License Application - General Business

2. License Application - General Business
   $50 Annual Fee

   $50 Annual Fee

4. Application Date*
   Application Date

5. Application Type*

   1. New

   1. Renewal

6. License Number

10. Business Information

12. Business Name*

14. Business Address*

16. City*

17. State*

18. Zip Code*

20. Mailing Address*

22. City*

23. State*

24. Zip Code*

26. Business Phone Number*

27. Business Fax Number

29. Business Email Address

33. Corporation, Partnership, or Franchise
    For businesses affiliated with a corporation, partnership, or franchise whose main office is located outside of Bel Aire, please fill out the complete information for the affiliation as well.

    For businesses affiliated with a corporation, partnership, or franchise whose main office is located outside of Bel Aire, please fill out the complete information for the affiliation as well.

35. Business Name

37. Business Address

39. City

40. State

41. Zip Code

43. Phone Number

44. Fax Number

48. Business Owner Information

50. Name*

52. Address*

54. City*

55. State*

56. Zip Code*

58. Home Phone Number*

59. Cellular Phone Number*

61. Additional Business Owner

63. Name

65. Address

67. City

68. State

69. Zip Code

71. Home Phone Number

72. Cellular Phone Number

74. 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.

78. Emergency Contact
    This information will be used by the Police Department in the event of an emergency.

    This information will be used by the Police Department in the event of an emergency.

80. Same as Business Owner*

    1. Yes

    1. No

82. Contact Name

    If you selected no, please add an emergency contact.

83. Home Phone Number

84. Cellular Phone Number

88. Description of Business

90. Days of Operation*

91. Hours of Operation*
    Hours of Operation Start Time

    —

    Hours of Operation End Time

93. Total Number of Employees*

94. Tax Identification Number*

96. Brief Description of Business Activities*

98. Food Handlers License Certification

    Restaurant Owners/managers, attach document certifying that all employee have current food handlers' certifications issued by the Wichita/Sedgwick County Health Department.

99. Combustible Substances List

    If applicable, attach a list of any combustible substances which are used or kept on the premises.

101. Business Impact on Surrounding Area

     The business may cause a direct or indirect increase in the following (check all that apply):

     1. Lighting

     1. Noise

     1. Odor

     1. Vehicle/ Pedestrian Traffic
105. Business Chamber Information

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

     1. Yes

     1. No
109. Electronic Signature*

110. Date*
     Date

114. Date Received
     Date Received

115. Receipt Number

117. City Zoning Administrator recommendation:

     1. Approve
     2. Reject

118. Reviewed by City Zoning Administrator, Signature & Date:

120. Chief of Police recommendation:

     1. Approve
     2. Reject

121. Reviewed by Chief of Police, Signature & Date:

123. Reject: Reason for Rejection

125. Issue: Assigned License Number

126. Date Issued
     Date Issued

Leave This Blank:


128. 1. Receive an email copy of this form.
129. Email address

     This field is not part of the form submission.

130. Submit

* indicates a required field