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Business Name Information

Instructions
This is an application for privilege to do business inside the city limits of Jacksonville. Please complete the entire application. If an item does not apply, enter ‘N/A’ in the available space.
Application Date*
Business Start Date*
Business Name*
Corporation Name*
If different from business name
Business Description*
Include all activities. Please note that if it is a tattoo business you are required to provide a copy of an Onslow County Health Department Certificate with this application.
Onslow County Health Department Certificate
Please provide your Onslow County Health Department Certificate if you are a tattoo business.
Business Location (Street Address)*
Mailing Address
If different from street address
Does your business have more than one location in North Carolina?*
1. Yes
1. No
If yes, list other locations in North Carolina:
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Home Occupation Use Permit Information
Important - Each business must have a principal location. A business is considered to be home based if the principal location of the business is a residence. This includes businesses of a mobile nature such as construction / home improvement companies, mobile car repair, power washing, and repair services. If the answer to both questions is yes, our policy requires that you obtain a Home Occupation Use Permit from our Zoning Division or Inspections Department.
Is the business located within Jacksonville city limits?:*
1. Yes
1. No
Is this business home based?*
1. Yes
1. No
Does the firm own the building?*
1. Yes
1. No
If not owned, the building is leased or rented from:
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Does your business sell retail or wholesale items?*
1. Yes
1. No
Describe in detail the type of items sold*
Contractors State License Number*
Expiration Date*
List Subcontractors*
Name, Address, and Contact Phone Number
Hotel / Motel Number of Rooms*
Restaurant Seating Capacity*
Will there be live entertainment?*
1. Yes
1. No
Does the business sell intoxicating beverages?*
If yes, you are required to complete a beer / wine application and submit it to the Jacksonville Police Department for processing.
1. Yes
1. No
Taxi Certificate (J) Number
Day Care - Number of Children Cared For*
Beauty Salon, Barber Shop, Manicurist - Number of Chairs*
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Manager’s Name*
Business Phone*
Federal EIN or Owner(s) Social Security Number (SSN)*
SSN is mandatory per Federal Statute 42 U.S.C. 405 (C)(i). The SSN may be used for the purpose of collecting owed taxes.
Business Name*
Signature of Applicant
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