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Business License Application Information/Instructions Thank you for choosing (City of Republic, Missouri)

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REPUBLIC BUILDS DEPARTMENT
204 North Main
Republic, Missouri 65738-1472
Phone: (417) 732-3150 Fax: (417) 732-3199
licensing@republicmo.com
Revised 12-15-2020
Business License Application
Information/Instructions
Thank you for choosing to do business in the City of Republic. Below is a checklist of steps to help expedite
your application.
***PLEASE NOTE*** According to City Ordinance, it is unlawful to operate a business before receiving
your Business License. Please allow two weeks for processing. A business license number will be assigned
when the application is turned in; however, the number is only a tracking device and not valid until you
have received your certificate.
Please fill out the attached Business License Application and return to the BUILDS
Department with payment.
If you will be operating the business out of your home, please fill out the Home Based Business
Questionnaire.
If you will be operating any type of construction business, you must provide a copy of your
Worker’s Compensation Liability Certificate, listing the City of Republic as a “Certificate
Holder”, or fill out the MO Worker’s Compensation Exemption Form. The Exemption Form
must also be notarized.
If you collect any sales tax, you must provide your Missouri Tax Identification Number and
submit a “No Tax Due” statement issued within 90 days of the application date.
If you provide any food services, you must contact the Greene County Health Department at
(417) 864-1017 as soon as possible. A copy of the building plans should also be submitted. A
permit may be required.
If you will be doing any remodeling to your business location, you must first apply for a
building permit with the BUILDS Department.
If you will have a sign for your business, please contact the BUILDS Department for a sign
permit.
If you have a physical location inside the Republic city limits and are applying for a new
commercial business, you must apply for a Commercial Change of Occupancy permit with the
BUILDS Department.
If you have any questions regarding any of the listed procedures,
please contact the BUILDS Department.
REPUBLIC BUILDS DEPARTMENT
204 North Main
Republic, Missouri 65738-1472
Phone: (417) 732-3150 Fax: (417) 732-3199
licensing@republicmo.com
Republic Business License Fees
(Please contact the BUILDS Department for details)
Regular Business License (expires December 31
st
)
Pro-rated after September 30
th
(expires December 31
st
)
$100.00
$25.00
Banks and Manufacturing
(expires December 31
st
)
$100.00
Home-based Business – other restrictions apply
(Located inside Republic City Limits)
(expires December 31
st
)
$25.00
Itinerant Merchant (includes Mobile Food
Vendors)
(expires December 31
st
)
Fee based upon size/weight of vehicle
Capacity of ½ ton or less
Capacity of ½ ton not exceeding 1 ½ ton
Capacity of over 1 ½ ton
$40.00 or
fraction
$60.00 or
fraction
$100.00 or
fraction
Apartment Houses, Hotels and Motels
($50 for first unit, $1 for each addition unit)
(expires December 31
st
)
$100.00 +
Temporary Seasonal License
(for period not to exceed 90 days)
Cannot be renewed.
$25.00
Solicitors License – other restrictions apply
Calendar Year (expires December 31
st
)
or Temporary for 90 days
$100.00
$50.00
Relocation (Change of Address Form)
$10.00
REPUBLIC BUILDS DEPARTMENT
204 North Main
Republic, Missouri 65738-1472
Phone: (417) 732-3150 Fax: (417) 732-3199
licensing@republicmo.com
Republic Business License Application
Please answer all questions completely.
Incomplete and unsigned applications will delay processing.
All business licenses expire on December 31
st
and must be renewed prior to that date.
Date: ____________________________
A
Reason for Applying
New Business License Reinstating Old Business
Purchase of Existing Business Other:
B
Business Name and Physical Location
1. Business Name (DBA Name)
2. Physical Location – Street (Do not use PO Box or Rural Route Number)
City
Zip Code
3. Business Telephone Number
If applicable, list the name of your business Facebook page
Facebook.com/ _________________________________________________
4. Describe the business activity, stating the major products sold and service provided.
Retail ____________________________ Service ____________________________
Wholesale ________________________ Manufacturer ______________________
Other ____________________________ Contractor _________________________
C
Business Activity
5. Do you offer retail sales of the following items? Select all that apply.
Alcoholic Beverages Alternative Nicotine Cigarettes or Other Tobacco
Precious Stones Gold/Silver E-Cigarettes or Vapor Products
Business License Application
licensing@republicmo.com
Page 2 of 5
Revised 12-15-2020
D
Ownership Type
6. Ownership Type:
Sole Proprietor Partnership Government Trust
All ownership types listed below, unless specifically exempted, are required to be registered with
the Missouri Secretary of State’s Office. A copy of your registration is to be included with this
application. For more information regarding registering your business, visit the Secretary of
State’s website at www.sos.mo.gov.
Limited Partnership Limited Liability Partnership Limited Liability Company
Missouri Corporation Non-Missouri Corporation
E
Owner Information
7. Owner Name (Enter Corporation, LLC or Partnership Name, if applicable).
Address
E-mail Address
City
State
Zip Code
County
If an individual is listed as the owner, you must also provide the following:
Date of birth (MM/DD/YY)
Telephone Number
F
Mailing Address (Forms, Licenses and Notices will be mailed to this address)
8. Address (street, rural route or PO Box)
City
State
Zip Code
G
Officer, Partner or Member
9. Provide the officer, partner or member of your business who will be responsible for the
purchase of the Business License.
