Town Of Prescott Valley Business License Division

Commercial Occupancy Application

Feb 07, 2023
submission #1206
Business License Application

Business License Status

What would you like to do today: ---
Is this a: ---
If you are are applying for or renewing a PV liquor License, please select which Series you are applying for ---

Business Name and Physical Location

Nature of Ownership ---
Business Street Address (Physical location of the business (cannot be a PO Box) 2727 N Lake Valley Rd
is the business location: ---
Mailing Address (Street name and number only) 7760 E State Route 69 Suite C5-354
Mailing Address City, State, & Zip Code Prescott Valley, AZ 86314
Business Phone Number +18886521199
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: PEST CONTROL
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

Name of the Business (If owned by another LLC) ---
1. Name of Owner (First and Last) ---
Title ---
Home Street Address of Owner (Cannot be a PO Box) ---
Telephone Number ---

Federal Tax ID or Social Security Number

Please enter your Federal Tax ID Number ---