dept.) DATE: LICENSE No. Fee received: CHECK CREDIT CARD CASH RECEIVED BY NAICS CODE ZONING DATE APPROVED: APPROVED BY: Town of Monument Business License Application 645 Beacon Lite Rd., Monument CO 80132 [PHONE REDACTED] www.townofmonument.org * ---PAGE BREAK--- LOCAL BUSINESSES If your business is physically located within the Town of Monument you MUST COMPLETE THIS PAGE Local Business Information (fields one and two required) SPECIFY ITEMS SOLD AND/OR SERVICES PERFORMED: TYPE OF BUSINESS (Check all that apply) Retail Communications Wholesale Medical Manufacturing Mail/Internet Order Service Leasing Construction Restaurant Home Occupation Office Only START DATE OF BUSINESS SQ FT OF BUILDING NUMBER OF EMPLOYEES CURRENT MANAGER’S NAME DO YOU OWN OR LEASE YOUR BUILDING? Own Lease Term of LESSOR NAME LESSOR ADDRESS CITY STATE ZIP Other Locations in Town IF YOU HAVE OTHER BUSINESSES LOCATED IN THE TOWN, COMPLETE THE FOLLOWING: (Use additional sheet if necessary) 1) NAME OF BUSINESS BUSINESS ADDRESS BUSINESS LICENSE NUMBER 2) NAME OF BUSINESS BUSINESS ADDRESS BUSINESS LICENSE NUMBER New Owner IF YOU PURCHASED THE BUSINESS IN WHOLE OR PART, COMPLETE THE FOLLOWING: DATE OF ACQUISITION PRIOR OWNER’S NAME PRIOR LICENSE NUMBER Local Business License Applicant Signature I, as the applicant, affirm under penalty of perjury, the business, premises, building or land use complies with the requirements of the Town codes or the close of entities having jurisdiction over activities conducted within the Town limit. I, as the applicant, declare under penalty of perjury, that this application has been examined by me; that the statements made herein are made in good faith and, to the best of my knowledge and belief, are true, correct and complete. I further state that I am qualified under Federal or State law to engage in the activity authorized by the license and I have read and understand the Business License Application information and checklist attached to this application. LOCAL BUSINESS APPLICANT’S SIGNATURE PRINTED NAME DATE (For HOME-BASED BUSINESSES, please complete the Home Occupation Agreement) Page 2 Local Owner Information (all fields are required) TYPE OF OWNERSHIP Individual Partnership LLP or LLLP LLC Corporation Government Non-Profit Other COMPLETE THE FOLLOWING FOR EACH OWNER, PARTNER, MEMBER, OR OFFICER NOT LISTED ON PAGE 1: (Use additional sheet if necessary) 1) NAME PHONE EMAIL RESIDENTIAL ADDRESS CITY STATE ZIP+4 2) NAME PHONE EMAIL RESIDENTIAL ADDRESS CITY STATE ZIP+4 ---PAGE BREAK--- Home Occupation Agreement Street Address (No PO Box): Business Name: Business Operator: Email: Phone: Nature of Business: (attach separate sheet if needed) Will Hazardous Materials be stored at this location? YES NO Stored Materials Storage Location: A home occupation is a business, profession, occupation or trade conducted entirely within a residential principal or accessory building, which use is accessory, incidental and secondary to the use of the building for dwelling purposes and does not change the essential residential character or appearance of such building or the neighborhood and is compatible with other permitted uses. (Please acknowledge that you have reviewed the below by placing a check mark in each box) □ I have read 17.48.200 Accessory uses; home occupation of the Town of Monument Municipal Code. □ I understand that the following specific uses shall not be permitted as accessory Class I home occupations in residential zone districts: beauty or barber shop; hospital or clinic; long term care facility; restaurant; bed & breakfast; group home; animal hospital or grooming establishment; kennel; medical or dental office; adult-oriented use; vehicle repair servicing, detailing or towing if vehicles are dispatched from the premises, or are brought to the premises, or are parked or stored on the premises or on an adjacent street. □ I understand that the following specific uses shall not be permitted as accessory Class II home occupations in residential zone districts, hospital or clinic, long term care facility, restaurant, bed and breakfast, group home, animal hospital, kennel, medical or dental office, adult-oriented use, or vehicle repair, servicing, detailing or towing if vehicles are dispatched from the premises, or are brought to the premises, or are parked or stored on the premises or on an adjacent street. Professional offices providing services not generating any medical or dental waste, including, but not limited to chiropractor, or massage therapist may be permitted if the business complies with all standards herein and all applicable codes. □ I understand that the Town of Monument has the right of an annual inspection to determine compliance with the applicable home occupation criteria, any conditions of approval, and all applicable municipal, state and federal regulations. □ I understand that in the event of a conflict between the provisions of the Town of Monument’s Municipal Code, Chapter 17.48.200, and applicable covenants, conditions and restrictions of record applicable to the above property, the more restrictive provision(s) shall govern and control. □ I understand and agree that I will apply for and obtain a Business License from the Town of Monument before commencing a home business. By my signature below, and the boxes checked above, I certify that I have read, understand and will comply with the Town’s zoning regulations. Printed Name of Business Owner: Signed Date Return to: Tina Erickson Business License Manager Phone: (719) 884-8047 645 Beacon Lite Rd [EMAIL REDACTED] Monument, Colorado 80132 ---PAGE BREAK--- BUSINESS PREMISE FORM (**PLEASE PRINT CLEARLY AND LEGIBLY) Please return completed form - Attention: Communications Center by : email [EMAIL REDACTED]; fax (719) 391-8917; or mail to: 27 E. Vermijo Ave., Colorado Springs, CO 80903 Date: Business Business Business Days & Hours of operation: Alarm Company & Phone Hazardous materials: Y / N (**If YES please notify your local fire department with the details.) AFTER HOURS CONTACTS 1. Name/position: Home Cell 2. Name/position: Home Cell 3. Name/position: Home Cell **PLEASE KEEP US INFORMED OF ANY CHANGES TO THE ABOVE INFORMATION SO THAT WE CAN BETTER SERVE YOU. THANK YOU