Fillable License Application Guidelines and Checklist (City of Minneapolis)

Fill Online, Printable, Fillable, Blank License Application Guidelines and Checklist (City of Minneapolis) Form

Use Fill to complete blank online CITY OF MINNEAPOLIS (MN) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

License Application Guidelines and Checklist (City of Minneapolis)

On average this form takes 22 minutes to complete

The License Application Guidelines and Checklist (City of Minneapolis) form is 4 pages long and contains:

  • 0 signatures
  • 23 check-boxes
  • 79 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Minneapolis

BROWSE CITY OF MINNEAPOLIS (MN) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
City of Minneapolis
Licenses and Consumer Services
350 So
uth 5
th
Street – Room 1
Minneapolis, MN 55415–1391
Phone: 612-673-2080
Fax: 612-673-3399 TTY: 612-673-2157
www.minneapolismn.gov/business-licensing
License Application
Guidelines and Checklist
For Office Use Only
Expiration: September 1
License Code: L027
w/ filling station: L026
Rev Code: 311008
MCO: 317
Adm Issuance: Yes
License Type: Motor Vehicle Repair Garage
DEFINITION: A business engaged in the repair of motor vehicles. Repairs include mechanical repairs, service, maintenance,
alterations, diagnostic testing or body work, and/or the addition of equipment, supplies or parts to a motor vehicle.
This license does not apply to businesses that (1) solely providing fuel, checking fluid levels, replacing filters and other
minor services
customarily performed by a gasoline filling station or (2) engaged exclusively in repairing the motor vehicles of its own fleet.
Every motor vehicle garage licensee shall maintain records that include all work orders, estimates, invoices and names of all
customers for whom motor vehicle repairs have been performed for at least two (2) years. A customer has a right to a copy of
documents maintained. All refuse must be stored in a completely enclosed building, trash transport (gondola), or covered cans.
All open off-street parking areas shall be surfaced with a dustless all-weather material capable of carrying a wheel load of four
thousand (4,000) pounds. All open automobile parking areas containing more than four (4) parking spaces shall be effectively
screened on each side by a wall, fence or dense plants. Each motor vehicle repair garage shall give reasonable notice of its policy
on storage charges. Motor vehicle repair garages are prohibited from using the city right-of-way to park, store or repair motor
vehicles including employees’ vehicles.
Staff
Initials
Application Checklist
Submit items below to: Minneapolis Development Review, 250 South 4
th
Street
Room 300 Public Service Center, Minneapolis, MN 55415 - Free Parking
1. License Application (Form #1)
2. Zoning Addendum (Form #2)
3. Certificate of Liability Insurance (Sample Form #3)
a. This must be furnished by your Insurance Agent with the mandatory changes.
b. You are required to have general liability which includes premises and operations insurance and
products and completed operations insurance with the following coverages:
$100,000 per occurrence and $300,000 aggregate for personal injury or death.
$10,000 per occurrence for property damage.
4. SAC Determination Letter – attach copy.
5. __________ Fee plus new license surcharge
This Section To Be Completed by Minneapolis Development Review Coordinator
DC:__________________________________ Temporary Application Number:__________________
Plumbing Permit Mechanical Permit Building Permit SAC Sidewalk Inspection PDR Review __________________
SAC Determination Letter Required: Yes No
Date Sent to EH _________________________________________
EH Staff Initials _________________________________________
Date Sent to EM
PCAB # _______________________________________________
EM Staff Initials ________________________________________
Date Returned to MDR __________________________________
Additional Information
1. Your License Application
a. Incomplete applications will be returned.
b. All applications must be signed by the owner.
c. No license will be issued for a period longer than one year.
d. Licenses are not transferable.
e. Make a duplicate copy of this packet for your personal records before submitting.
f. Minnesota Sales Tax ID Number
or 651-296-6181.
g. If you are applying for multiple licenses, applications may be combined. Talk to Licenses Staff at 300 Public Service Center.
2. Fire Department Approval - Approval of the Fire Department is required before a license will be granted. This will be requested by a License Inspector.
3. Pollution Control Annual Billing/PCAB - A PCAB Number is required before a license will be granted. This will be requested by a License
Inspector. PCAB# ___________________.
4. Hours of Operation – 1 City Hall: Mondays – Thursdays: 8:00 am – 4:00 pm. Fridays: 10:00 am – 4:00 pm.
