BUSINESS LICENSE APPLICATION City of Bozeman Account #_____________________________ STIFF BUILDING 20 East Olive Street, Bozeman, Montana 59715 (406) 582-226 NAICS #_____________________________ License valid only for the location and use of property listed below NEW BUSINESS CHANGE OF BUSINESS LOCATION (12.02.070) TRANSFER OF OWNERSHIP (12.02.080 Except Medical Marijuana) RENEWAL %86,1(66NAME CHANGE MEDICAL MARIJUANA BUSINESS NAME PHYSICAL BUSINESS ADDRESS STREET CITY ST ZIP MAILING ADDRESS STREET CITY ST ZIP BUS. TELEPHONE EMAIL ADDRESS ZONING DISTRICT OWNER FULL LEGAL NAME PRIMARY TELEPHONE SECONDARY PHONE CO- OWNER OR MANAGER FULL LEGAL NAME PRIMARY TELEPHONE SECONDARY PHONE Please provide a detailed description of the proposed business: HOME-BASED LOCATION - $50.00 2872)&,7</,0,76LOCATION - $50.00 COMMERCIAL LOCATION - $50.00 (Copy of Driver's License Required with Application) What is current use of property: ________________________________________________________________________________ Will there be any of the following changes? NO YES IF YES, YOU WILL NEED PLEASE COMPLETE NO YES Construction Changes Building Permit Fire Suppression Electrical Changes Electrical Permit Security Alarm Mechanical Changes Mechanical Permit Monitored By: __________________________ Plumbing Changes Plumbing Permit # of Full Time Employees ________________ New or Relocated Signs Sign Permit # of Part Time Employees ________________ IF COMMERCIAL Emergency Contact: __________________________________ Phone: ___________________ Email: ______________________________ Other Emergency Information: _________________________________________________________________________________________ This application is made subject to the terms of the Bozeman Municipal Code. I understand the license issued hereunder is NOT TRANSFERABLE, except as provided in Chapter 12.02 BMC, and that the information I have supplied is correct to the best of my knowledge. Signature Date FOR OFFICE USE ONLY Zoning Occupancy Construction Type APPROVED REJECTED DATE COMMENTS: Building Engineering Fire Police Planning __________ - Make Checks Payable to: City of Bozeman - .