City of Camdenton. 437 W US Hwy 54 Camdenton, MO Application for a City Business License

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City of Camdenton 437 W US Hwy 54 Camdenton, MO 65020 Application for a City Business License License expires May 31 of each year. Beginning July 1, a penalty will be added for each month the license is delinquent and business has been conducted in the City of Camdenton. Fees are based on the type of license obtained, date of approval and the date that the business begins operating in Camdenton. Businesses Physically Located in Camdenton, Please Include: City Code Section 605.030 (B) If Sales Tax is collected a No Tax Due letter from the Missouri Department of Revenue-573-751-9268 OR http://dor.mo.gov/ must accompany the application. Missouri Retail Sales Tax License# Business Classification/Ownership City Code Section 605.010 Please indicate ownership status: Individual Partnership Corporation LLC LLP Professional Not for Profit (Please Provide 501c3 Documents) Other explain: Applicant Information NAME OF BUSINESS (d/b/a) Mailing Address Physical Address (if different): Mailing City, State, Zip Physical City, State, Zip Detailed Description of Business, Organization, Trade Business Phone Number Business Fax Number EIN/FIN # Number of Employees, other than owner Manager Manager Phone Number Owner Name Owner Mailing Address Owner Phone Number Owner City, State, Zip Email Address/Website ADDITIONAL BUSINESS OWNER S NAME (if applicable) ADDITIONAL BUSINESS OWNER S CELL PHONE ADDITIONAL BUSINESS OWNER S ADDRESS ADDITIONAL BUSINESS OWNER S PHONE # ADDITIONAL BUSINESS OWNER S EMAIL ADDRESS 1 OF 3

TO BE CONSIDERED FOR A LICENSE TO CONDUCT BUSINESS IN THE CITY OF CAMDENTON APPLICANTS MUST PROVIDE THE FOLLOWING: 1. The applicant must submit with the application the appropriate license fee as required by City Code Section 605.030. 2. The Application for a Business License for any business with a physical location inside the City limits must be completed and signed by the owner/managing officer of the business. A new application is required for CHANGE IN OWNERSHIP 0R CHANGE IN LOCATION OR CHANGE IN OCCUPANCY TYPE BY CITY CODE SECTION 605.090 3. In an effort to safeguard life and property of the citizens of Camdenton the following procedures shall be followed relating to the issuance of a CERTIFICATE OF OCCUPANCY: A. NEW OR CHANGE OF OWNERSHIP/LOCATION/OCCUPANCY BUSINESS INSPECTION: a. Inspections will be coordinated with the Code & Fire Official for compliance with the Fire Prevention Code. See attached checklist please note that not all items on the checklist will apply to every business location and there may be additional items not included on this list for certain type of businesses. This list is provided so you, the business owner/manager, can address these issues prior to calling to schedule an inspection. Any Code violations will be noted and a letter of insufficiency issued to the owner/manager. b. The Certificate of Occupancy and/or Business License will not be issued before all code violations are corrected. c. At the Code and Fire Official s discretion a temporary certificate of occupancy may be issued in instances where the building is safe to occupy and determined that the materials necessary to mitigate the violation is actually ordered and not available from other sources. 4. If you will be installing signage or changing existing signage for your business you must complete a sign permit application (see attached). Complete Sign Code (Section 440.220) available online at www.camdentoncity.com. 5. Any renovations/remodels of the business structure inside or outside may require a building permit. Please contact the City Building Official at 573-346-3600 prior to beginning any work to discuss your plans and need for periodic inspections. Failure to obtain a building permit prior to any construction could result in additional fines and fees being assessed as well as work being redone. A BUSINESS MAY NOT OPERATE UNTIL A BUSINESS LICENSE IS APPROVED AND ISSUED Store Front Businesses Located in Camdenton: Please provide contact information in case of emergency events Emergency Contact Name & Title 24-hour Phone Number Alarm Company Name Alarm Company Phone Number Do you have chemicals or products on the premises that would present one of the following hazards: Fire Hazard Immediate Health Hazard Delayed Health Hazard Where are the hazards located? Does the Building have a Fire Sprinkler System YES NO Building Owner Name and Phone Number: Applicant Certification NOTICE TO ALL BUSINESS OWNERS IN THE CITY LIMITS OF CAMDENTON: AS REQUIRED BY 144.083.4 RSMo. Verification of paid Missouri State Sales Tax (No-Tax Due Letter from the Missouri Department of Revenue) must be submitted with this application. A copy of the Missouri Retail Sales Tax license listing the City of Camdenton must accompany this application. WE/I UNDERSTAND THIS BUSINESS LICENSE AUTHORIZES ONLY THE VENDING OF GOODS, WARES, MERCHANDISE AND/OR SERVICES FOR THE ACTIVITY DESCRIBED IN THE DETAILED DESCRIPTION OF BUSINESS ACTIVITY FOR THIS APPLICATION. 2 OF 3

