2. Business Name
   Please indicate the name of the business you represent
3. Representative Name
   Name of person representing the business
5. Primamry Phone Number
6. Other phone number
7. Email
9. Street Address of Business
11. City
12. State
13. Zip
15. Hours and Days of Business Operation
    Please list the days and hours that your business is open.
17. Special Considerations
    Please list any information about your business that we should take into consideration when issuing special event permits.
19. Signed
    Please type your name acknowledging that you request notification about special event permits.
20. Note: Notifications will be made by email, but in some instances, staff may contact you by phone, mail or in person.
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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field