5. Information in Other Languages: Para asistencia 612-673-2700 - Rau kev pab 612-673-2800 - Hadii aad Caawimaad u baahantahay 612-673-3500.
This document must be stapled and all pages attached to avoid processing errors. Page 1 of 5 - August 2015
1. BACKGROUND INFORMATION
Name of Person filling out this application
(Last, First, Middle)
Starting a new business in a new building. (New Business)
Starting a new business in an existing building. (New Business)
Taking over an existing business (New Owner)
Name of existing business: ___________________________
Adding a new license to an existing business (New License)
MN Sales Tax ID, Social Security, or Individual Tax ID
Number
Legal/Corporate Name of Business
Trade Name(DBA)
Business Telephone
Business Address
City
State
Zip Code
Mailing Address (If different than Business Address)
City
State
Zip Code
Name of Person Filling out the Application
Title
Telephone Number
E-mail Address (Required)
Fax Number
Cell Phone Number
Type of Ownership: Corporation LLC
Sole Proprietor Partnership Non Profit
State of Incorporation
Date of Incorporation
Is this business publicly traded? Yes No
2. PARTNERS, OWNERS, AND CORPORATE MEMBERS
(Attach additional sheets if necessary.)
Full Name: Last, First, Middle
Telephone
Date of Birth
Title/% of Ownership
Home Address
City
State
Zip Code
Full Name: Last, First, Middle
Telephone
Date of Birth
Title/% of Ownership
Home Address
City
State
Zip Code
Full Name: Last, First, Middle
Telephone
Date of Birth
Title/% of Ownership
Home Address
City
State
Zip Code
Have any of the people listed above been convicted of a crime? YES NO
If yes, please provide or attach specific information about dates and conviction.
City of Minneapolis
Licenses and Consumer Services
350 South 5
th
Street – Room 1
Minneapolis, MN 55415–1391
Phone: 612-673-2080
Fax: 612-673-3399 TTY: 612-673-2157
www.minneapolismn.gov/business-licensing
For Office Use Only
License # L
CSR:
Fee: $
License Application
Date:
#1
This document must be stapled and all pages attached to avoid processing errors. Page 2 of 5 - August 2015
3. COMPANY OPERATIONS
Square Footage for Business Use
Hours of Operation
Describe in detail the principal products, types of entertainment, and/or services rendered.
List any licenses you currently have or previously held in Minneapolis (Business or Individual).
Have you ever had a business license denied or revoked by Minneapolis or another government entity? YES NO
If Yes, Indicate the Date of Denial/Revocation, Government Agency, and Reason for Denial or Revocation.
Are you planning or have you completed any construction or
remodeling? YES NO
Name of Contractor or Building Manager
Explain the scope of the remodeling or construction.
4. WORKERS COMPENSATION
Workers’ Compensation Company
Policy Number
Dates of Coverage
OR:
I certify that I am not required to carry workers’ compensation insurance because: I am self-insured. I am the sole
proprietor and I have no employees. I have no employees who are covered by workers’ compensation law. Only
employees who are specifically exempted by statute are not covered by the workers’ compensation law. These include
spouse, parents, and children regardless of age. All other workers whose work is controllable by the employer must be
covered.
5. VEHICLES
Will there be vehicles used in the business? YES NO
Year/Make/Model
Vehicle Company ID #
VIN Number
License Plate # / State
6. VERIFICATION
The data you furnish on this application will be used by the City of Minneapolis to assess your qualifications for licensure.
Disclosure of this information is voluntary. You are not legally required to provide this data; however, if you fail to do so, the
City of Minneapolis may be unable to process this application. Disclosure of your Minnesota Tax ID Number, Social Security
Number, or Individual Tax ID Number is required by Minnesota Statutes 270C.72, and your Social Security number may be
requested by and released to the Minnesota Commissioner of Revenue. After issuance of a license, all information
contained in this application, except your Social Security Number, will be public information pursuant to Minnesota Statutes,
Chapter 13.
A SIGNATURE IS REQUIRED IN ORDER TO PROCESS THIS APPLICATION
I, (print name) __________________________________________________, certify or declare under penalty of perjury under
the laws of the State of Minnesota that the foregoing is true and correct. All information given is subject to verification by
the State of Minnesota. I understand that false information may result in the denial, suspension or revocation of my
business license.
SIGNATURE OF APPLICANT ______________________________________ DATE ___________________________________
This document must be stapled and all pages attached to avoid processing errors. Page 3 of 5 - August 2015
#2
City of Minneapolis
Community Planning & Economic Development
Planning Division
250 South 4
th
