****** PLEASE FILL OUT FORM COMPLETELY. DO NOT LEAVE ANY BLANKS
******
CITY OF ELOY
BUSINESS LICENSE APPLICATION
624 NORTH MAIN STREET
ELOY, AZ 85131
Phone: 520.464.3401 Fax: 520.466.3760
TPT TAX # Register of Contractor # (Roc)
TAX PRIVILEGE TRANSACTION #
PLEASE TYPE OR PRINT LEGIBLY:
Assessor’s Parcel No:
(City Limits Only-License will not be issued without number)
Business Name: _______________________________DBA: _ __
Business Location: City/State/Zip: __
Business Mailing Address: __________
City/State/Zip:
Business
Telephone: Fax:
Email:
____
Date
Business Began: Classification: Individual __ Partnership __
Corporation:
Is
property location of Business owned by the Business: Yes No
If
no,
give
name
and
address
of
Property
Owner:
Previous Owner: Previous
Use:
Are
you proposing new additions/changes to the Structure: Yes No
I Understand that the issuance of a Business License by the City of Eloy does not necessarily mean
that my business has complied with County, State and Federal requirements which may apply to my business.
I Certify that the information contained on this application is true and correct to the best of my
knowledge.
_
SIGNATURE DATE
FOR OFFICE USE ONLY
FEE PAID No Yes Business Name Change $
Date paid: Check # Cash
Annual $
Prorated $
DEPARTMENT
INITIALS
APPROVED
Approved w/ Conditions
DENIED
COMMUNITY
DEVELOPMENT
DIRECTOR
BUILDING OFFICIAL
P.W. DIRECTOR
POLICE CHIEF
CODE ENFORCEMENT
FIRE DISTRICT
FINANCE DIRECTOR
Date received by Finance Department:
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signature
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- 2-
ZONING USE QUESTIONNAIRE
(FOR BUSINESS LICENSE APPLICATIONS)
Consideration of your request for a City of Eloy business license requires the following
information for the Planning and Zoning Division in order to determine the legality of your
proposed use of property:
Business Type:
Please explain in detail what type of work will be done:
Will your business occupy a permanent structure in the City of Eloy? Yes No
If no, please explain the location of the property that will be used for the business:
Is the structure a residence or a commercial or industrial building?
Do you own your business premises? Yes No
If no, provide property owners name, address and phone number and attach a notarized
written consent form or a lease agreement (City Limits Only):
Check one: New Business New Owner - Existing Business
Existing Business - New Location Existing Business - New to Eloy
Existing Business - Lapsed License Existing Business Address Change
Existing Business Additional Business Activity
The issuance of a business license does not grant any rights to violate any provision of the zoning ordinance. There
are very specific limitations on the use of a residence for business activity. Similarly, possession of a business
license for a Mobile business does not confer the right to set on public or private property without the written
consent of the owner in possession. Construction services offered to the public also require a contractors license.
- 3-
CITY OF ELOY
BUSINESS LICENSE INFORMATION
Name of Business Owner/Operator:
Home Address:
City:
State:
Zip:
Telephone: Fax: Email:
Social Security#: Date of Birth:
Drivers License #: State of Issuance:
Height: Weight: Hair: Eyes:
EMERGENCY CONTACT DURING NON-BUSINESS HOURS:
Name: Telephone #:
Address:
*APPLICANT(S) IS (ARE) SUBJECT TO A CRIMINAL HISTORY
BACKGROUND CHECK*
- 4-
CITY OF ELOY POLICE
DEPARTMENT
EMERGENCY RESPONSE LIST
BUSINESS
NAME:
ADDRESS:
BUSINESS
TELEPHONE
NUMBER:
OWNER:
_
HOME
ADDRESS:
PERSONS TO CALL IN ORDER OF PREFERENCE
1.
NAME:
2.
NAME:
3.
NAME:
4.
NAME:
5.
NAME:
PHONE:
PHONE:
__
PHONE:
PHONE:
_
PHONE:
BUILDING
TYPE:
(Masonry),
(Frame),
(Other)
?
ALARM
SYSTEM:
Yes
No
Type?
