197 East Tabernacle, St. George, Utah 84770
Name of Business (Name must be registered with the State of Utah) |
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Business Address |
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Mailing Address |
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Type of Organization: |
# of part time ____ and full time ____ employees? |
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Detailed Description of Business: |
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Proprietorship ( ) |
Corporation ( ) |
Partnership ( ) |
LLC ( ) |
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Type of Chemicals Used: |
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Business Owner |
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Email Address: |
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Phone: (____)____________ |
Name: |
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SSN# / Fed Tax # |
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State Sales Tax # |
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State License # |
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' Q $10.00 Application Processing Fee |
' Q$75.00 Building Inspection Fee |
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PLEASE TAKE NOTICE that under Ordinance No. 2011-1014-O, all businesses |
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that receive a business license from Washington County must participate in the |
This form is an application for a business license. The receipt for payment of |
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E-Verify program to verify the employment authorization of any newly hired |
license fees thereof does not constitute being approved to operate a business. |
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employees. By submitting a signed application, the applicant certifies that (1) the |
The actual license will be issued only when all inspections are completed and |
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business has used E-Verify to verify the employment authorization for all |
signed off by the various County departments and the Business License |
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employees hired after December 17, 2011, and (2) the business will use E-Verify |
Office gives approval. Washington County shall not be held responsible for |
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to verify the employment authorization of each newly hired employee no later |
delays in processing an incomplete application, or for property improvements |
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than three days after the employee is hired. Additionally, an applicant is required |
and other business expenditures occurring before the license applicant |
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to re-affirm its use of E-Verify annually on its business license renewal |
receives final approval. |
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application. |
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Annual License Fees are as Follows: |
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1/We hereby agree to conduct said business strictly in accordance with the |
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' Q $50.00 |
Standard Business License |
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Laws and Ordinances covering such business, and swear under penalty of law |
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' Q$500.00 |
Beer License |
A {a package}(CA, SA, AA) |
that the information contained herein is true to the best of my knowledge. |
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' Q$500.00 |
Beer License |
B {be consumed}(CA, SA, AA) |
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' Q $10.00 |
Ea. Full Time employee |
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X____________________________________________ |
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' Q $ 5.00 |
Ea. Part Time employee |
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Signature |
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License Fee $______________ |
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PLEASE NOTE: (72 hrs. required for processing) |
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(CA = County Commission Approval Required, SA = Sheriff Approval |
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Required, AA = County Attorney Approval Required) |
1. Business Licenses expire annually on December 31. |
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If Applicable: |
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2. License renewal fees are due on or before January 31. |
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County Commission ________________________ Date: __________ |
3. A late fee of $10.00 after January 31. |
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' QCounty Attorney / County Sheriff Certificate attached if applicable. |
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OFFICE USE ONLY |
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BUSINESS LICENSE DEPARTMENT USE ONLY |
Zone: _____________________________________ Home Office Only ( |
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County License # ________________________ Clerk _____________ |
Home Occupation Permit: |
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Notes: |
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___________________________________________ Home Occupation ( |
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Building Inspection: ______________________________ Date: __________ |
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Building Officials Signature |
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Health Department: (Report)_______________________ Date: __________ |
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Planner s Initials |
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Other Requirements:_____________________________________________ |
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' QApproved by County Planner ____________________ Date: __________ |
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DATE RECEIVED ___________________________________ |
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