St. Room 300
Minneapolis MN 55415-1316
Telephone 612-673-3000 or 311 Fax 612-673-2526
Zoning Addendum
Applicants requesting a business license must be in compliance with all zoning regulations before a license can be approved. Bring this form
to the Development Review Customer Service Center at the above address, or call (612) 673-3000 or 311 to schedule an appointment for a
City Planner to complete the remainder of this application. Approval from the Development Services Division and/or City Planning
Commission may be required
before the Business Licensing Division will accept your application.
z
======================
THIS SECTION IS TO BE COMPLETED BY THE APPLICANT
======================
1. Legal Corporate Name of Business _ Trade Name (DBA) _
2. Proposed Business Address _
3.
Contact
Person
Telephone _
4. Entertainment: Check and describe all categories of entertainment you are planning to provide on your premises.
No entertainment.
Limited Entertainment: Limited to literary readings, storytelling, live solo comedians, electronically reproduced music (TV radio),
karaoke, jukebox, amplified or non-amplified music by five or fewer musicians, and group singing participated in by patrons of the
establishment. No patron dancing. Describe below.
General Entertainment: Other forms of entertainment which do not meet the definition above. Examples include two or more
comedians, bands with amplified musical instruments, patrons dancing, plays, shows, contests, etc. Describe below.
Adult Entertainment: Persons who are unclothed or in attire/costume which exposes any portion of female breasts
and/or male or female genitals (nude or semi-nude). Describe below.
=======================
THIS SECTION IS TO BE COMPLETED BY CITY PLANNER =======================
5. Zoning district: _ Proposed land use(s): _
6. Are there any existing land use approvals for this address which affect this license application? YES NO
If Yes, provide a brief description of any land use history relevant to the proposed licensure.
7.
Comments:
_
_
8. Is an inspection by Zoning Enforcement Staff required? YES NO
====================
THIS SECTION IS TO BE COMPLETED BY ZONING INSPECTOR =====================
9. Is the site in compliance with all existing Conditions of Approval? YES NO If No, List requirements for compliance:
10.
Comments:
CPED Planning Staff Signature DATE _ EXT
_
================== AUTHORIZED HOURS TO BE COMPLETED BY LICENSE INSPECTOR ===================
R, OR, C1, C2, C3S, C4, and I: Sun - Thurs, 6:00 am to 10:00 pm; Fri - Sat, 6:00 am to 11:00 pm.
Downtown and C3A: Sun - Thurs, 6:00 am - 1:00 am; Fri - Sat, 6:00 am - 2:00 am.
This document must be stapled and all pages attached to avoid processing errors. Page 4 of 5 - August 2015
\
City of Minneapolis #
Requirements for Insurance
Certificates
CERTIFICATE OF LIABILITY INSURANCE
Certificate cannot be
pending,
binder or
TBA.
The Legal/Corporate
Name
must match
exactly
(word for word) to
the
Approved Licensee
Name
(including Inc, or
LLC),
Trade Name
(DBA)
and address of
premises.
PRODUCER
Agency
Address
City, State, Zip
INSURED
COVERAGES
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER.
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY
INSR
LTR TYPE OF INSURANCE
POLICY
NUMBER
EFFECTIVE
DATE
(MM/DD/YY)
POLICY
EXPIRATION
DATE (MM/DD/YY) LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $
†
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any $
one
fire)
†
CLAIMS
MADE
†
OCCUR
†
†
MED EXP $
(Any one person)
PERSONAL & ADV $
INJURY
GENERAL $
AGGREGATE
GEN’L AGGREGATE LIMIT APPLIES PER: PRODUCTS – $
COMP/OP AGG
†
POLICY
†
PROJECT
†
LOC
AUTOMOBILE
LIABILITY
†
ANY
AUTO
†
ALL OWNED
AUTOS
COMBINED
SINGLE LIMIT
$
(Ea accident)
BODILY INJURY
†
SCHEDULED
AUTOS
†
HIRED
AUTOS
†
NON – OWNED
AUTOS
†
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
$
†
(Per accident)
GARAGE LIABILITY
AUTO ONLY – (Ea
$
Accident)
OTHER
EA
†
ANY
AUTO
†
THAN
AUTO
ACC $
ONLY:
AGG $
EXCESS LIABILITY EACH OCCURRENCE $
†
OCCUR
†
CLAIMS MADE AGGREGATE $
$
†
DEDUCTIBLE $
†
RETENTION
$
A WORKER’S COMPENSATION AND EM
PLOYER’S LIABILITY
OTHER
X/WC STATUTORY
LIMITS / OTHER
E.L. EACH
ACCIDENT
E.L. DISEASE – EA
EMPLOYEE
E.L. DISEASE –
POLICY LIMIT
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS:
ADDITIONAL INSURED; INSURER LETTER
Original signature or
stamp of Agent.
CERTIFICATE HOLDER
City of Minneapolis
Licenses and Consumer Services
1-C City Hall
350 South 5th Street
Minneapolis, MN 55415
AUTHORIZED REPRESENTATIVE
Applications will be returned if requirements are not complete.
This document must be stapled and all pages attached to avoid processing errors. Page 5 of 5 - August 2015
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

License Application Guidelines and Checklist (City of Minneapolis)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 27 May 2022

Message

View Audit Log
Print With Audit Log
Duplicate Document