Name (Last, First, Middle Initial)
Title
Home Address
City
Business License Application
licensing@republicmo.com
Page 3 of 5
Revised 12-15-2020
State
Zip Code
County
Date of Birth
(MM/DD/YY)
H
Retail Sales (Sales Tax Requirement)
10. Are required to collect and/or pay sales tax within the City of Republic? If so, you are
required to have a Sales Tax ID Number issued by the State of Missouri. If yes, please attach a
copy of your Missouri No Tax Due Statement issued within the last 3 months from the Missouri
Department of Revenue. For more information, visit www.dor.mo.gov.
Yes No My business sales tax ID# is:________________________________
I
Contractors and Subcontractors
11. Per RSMo. 287.061 - If you are a Contractor or Subcontractor, you are required to provide a
copy of your Workers’ Compensation Insurance Certificate
listing the City of Republic as a
“Certificate Holder”. If you are exempt by the Missouri State guidelines, you will be required to
fill out the Missouri Exemption Form WC-134 (Please ask our office for a copy).
If you are a Subcontractor, please list the Contractor you will be working for:
J
Home Based Businesses (Located inside the city limits of Republic)
12. If your business is operated in your home and is located inside the city limits of Republic,
please fill out the “Home Based Business Questionnaire” (Please ask our office for a copy).
K
Zoning Requirements
13. If you have a physical location inside the city limits and are applying for a commercial business
license, please contact the Community Development Department at 417-732-3150 for a Change
of Occupancy Permit.
14. City Ordinance #05-72 requires your business provide designated handicapped parking
spaces at your place of business and you must show compliance when applying for a business
license (Please attach a picture of your handicapped parking spaces and sign).
15. Do you plan to make any changes to the building or property associated with the business?
Yes No
If you plan to make changes, you will need to contact the Community Development Department
prior to approval of your business license.
16. If you will be building a fence or adding an accessory building to the premise, please contact
the Community Development Department for the necessary permits.
Business License Application
licensing@republicmo.com
Page 4 of 5
Revised 12-15-2020
For review and signature.
Under penalties of perjury, I declare the above information and any attached supplements are
true, complete and correct. I understand that filing false information may result in the closing
of my business. This application must be signed by the owner, if t
he business is a sole
proprietorship, or by an individual listed in the Officer, Partners, or Members section of this
application. The signing party is acknowledging they have direct supervision or control over the
business license.
State and/or
Federal law provisions regulate the presence of aliens in the United States. I
understand that pursuant to 2008 Missouri House Bill 1549 certain public benefits are
prohibited by law from being provided to aliens unlawfully present in the United States and
that I do not and will not knowingly employ a person who is an unauthorized alien in
connection with the business for which the permit or license has been or is being obtained and
assert the obtaining of the permit or license will not violate the prohibition on providing certain
public benefits for aliens unlawfully present in the United States as set forth in H.B.
1549. Should I become aware, after issuance of the permit or license and during the term of
the permit or license that the business is in violation of H.B. 1549, I will immediately notify the
City of the violation. I understand failure to do so may result in denial/revocation/suspension
of the permit or license. After notification of the violation is provided to the City, the business
shall immediately advise the City of steps being taken to correct the violation. Failure to timely
correct the violation may result in denial/revocation/suspension of the permit or license.
L
Employees
17. Total number of employees you anticipate will be working for your business?
Full Time (Including yourself) _________________________
Part-Time (Including yourself) ________________________
M
Food and/or Beverages
18. If you will be selling food and/or beverages, an inspection may be required from the Greene
County Health Department prior to approval of your business license. For more information,
contact the Health Department at (417) 864-1017.
Does your business sell food and/or beverages? Yes No
Have you contacted the Greene County Health Department? Yes No
Business License Application
licensing@republicmo.com
Page 5 of 5
Revised 12-15-2020
I understand that I am not to conduct business until my application has been approved and my
business license has been received.
Signature of Applicant
Title
Date
(MM/DD/YY)
Printed Name
E-Mail Address
Mail to: Republic BUILDS Department
Public Works & Community Development
204 North Main Street
Republic, MO 65738
Phone: (417) 732-3150
Fax: (417) 732-3199
E-mail: licensing@republicmo.com
click to sign
signature
click to edit
Revised 12/29/2020
City of Republic Business License #:
Application Date:
Permit No:
Site Information
Site Address:
Legal
Description
(office use only)
PIN:
Lot Number:
Subdivision:
Zoning:
Owner Information
Name:
Address:
City:
State:
Email Address:
Phone Number:
Zip:
Design Professional
in Charge
Name (Contact Person):
Name (Company):
Address:
City:
State:
Email Address:
Phone Number:
Zip:
Other Design Official
Name (Contact Person):
Name (Company):
Address:
City:
State:
Email Address:
Phone Number:
Zip:
Project Information
(please mark descriptions
appropriate to the project)
Whitebox Infill
Remodel
Use Group(s):
Construction Type(s):
Number of dwelling units to be
included in finished project (if applicable):
Total Square Footage(s):
Project Description:
By signing this application form, I hereby acknowledge that the information I have provided is complete and accurate to the best of my
knowledge. Furthermore, I acknowledge my responsibility to conform to the applicable federal, state and local regulations pertaining to
the project described by this application and attachments. I also understand that this application will expire within 180 days of the date of
my signing, unless extended in writing by the Building Official.
Date
Name (please print)
Signature
BUILDS Department
Phone: (417) 732-3150
Email: permits@republicmo.com
Building Permit Application
Change of Occupancy
New Occupation
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Completed 28 May 2021

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