Davidson County Clerk
Business Tax Division
D
ATE
_________________
VENDOR PERMIT _________________
BUSINESS NUMBER _________________
RECEIPT NUMBER _________________
EXPIRATION DATE _________________
APPLICATION FOR SIDEWALK ENCROACHMENT PERMIT
T
he following documents are needed prior to submitting this application:
1
. A
copy of the insurance policy showing comprehensive general liability coverage not less than $1,000,000.
**Metropolitan Government must
be listed on the certificate as an additional insured.**
2. A copy of the driver’s license and three full-face photographs of the owner/vendor operating the stand.
3. A copy of the driver’s license and three full-face photographs of each employee operating the stand.
4. A copy of the health permit (if applicable).
5
. A
photograph of the vendor’s stand.
BUSINESS INFORMATION
____________________________________________________
Give brief description of products sold
Name (Give advertised business name) or services performed. *Note-Food &
Beverage vendors must have Health
____________________________________________________ Permit from local Health Dept.
Mailing Address
_________________________________________
____________________________________________________
City State Zip _________________________________________
_________________ ___________________________ _________________________________________
Business Telephone Number Email Approximate expected location of cart
TYPE OF BUSINESS
T
ype of Ownership:
Proprietorship
Partnership
Corporation (Name) __________________________
_______________________________________________ ____________________________________________
Contact Agent for Vending Stands Phone Date Sidewalk Vending Begins/Ends (If Temporary)
` 10 Day Period Max, Max 10 permits per year.
OWNERSHIP INFORMATION
I
dentify owners, officers, and/or partners (attach extra sheet if necessary)
___________________________________________________ _____________________ ________________________
(1) Name Title Home Phone Driver’s License Number
___________________________________________________ _____________________ ________________________
Street Address City State Zip
___________________________________________________ _____________________ ________________________
(2) Name Title Home Phone Driver’s License Number
_____________________
______________________________ _____________________ ________________________
Street Address City State Zip
EMPLOYEES
_______________________________________________ ____________________________________________
N
ame Phone Name Phone
_______________________________________________ ____________________________________________
Name Phone Name Phone
SIGNATURES
Signature of Owners or Corporate Officer (All owners must sign)
___________________________________________________
__________________________________________________
___________________________________________________ __________________________________________________
Mail to: Davidson County Clerk, Business Tax Division
Make remittance payable to “Davidso
n County
Clerk” Please call (615) 862-6254 with questions.
P.O. Box
196333, Nashville TN 37219-6333