Certification Statement Issuance of this Occupational License does not ensure that the applicant is compliant with Camdenton City Code. Applicants are urged to make their own inquiries to ensure legal compliance regarding these areas. I hereby certify that the business or occupation I intend to pursue under the authority of the license for which I am apply does not violate or otherwise conflict with existing laws of the State of Missouri. I hereby state the information contained herein is true, correct and complete to the best of my knowledge. I also acknowledge that this is only an application and is not approval to operate a business. Please note: this application must be fully completed and legible before it will be processed WE/I UNDERSTAND THAT PER CITY CODE 400.080 THAT IT IS NOT PERMISSIBLE FOR ANYONE TO LIVE IN OR STAY OVERNIGHT IN ANY BUSINESS UNLESS SPECIFICALLY ZONED FOR DWELLING PURPOSES. Initials Date CERTIFICATION I am authorized by the applicant to sign on his/her/its behalf and have read fully and completely this application and all laws or ordinances referred to herein. The information contained herein Is true, correct and complete to the best of my knowledge, information, and belief. Signature of Principal Officer Date OFFICE USE ONLY LICENSE # CITY CLERK APPROVAL: DATE PAID: AMOUNT PAID: EMAILED TO LICENSE GROUP SENT FOR INSPECTIONS INSPECTION INFORMATION DATE LICENSE ISSUED (BUSINESS LICENSE APPLICATION REVISED 03/17) 3 OF 3

SECTION 2 INSPECTION CHECKLIST Compressed Gases Cylinders secured Cylinders labeled Cooking Appliances Hood System Clean System inspected Pull station accessible All fuel shut offs in place Proper fire extinquisher Egress Doors and Aisles Exit doors not blocked/locked Panic hardware operational Exit doors open fullv Exit aisles maintained (36" min) Electrical Cover plates on all outlet/switches Extension cords for temporary use only Electric panel property marked All blanks filled in electrical panel Min. 3' clearance around electric panel Exit Signs Illuminates aoorooriatelv Emergency Lights Lights work when tested Lights properly aimed Free of obstructions Fire Alarm System Reset instructions posted Key to unlock panel accessible Inspected annually Detectors operational Fire Doors Doors close properly Door unobstructed Fire Extinguishers Properly identified Installed correctly Easy to access Annually inspected Proper type for hazard Flammable Liquid Storage Stored in approved cabinet Ignition sources removed Heating Equipment Combustibles min 36" away Filters clean and free of build up Vent pipes properly connected Miscellaneous Knox Box contains current kevs MSDS readily accessible Address posted/visible/maintained Sprinkler System FDC visible and marked System inspected and tagged annually Protective caps on FDC No storage within 18" of ceiling Valves secured in open position Svstem design plate present Housekeeping Waste removed Storage min. 24" from ceiling Smoking materials in metal container PLEASE NOTE: That not all items on this checklist will apply to every business location and there may be additional items that will be inspected that are not included on this list for certain type businesses. This list is provided as a guide, so you, the business owner/manager, can address these issues prior to calling to schedule your inspection.

