Commercial Occupancy

Business License Status

What would you like to do today:	---
Is this a:	---
If you are are applying for a Prescott Valley local license, please select which Series you are applying for	---

Business Name and Physical Location

Business name or Trade Name	Quailwood Greens Golf Course
Nature of Ownership	---
Business Street Address (Physical location of the business (cannot be a PO Box)	12625 E VILLAGE CREEK BLVD
is the business location:	---
Mailing Address (Street name and number only)	3350 N MOUNTAIN VIEW DR
Mailing Address City, State, & Zip Code	PRESCOTT VALLEY AZ 86314
Business Phone Number	+19287720130
Alternate # (Emergency Phone Number)	---
Number of Employees	---
Please choose the most applicable to your business:	---
Please read carefully through the following list and choose the closest description of your business:	AMUSEMENTS
Business Description (Please describe in detail the nature of the business)	---
Will your business be selling or serving alcohol?	---
Start of business date	---
Locations where the business or applicant has operated during the last 5 years:	---

Applicant Information (Must be completed by the person filling out this application)

Name (First and Last)	---
Home Address (No PO Boxes)	---
Phone number	---
Driver's License Number	---
Driver's License Expiration Date	---
Date of Birth	---
Social Security Number (Last four (4) digits ONLY)	---

LLC Ownership Information

State in which the LLC was legally established	---
1. Name (First and Last)	---
Title	---
Home Street Address (Cannot be a PO Box)	---
Telephone Number	---
2. Name (First and Last)	---
Title	---
Home Street Address (cannot be a PO Box)	---
Telephone Number	---

Federal Tax ID or Social Security Number

Please enter your Federal Tax ID Number

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Transaction Privilege Tax (TPT) - Sales Tax

Please enter your Transaction Privilege Tax (TPT) Number

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Professional Licenses

Professional License or Permit Number & Description

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Liquor License Information

Have you applied for a Liquor License with the State of Arizona Department of Liquor Licenses and Control?

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Application Affidavit

Applicant Affidavit

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Commercial Occupancy Permit Application- Information

What business is currently, or has most recently, occupied this business site?	---
if applicable, what other businesses are located in this building or on this site?	---
# of employees:	---
Sq. Ft. of general floor area:	---
Sq. Ft. of public floor area:	---
# of parking spaces:	---
Are the parking spaces paved?	---
# of ADA Handicapped parking spaces:	---
# of wall mounted business signs:	---
# of free standing signs:	---
Is this site landscaped?	---
Is there outdoor lighting? If Yes, please specify how many.	---
Do you intend to do any internal/external improvements to the building(s)? If Yes, please describe the type of improvements. (Ex: plumbing, sink, electrical, partitions, etc.)	---

Business Information Continued

Normal operating schedule: please list operations hours/day & days/week (Ex. 8hrs/day, 7 days per week)	---
Please check any of the following: Will this facility use __________.	---
Do you or will you store chemicals on site in excess of normal household quantities?	---
Do you or will you store or use petroleum or non-petroleum oils or greases in your business?	---
Do you or will you discharge any wastewater (other than domestic wastes from toilets, showers, etc.) to the sewer system?	---

Prescott Valley Police Department Business Identification

Alarm Company Name and Phone Number	---
1. Name and Phone Number of the Responsible Party	---
2. Name and Phone Number of the Responsible Party	---

(Internal) Late Fees

Do they need a late fee?

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