_
HAZARD
MATERIAL:
Yes
No
OPERATING
HOURS:
-
OPERATING
DAYS:
-
(Revised
9/29/2011)
City of Eloy
Finance Department
628 North Main Street
Eloy, Arizona, 85131
Licensing Eligibility Requirement Form (ARS § 41-1080)
Effective October 1, 2008, a new law went into effect preventing the City from issuing a license (either new or
renewed) to an individual unless the individual has provided the City of Eloy with one of the forms of
identification listed below. If your business is incorporated, provide a certificate of good standing.
To become or remain eligible for a license, complete this form and present one of the forms of identification as
listed below to the City of Eloys Finance Department for processing. Please indicate which form is presented.
An Arizona driver license issued after 1996 or an Arizona non-operating identification
A driver license issued by a state that verifies lawful presence in the United States. (Licenses
from HI, IL, ME, MD, NM, TX, UT and WA are not acceptable.)
A birth certificate or delayed birth certificate issued in any state, territory or possession of the
United States.
A United States certificate of birth abroad.
A United States passport.
A foreign passport with a United States visa.
An I-94 form with a photograph.
An United States citizenship and immigration services employment authorization document or
refugee travel document.
A United States certificate of naturalization.
A United States certificate of citizenship.
A tribal certificate of Indian blood.
A tribal or Bureau of Indian Affairs affidavit of birth.
Corporate certificate of good standing
By my signature below, I hereby certify, under penalty of perjury, that I am legally authorized to be present in
the United States.
Full Signature of Licensee Date
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signature
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Business License Fee Schedule
Business License Description
Proposed
Business
License Fee
General Fixed Business (that maintains a physical location in the City limits)
Other than specified below
$75
General Fixed Business (that do NOT maintain a physical location in the City
limits)
Other than specified below
$75
Daily Business Transaction License
$10
Liquor License:
Series # 6
On-sale retailers licensed to sell all spirituous liquors
$250
Series # 7
On-sale retailers licensed to sell beer and wine
$175
Series # 8
On-sale retailers licensed to sell beer
$150
Series # 9
Off-sale retailers licensed to sell all spirituous liquors
$175
Series # 10 - Off-sale retailers licensed to sell beer and wine
$150
Series # 11 - Off-sale retailers licensed to sell beer
$125
Series # 16
Restaurant retailers licensed to sell all spirituous liquor
$250
Hotel, Apartment, RV Parks, Mobile Home Parks and Rest Homes:
1-10 Units
$50
11-50 Units
$75
Over 50 Units
$100
Wholesalers, manufacturers, and providers of services without a fixed place of
business within the City limits
$75
Pawnbrokers, secondhand dealers, junk dealer or junk collector
$75
Barber Shops/Beauty Operators and owner
$50
Barber/Beauty Operators
Individual
$25
Peddlers and Transient Merchants are defined in this chapter:
Application Fee
$10
Per Day
$25
Each Helper
$5
Per Month in excess of one month
$300
Mobile Vendor
$75 plus
application
fee of $25
Promotors of entertainment, circuses, bazaars, etc., who receive a percentage
of receipts or other consideration for their services. Each such promoter shall
also obtain liability insurance of a minimum of $1 million naming the City as
insured.
$100 per
week
Animal Show
$100 a week
Circus Parade Only
$50 a day
Handbill Distributor
$10 a day
Amusement Company, such as Ferris wheel, merry go-round not part of circus
$175 a day
Wrestling/Boxing/Martial Arts Exhibition
$175 a day
Road Show, Carnival or Circus
$175 a day
Practice of Palmistry, Phrenology, Astrology, Fortune Telling, Mind Reading,
Clairvoyancy, Magic or any healing practices not licensed by the State of
Arizona or any similar calling without a fixed place of business.
$250
Yard Sale
$0
Adult Oriented Business
See Article VII
Medical Marijuana:
Annual Medical Marijuana Business License Application and
Investigation Fee
$500
Annual Medical Marijuana employee License Fee (per employee)
$250
Annual Medical Marijuana Business License Fee
$250
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