Date Submitted: ______________
Date Approved: ______________
License #: __________________
Period: _____________________
In-Town Business License Application
1. Type of Application
App Type (check one) Business Type (check one) Ownership Type (check one) Other (check all that apply)
New Business Store Front Corporation LLC Retail sales
Ownership change Home business Partnership LLP Food prep/sales
Name change Other Not for profit Other Alcohol sales/service
Location change Sole Proprietorship Fireworks sales/displays
Renewal General Contractor
Other Contractor
Other (not listed above)
2. Business information
Fictitious Name (DBA): _______________________________________________________________________
Legal/Corporation Name: _____________________________________________________________________
Missouri State Sales Tax #: __________________ Website: ____________________________________
Business Address (no PO’s): __________________________________________________________________
City/State/Zip: ______________________________________________________________________________
Business Phone: ___________________________________ Business Fax: __________________________
Mailing Address (if different from above): ________________________________________________________
City/State/Zip: _______________________________________ Email: ________________________________
Type of business: ________________________________________________ __________________________
3. Business owner information (if more than one owner additional information to be attached)
Name of sole owner, primary partner, or president: ____________________________ Title: _______________
Address (if different from above): _________________________________ Phone: _____________________
City/State/Zip: ________________________________________________ Email: ______________________
Alternative Contact: ___________________________________________ Phone: _____________________
4. Property owner information (if different from business owner)
Fictitious Name (DBA): _______________________________________________________________________
Legal/Corporation Name: _____________________________________________________________________
Name of owner/primary partner/president: __________________________ Title: _______________________
Address: ____________________________________________________ Phone: _____________________
City/State/Zip: ________________________________________________ Email: ______________________
5. Affidavits (complete only those that apply)
City taxes & fees paid in full: Parkville Municipal Code Section 605.120 requires payment of all applicable City
taxes (sales, property, & others) and fees related to a business prior to issuance of a license or renewal.
I certify by signature below that all taxes and fees owed the City of Parkville by this business are paid in full.
Signature ___________________________________________________ Date: _______________________
Missouri State sales taxes paid in full (business with sales tax only): Beginning January 1, 2009 all
businesses requiring a Missouri State sales tax license must demonstrate that no State sales taxes are due at
the time of application. Proof of no taxes due must also be attached.
I certify by signature below that all Missouri State sales taxes owed by this business are paid in full.
Signature ___________________________________________________ Date: _______________________
Workers compensation (construction only): State law requires all construction industry businesses to
provide a certificate of insurance for Workers’ Compensation Coverage, unless specifically exempt. Although
the City does not require proof for non-construction businesses, check with the Missouri Department of Labor for
other requirements.
I certify by signature below that the above business is adequately insured a copy of which is attached.
I certify by signature below that the above business is exempt from the Missouri Workers’ Compensation Law
(must include signed affidavit of exemption).
Signature ___________________________________________________ Date: _______________________
Date Submitted: ______________
Date Approved: ______________
License #: __________________
Period: _____________________
6. Checklist of submittals required at time of application
For more information about the requirements below, visit
Completed application License fee Signature of business and property owners
Fictitious Name/DBA Legal Name Business Personal Property Taxes Paid
(doing business under name other than legal name; (sole proprietors exempt) *Renewals only; new applicants see New Businesses
sole proprietors doing business under name other than personal)
NEW BUSINESSES (or businesses with change in ownership or location):
City of Parkville Certificate of Occupancy (inspections)
Southern Platte Fire Protection District Certification of Occupancy (inspections)
Emergency Contact Information Form (given to Police Department to have on file in case of emergency)
Waiver showing business personal property registered with Platte County Assessor’s Office
RETAIL SALES (for all businesses where goods are sold at retail):
Missouri Tax ID number and No Tax Due Statement (for Parkville address)
Platte County Merchants License
Affidavit to Make Retail Sales (only required if in process of obtaining MO tax ID number, but do not have it at time of application)
FOOD SALES (all businesses preparing/selling perishable foods):
Platte County Health Department Permit
Platte County Merchants License
Missouri Tax ID number and No Tax Due Statement (for Parkville address)
Affidavit to Make Retail Sales (only required if in process of obtaining MO tax ID number and do not have at time of application)
Completed and signed Home-based Compliance Affidavit
Waiver for business personal property tax payment from Platte County Assessor’s Office
Copy of current worker’s compensation coverage or affidavit of no coverage (required by RSMo 287.061)
Copy of electricians license(s) for any business providing electrical contracting services (license from metro)
Other Applications required separate from business / occupational license (as applicable)
Liquor license (contact City Clerk; must be approved by Board of Aldermen)
Peddlers, solicitors and canvassers permits and identification cards (contact City Clerk)
Sign and temporary sign permit(s) (contact Community Development/CD)
Temporary event permit (contact CD)
Site plan, plat, building permit, and all other use or construction approvals prior to issuance (contact CD)
7. Acknowledgements and authorization signatures (both signatures required)
I, the undersigned, do hereby authorize submittal of this application and associated documents and certify and affirm by my
signature all information I have provided herein is true and correct. I do hereby agree to comply with all applicable Parkville
Municipal Codes and conditions of approval. I further understand that any violations from the provisions of said codes or
conditions of approval shall constitute cause for the retraction of this permit, and enforcement and penalties as prescribed by
the Parkville Municipal Code shall be applied. I understand that this application is non-transferable and that changes, may
require submittal of a new application. I understand that in any case this application must be renewed annually.
Business owner (printed name) _________________________________________ Title: _______________
Signature ___________________________________________________________ Date: _______________
Property owner (printed name) _________________________________________ Title: _______________
Signature ___________________________________________________________ Date: _______________
By signing as the property owner, you are confirming the business has been authorized to use your property.
For City Use Only
License Fee $_____________ Date paid: _____________ By: Check # _________ MO# ________
Received by: _____________________________________ Credit Card Cash
Conditions (if any): __________________________________________________________________________
Application accepted as complete by: ______________________________________ Date: ________________