Revised 4/2013
CITY OF PORTAGE
JUNK DEALER LICENSE APPLICATION
License Fee: $25.00 plus $5.00 for each
additional storage building, yard or premises
Receipt #:_____________
To the Clerk of the City of Portage: Application is hereby made for a license for junk dealer.
Name:_________________________________________________
Address:_______________________________________________
Phone Number__________________________________________
The undersigned agrees to comply with and be bound by all the laws, ordinances, rules, regulations and penalties
covering the business for which the license is applied. The license expires on June 30, ______.
Date:_________________________ _____________________________________
(Signature of Applicant)
For Office Use Only
Department Approval:
Department
Approval
Denied
Signature/Date
City Clerk
Fire Chief
Police Chief
If denied, explain reason: ____________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
E-mail address__________________________________________
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