Business License Application
Business Status
| What would you like to do today: |
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New Application
| Is this a: |
None of the above
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Business Name and Physical Location
| Business Name or Trade Name |
Evergreen
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| Business Street Address (Physical location of the business cannot be a PO Box) |
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| Mailing Address (Street name and number only) |
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| Mailing Address City, State, & Zip Code |
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| Business Phone Number |
+17607747004
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| Alternate # (Emergency Phone Number) |
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| Number of Employees |
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| Please read trough the list carefully and select the closest description of your business: |
HOME OCCUPANCY OFFICE
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| Business Description (Please describe in detail the nature of the business) |
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| Start of business date |
2024-05-01
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| Locations where the business or applicant has operated during the last five (5) years |
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| is the business location: |
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Applicant Information (Must be completed by the person filling out this application)
| Name (First and Last) |
Eileen Diaz
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