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2. For questions, contact the Community Development Department by phone at (407) 262-7700 Ext. 1109 or email communitydev@casselberry.org.
4. Notice: Renovations (including painting) to a business site or structure located on U.S. Highway 17/92 or State Road 436 in the Community Redevelopment District requires approval from the Community Redevelopment Agency Board. Please check with the Community Development Department prior to making any site improvements as they may be required to be redone.
6. No outside storage or display of goods, materials, services, equipment, or vehicles are allowed.
8. BUSINESS INFORMATION:
10. Business Name
12. Business Address
13. Suite Number
15. City
16. State
17. Zip
19. Owner(s) Name
20. Phone Number
22. E-mail address
23. If Sole Proprietor, Social Security Number
25. Shopping Center (if applicable)
27. Previous Business Name/Use at this Location
29. Mailing Address for Renewal Notice
31. CORPORATION INFORMATION:
33. Name
34. Federal Identification Number
36. Owner of Business
37. Phone Number
39. Mailing Address
41. Business Categories (check all that apply)

    1. Finance
    2. Insurance
    3. Real Estate
    4. Professional Services
    5. Health Services
    6. Personal Service
    7. Business Service

    1. Vehicular Service
    2. Vehicular Sales
    3. Construction/Contractor
    4. Adult Entertainment
    5. Manufacturing
    6. Restaurant with/without alcohol
    7. Lounge/Bar

    1. Rentals (Commercial/Industrial)
    2. Rentals (Residential Units)
    3. Schools
    4. Day Care
    5. Group Homes
    6. Social Services - Other
    7. Amusement

    1. Vendor/Machines and Devices/ATM
    2. Retail/Wholesale Trade
    3. Telemarketing (Exempt/Non-Exempt)
    4. Drive-Thru's
    5. Taxi/Limousine
    6. Other
43. Detailed description of business activities and products
45. USAGE/UNIT/FEE INFORMATION (PLEASE ANSWER THOSE APPLICABLE TO THE USE)
47. Number of Employees
49. Please complete the following for Restaurant/Lounge only:
50. Number of Seats
51. Serving Alcoholic Beverages

    1. Yes
    2. No
53. Please complete the following for School/Day Care/Group Home only:
54. Number of Students/Residents/Beds
56. Please complete the following for Rentals (Residential/Commercial) only:
57. Number of Units
58. Square Footage
60. Please complete the following for Vending only:
61. Number of Vending/Coin Operated Machines
62. ATM's
64. Please complete the following for Taxicab/Limousine only:
65. Number of Vehicles
67. Applicant Signature
68. Date
72. Office Use Only
74. Zoning
75. Primary Use
77. Is proposed use permitted within this zoning district?

    1. Yes
    2. No
78. Community Redevelopment District

    1. Yes
    2. No
81. Business Classification
83. City of Casselberry
85. Classification
86. Fee
88. Classfication
89. Fee
91. Classification
92. Fee
94. Classification
95. Fee
97. Seminole County

    1. SCA - non regulated
    2. SCB - regulated
98. Fee
101. Total Fee
103. Comments and/or conditions attached to the issuance of this Business Tax Receipt
105. Reviewer's Signature
106. Date
111. CERTIFICATE OF EXEMPTION FROM FICTITIOUS NAME ACT
113. I,_________________________________________(print), hereby certify that I am exempt from the requirements of the Fictitious Name Act, pursuant to S.205.023, Florida Statutes, and Section 6, Chapter 90-267, Laws of Florida, as follows:

     1. I am an attorney licensed to practice in the state of Florida.
     2. I am licensed by the Department of Business and Professional Regulations.
     3. I am incorporated under the following registered corporate name, trademark, LLC, partnership or service mark ______________________________________________________.
     4. I am doing business under my legal name.
115. Applicant Signature
116. Date
120. The following forms must also be submitted with this application:
122. Emergency Business Contact Information
     The Emergency Business Contact Information Form is required and must be submitted with the Business Tax Receipt application.
124. Security Alarm Registration
     If applicable, please complete the Security Alarm Registration Form.
126. eBiz Registration Form
     This form is voluntary. If interested, please complete and submit this form with the Business Tax Receipt application.
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127. Print Only

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