CITY OF GLEN DALE APPLICATION FOR CITY LICENSE FOR THE FISCAL YEAR 2010-2011

NAME OF BUSINESS TO BE LICENSED:_______________________________________________________________________________

ADDRESS OF BUSINESS:___________________________________________________________________________________________

CITY ________________________________________________ STATE ____________ ZIP __________________________

WV Business Registration Account Number: ________________________                 Submit copy of Business Registration Certificate

* WV State Contractors Number: _________________________________                 Submit copy of WV Contractors License Certificate

TELEPHONE: (_______) _________________ 

NO CITY LICENSE CAN BEE ISSUED UNLESS YOU PROVIDE A COPY OF YOUR WEST VIRGINIA BUSINESS REGISTRATION CERTIFICATE

  Units Fees Amount
Attorney, Optometrist, Veterinarian, Chiropodist, Architect   $ 5.50  
Auctions   $ 15.50  
Beer (Dispenser)   $ 100.00  
Beer (Package)   $ 50.00  
Billiard or Pool Table First One   $ 25.50  
Billiard or Pool Table Each Additional One   $ 15.50  
Bowling Alley First One   $ 25.50  
Bowling Alley Each Additional One   $ 15.50  
Car Wash   $ 15.50  
Cigarette Machine   $ 12.50  
Contractor * Submit copy of WV Contractors License   $ 15.50  
General Business License   $ 15.50  
Juke Box   $ 12.50  
Itinerant Vendors   $ 500.50  
Itinerant Wholesalers   $ 50.50  
Physicians, Surgeons, Podiatrist, Engineer, Chiropractor   $ 15.50  
Osteopath Physician   $ 10.50  
Private Club Licensed by State, Private Club   $ 500.50  
Pinball Machines   $ 12.50  
Photographers   $ 10.50  
Pop Machines   $ 12.50  
Real Estate   $ 15.50  
Video Machine   $ 12.50  
Wine   $ 150.50  

Total

     

Late fee is 10% of regular fee for each month or fraction of a month of default (709.99). You can be fined up to $500.00 for failure to display or have a current city license (705.19; 705.99)

CITY LICENSE NUMBER : _____________________________   DATE OF PAYMENT: ____________________________________________________________

SIGNATURE OF APPLICANT:___________________________________________________   Date: ______________________________________________

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 [City of Glen Dale, WV].