Action Center / Business License - Standard Application / Davenport, Iowa

General Information

Business Name*

Parent Company Name

Country*

Address 1*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region*

Postal Code*

Country*

Address 1*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region*

Postal Code*

Business Phone*

Phone Area Code-Phone 3-Phone 4 ext Extension

Cell Phone

Phone Area Code-Phone 3-Phone 4

Business Start Date*

MonthDay Year,

Ownership*

Email*

Website URL

ProtocolURI

Owner's or Principal's Name(s)

Owner or Principal's Name 1*

Address 1*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Owner Phone 1*

Phone Area Code-Phone 3-Phone 4 ext Extension

Title Owner 1*

Owner Name 2

Address 1

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Owner 2 Phone

Phone Area Code-Phone 3-Phone 4 ext Extension

Owner 2 Title*

Real Estate Owner Information

Country

Address 1

Address 2

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region

Postal Code

License Specific Information

Fully Describe Business Operation*

Iowa Sales Tax ID No.*

Exact Size of Retail/Wholesale Sales Area

Exact Size of Storage/Manufacturing Area:

Licenses - Check all that apply

Public Amusements put number by each. '0' if none.

Amusement Device (5.12)*

Game Machine*

Bowling Alley Number of Lanes*

Jukeboxes*

Please Do Not Complete The Following Field

Pool Table*

Miniature Golf*

Theatre*

Fee Schedule:

0032 Amusement Device: $20/per
0038 Auction Sales Room: Annually, $100; Daily $10
0039 Auctioneer Yearly: $100
0040 Auction Close Out Sale: $100
0055 Bowling Alley: $25/Lane
0086 Dancehall, in nightclub: $200 0087 Dancehall, Primary Business: $200 0117 Game Machine: $50/each
0141 Jukebox: $50 / each
0154 Minature Golf: $100 / each
0172 Pool Tables: $50 / each
0118 Garage Public: $50 0228 Gasoline Station: $50 0187 Retail, No Floor Space: $50
0189 Retail, Seasonal: $25
0186 Retail, < 4,000 sq.ft: $75, >4000 sq/ft $75, pluse $50 for each additional 5,000 sq/ft 0209 Theatre: $150 first 600 Seats, $75 for each additional 400, Max $600. 0025 Tobacco / Vapor: $100