Business License #
Sewer Dept.
Building Dept.
Planning/Zoning
CIT
Y OF OSAGE BEACH
BUSINESS/MERCHANT LICENSE APPLICATION
Business Name Business Phone #
Pl
ease Indicate Ownership Status: [ ] Individual [ ] Partnership [ ] Corporation [ ]LLC
Business Street Address/Location
Business Mailing Address City State Zip
E-Mail: Website:
Owner Name Owner Phone #
Owner Mailing Address City State Zip
Name of Manager/Emergency Contact Person Emergency Phone #
Ty
pe of Business: [ ] Entertainment [ ] Healthcare [ ] Retail
[ ] Financial Services [ ] Massage [ ] Service
[ ] Food Sales / Service [ ] Real Estate [ ] Solicitor
[ ] Gas / Convenience
Please Describe Business in Detail
May the City of Osage Beach make available to the public any/all information provided on this application? [ ] Yes
[ ] No
Missouri Retail Sales Tax Identification # Federal Tax Identification #
Applicant Signature Date
**** Al
l Business Licenses Expire on April 30 ****