It is the business owner's responsibility to notify City Hall immediately if there are any changes to the business entity from the information submitted on this application. Business licenses are paid for the period from July 1st through June 30th. It is the business owner's responsibility to renew the business license each ear by July 1st, whether they receive a renewal form or not.

General Business Information

Business Name (DBA):*

Business Location: (Cannot be P.O. Box)*

Mailing Address (if different than Business location):

Business Phone:*

Email Address:*

Type of Business:*

Date Business Began/Will Begin:*

Description of Business:*

Federal Taxpayer ID#*

Missouri Sales Tax ID#*

Number of Employees (Only if business is located within Pacific City limits):

Full Time:

Part Time:

Type of Business: (Check the one category that best describes the business)*

Construction Manufacturing Finance/Insurance/Real Estate Restaurant/Fast Food Retail Wholesale

Service Salon/Barber Landlord Accommodations and Foodservices Arts/Entertainment/Recreation Other

If other business, please specify:

Legal Name of Owner(s)

Owner's Name:*

Phone Number:*

Home Address/City/ST/Zip:*

Copy of Driver's License*

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Copy of Insurance

(ALL businesses with 1 or more employees are required to supply the City with a Certificate of Liability Insurance)*

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Other Contact Information

Business Manager's Name (if different than owner):

APPLICANT agrees to comply with all applicable code and ordinances of the City of Pacific by typing their name in the box as signature. APPLICANT understands that the issuance of the license creates no legal liability, expressed or implied, on the City of Pacific. APPLICANT certifies the information submitted is accurate. APPLICANT agrees to allow the Building Inspector and Fire Department Personnel full access for compliance inspection during normal business hours. Full payment of permit fees required prior to application processing or inspection (check payable to "City of Pacific").

Failure to comply with any of the above requirements may result in a civil citation and/or fines.*