CITY OF CAMDENTON OFFICE OF THE BUU.,DING OFFICIAL SIGN PERMIT APPLICATION SECTION 3 Permit# DATE! I A.~W S~GN ~u 7!I 2.'m<C'll'J:D W_'lilflIOu'F i... il2gail ign PERil&I'il'WLJLIL BJ& f{flquf~ Jll, 70 PA 159% Vl!F 1IBlZ 1!'.i-\N::i>AHID S.KGN PllF.:MliT YEE. BUSINESS NAME: ~ ADDRESS: ~ PHONE: EMAIL ADDRESS: BUILDING OWNER: ~ DESCRIPTION OF SIGN: - ---- - - ---- ---- ------------ HEIGHf OF SIGN: Ff. SQUARE Ff: NAME OF PERSON, FIRM, CORPORATION, OR ASSOCIATION ERECTING SIGN: Attach copy of specifications used in anchoring or attaching sign Attach copy of sign design/art work at a minimum of a W' scale. Attach plot plan showing property lines and building lines, proposed and existing buildings, and sign structures. Attach written consent of the owner of the building. structure of land to which, or on which, the structure is to be erected. All illuminated signs shall bear the underwriters laboratories label or built to comply with UL requirements. Digital signs: Attach written certification that the sign is equipped with auto-dimming technology. Such other information the building official shall require to show full compliance with this and all other laws and ordinances of the city. Application must be completed in detail. Wind shear factors and professional design required for all pole signs. PLEASE NOTE: NO SIGNS SHALL BE ERECTED UNTIL APPROVED BY THE BUILDING OFFICIAL. ESTIMA1ED COST: $ APPLICANT'S SIGNATURE------ --- ---- DO NOT WRITE BELOW TIDS LINE BOARD APPROVAL REQUIRED: 0 YES BUILDING PERMIT REQUIRED: 0 YES 0 NO 0 NO BOARD APPROVAL DATE:--- --- PERMIT#: SIGN APPLICATION APPROVED: 0 YES 0 NO DATE APPROVED: - ----- - - FOOTING INSPECTION DATE:---------- ROUGH-IN INPSECTION DATE:--------- FINAL INSPECTION DATE:----------- PERMIT FEE: $

SIGN CONTRACTORS AFFIDAVIT FOR DIGITAL SIGNS I hereby affirm and certify that at installation, the sign being installed under this permit will adhere to the following requirements of the City of Camdenton Municipal Code, Title IV Zoning Code, Section 400.220: Sign Regulations. Subject to the limitations set forth in these sections for digital signs (electronic message signs), digital signs shall be allowed under the following conditions: 1. Digital signs shall display static messages for a period of at least two (2) seconds. 2. Digital signs shall not flash, scintillate or contain any effects that resemble a traffic signal or emergency vehicle strobe lighting. 3. Digital signs shall not use traditional primary colors of red, blue or yellow as solid background colors. Digital signs shall not use w_hite as a solid background color except for testing purposes. 4. Digital signs shall use dimming technology which automatically adjusts the brightness of the sign based on ambient light conditions. Each application for a digital sign permit must include a certification signed by the contractor that the digital sign will so be equipped. The standard for the brightness adjustment as ambient light intensity declines shall be a maximum increase of light intensity from the digital sign of 0.3 foot-candles over ambient levels as measured using a foot-candle meter at the pre-set distance in accordance with the following Table. Phone Number: Company Name & Address: By Affiant: Date: Print Name: STATE OF MISSOURI Subscribed and sworn to before me this day of, 20 My Commission Expires: Notary Public

Procedure for Measuring llluminance of a Digital Sign 1) Utilize a foot-candle meter at the following distances based upon the square footage of the sign. Meter shall be capable of measuring up to two (2) decimal places. 2) Meter must be set perpendicular to the sign face being measured. If the sign face is fifteen (15) feet above grade then the meter must be at that elevation to obtain an accurate measurement. 3) At least one (1) hour past sunset, the digital sign must be setup to be turned off or black and the first measurement taken at this time. This will establish the base line ambient light at this location. 4) The digital sign must then display a solid white (or the solid color of a monochrome display). The second measurement shall be taken at this time. The difference between the measurements shall equal no more than 0-3 foot-candles or less. If not, then the sign must be adjusted to comply with standard. Sign Area versus Measurement Distance Area of Sign in Square Feet Measurement Distance in Feet 10 32 15 39 20 45 25 50 30 55 32 56.5 For signs with an area in square feet other than those specifically listed in the table (i.e., 12 sq.ft.), the measurement distance may be calculated with the following formula: Measurement Distance =.Jarea of sign sq ft.x 100