CITY OF SPRINGFIELD, MISSOURI
HOME OCCUPATION (HOME-BASED BUSINESS)
QUESTIONNAIRE
HOME Occupation Questionnaire REV 4/2019
BUS LIC/Permit #: __________________________
Date: ___________________
LIC Personnel: _______________________________________
_____________________________________________________
Business Type: _______________________________________
Business Address: ________________________________________________________________________________________________________
Mailing Address: _________________________________________________________________________________________________________
Business Phone: _____________________________________________
E-Mail: _____________________________________________________
Is this business operating at this location now?
If yes, what date did it start? ________________________________________
Type of license requested: _____________________________________
Last type of use at this location: __________________________________
Proposed use at this location
(be specific as to type of services rendered, product sold, delivered, made): _________________________________________
_______________________________________________________________________________________________________________________
PLEASE ANSWER THE FOLLOWING AS THEY RELATE TO YOUR BUSINESS
Is the address listed as yo
ur primary residence? Yes No
Will the function of the home occupation take more than 20% of the total floor area of the home and garage?
Will you sell products in conjunction with your business?
If yes, answer the following:
Are products sold through mail order only?
If no, please explain: ____________________________________________
Will products be made in the home?
Do you use a kiln larger than six (6) cubic feet?
Are the products arts, crafts, or ceramics?
Does the product require millwork, finishing, or refinishing?
Will merchandise be stored on site?
If yes, please specify the length of time products are expected to sit on site: ________
___________________________________________________________________________________________________________________
Will equipment be stored on site?
Yes No
If yes, list equipment: ______________________________________________________
___________________________________________________________________________________________________________________
Does the storage location require one of your cars to regularly park on the street?
Will equipment be stored in the house?
Yes No
If no, please explain: ____________________________________________
Will customers or clients visit the site?
If yes, how many ________________ and how frequently _____________________
Will employees, other than residents of the home, work on site?
Will a vehicle used in the operation of the business be stored at your residence?
If yes, answer the following:
Is the vehicle your personal vehicle?
Is there advertising on the vehicle?
Is the vehicle gross weight more than 19,500lbs or any single unit more than one drive axle?
I have received, read, and understood the “Home Occupations-Guidelines and Use Limitations.” I will abide by all such regulations and understand
that a violation of these limitations is justification for revoking my license and for prosecution for a zone violation.
Signature of Applicant: _____________________________________________________
Date: _________________________________________
Planning Personnel: ____________________ Date: _______________ BDS Personnel: ____________________ Date: _______________
Comments: ____________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
Proposed location is zoned: _________________________________
For Residential Zones, the use is:
Approved (for mailing address & phone use and must be stated on business license)
Building Development Services
Plans, Construction Permits, New Certificate of Occupancy
may be required. Please contact the project facilitator for additional
information at 417-864-1079 or iusukumah@springfieldmo.gov
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