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Business Licence Application Form Page 1 of 3 City of Maple Ridge April 2016 11995 Haney Place, Maple Ridge, BC V2X 6A9 Tel: 604-467-7440 Fax: 604-467-7445 Email inquiries: licencesandbylaws@maplerid
ge.ca Web Site: www.mapleridge.ca □ COMMERCIAL/INDUSTRIAL □ HOME BASED □ NON RESIDENT □ NEW □ INTER-MUNICIPAL LICENCE ($250) □ CHANGE OF BUSINESS NAME □ CHANGE OF OWNER ($50 COMMERCIAL)
□ CHANGE OF LOCATION ($50 COMMERCIAL) SECTION A: BUSINESS INFORMATION. TO BE COMPLETED BY ALL BUSINESS LICENCE APPLICANTS. NOTE: BUSINESS INFORMATION IS NOT CONSIDERED PERSONAL INFORMATION
AND MAY BE RELEASED IN A PUBLIC DOCUMENT. BUSINESS NAME TYPE OF BUSINESS (FULLY DESCRIBE SERVICES) PROPOSED START DATE OF BUSINESS INCLUDE BUSINESS IN LICENCE DIRECTORY? □ YES □ NO
BUSINESS OWNER NAME BUSINESS ADDRESS INCLUDING POSTAL CODE MAILING ADDRESS (IF DIFFERENT FROM ABOVE) TELEPHONE AND CONTACT INFORMATION * (*PHONE NUMBERS ARE RELEASED IN A PUBLIC DOCUMENT)
WORK: FAX: MOBILE: EMAIL ADDRESS: WEBSITE: NUMBER OF EMPLOYEES (INCLUDING OWNERS) FULL TIME: PART TIME: CONTRACTORS WITH THE FOLLOWING BUSINESSES, PLEASE PROVIDE COPIES OF YOUR TRADE
ACCREDITATION/LICENCE PLEASE CIRCLE: ELECTRICAL GAS PLUMBING SECURITY SECTION B: HOME BASED BUSINESS -ADDITIONAL INFORMATION IF YOUR BUSINESS IS OPERATING FROM YOUR HOME IN MAPLE RIDGE.
*** PLEASE NOTE: A HOME INSPECTION IS REQUIRED PRIOR TO ISSUANCE OF LICENCE TO ENSURE COMPLIANCE WITH ACCESSORY HOME OCCUPATION USE. *** TOTAL GROSS AREA OF THE HOME (M2) : AMOUNT OF
FLOOR SPACE USED FOR THE BUSINESS (M2): ARE GOODS, VEHICLES OR EQUIPMENT STORED ON THE PREMISES? □ YES □ NO IF YES, PLEASE EXPLAIN: IS MERCHANDISE SOLD TO THE GENERAL PUBLIC? □ YES
□ NO IF YES, DOES THE PUBLIC ENTER ONTO THE PREMISES TO COLLECT THE MERCHANDISE? □ YES □ NO ARE YOU OPERATING A DAYCARE? □ YES □ NO IF YES, NUMBER OF CHILDREN IN YOUR CARE:
Business Licence Application Form Page 2 of 3 City of Maple Ridge April 2016 11995 Haney Place, Maple Ridge, BC V2X 6A9 Tel: 604-467-7440 Fax: 604-467-7445 Email inquiries: licencesandbylaws@maplerid
ge.ca Web Site: www.mapleridge.ca Business Licences are public records that are available for inspection upon request at the City of Maple Ridge. The City may also use business licence
information, including those of home-based businesses for publication on the City’s website. All information gathered for business licensing purposes is managed in accordance with the
provisions of the Freedom of Information and Protection of Privacy Act. SECTION C: COMMERCIAL BUSINESS -ADDITIONAL INFORMATION IF YOUR BUSINESS IS OPERATING FROM A COMMERCIAL OR INDUSTRIAL
UNIT IN MAPLE RIDGE. ARE YOU MAKING OR HAVE YOU MADE STRUCTURAL CHANGES/RENOVATIONS TO THE PREMISES /UNIT? □ YES □ NO IF YES PLEASE DESCRIBE (PLEASE NOTE PERMITS MAY BE REQUIRED) TOTAL
GROSS FLOOR AREA OF BUSINESS (M2) : (FEE MAY BE CALCULATED ON M2) ARE YOU SHARING PREMISES WITH ANOTHER BUSINESS? □ YES □ NO IF YES, NAME OF BUSINESS: IF OPERATING A RESTAURANT/CAFÉ?
PLEASE PROVIDE THE FOLLOWING INFORMATION: NUMBER OF SEATS IN THE RESTAURANT __________ PLEASE CONTACT THE LOCAL FRASER HEALTH AUTHORITY IN ORDER TO OBTAIN FRASER HEALTH APPROVAL WILL
YOU BE HOLDING ANY CLASSES? □ YES □ NO IF YES: PLEASE LIST THE TYPE OF CLASSES: ____________________________ MAXIMUM NUMBER OF PARTICIPANTS PER CLASS: __________________ WILL YOU BE
SERVING ALCOHOL? □ YES □ NO TYPE OF LIQUOR LICENCE (PLEASE CONTACT THE BC LIQUOR CONTROL BOARD TO OBTAIN APPROVAL) BUSINESS EMERGENCY CONTACT PERSON (FOR RCMP OR FIRE EMERGENCIES AT
YOUR BUSINESS) NAME: ____________________________________________________ PHONE :__________________________ HOME ADDRESS:_____________________________________________________________________________
____ I/we the undersigned make application for a business licence in accordance with the information given and declare the statements are true and correct. I/we understand that a business
cannot operate without first obtaining a valid business licence and payment of the application fee does not guarantee the issuance of a licence. I/we undertake, if granted the licence
applied for, to comply with each and every obligation contained in bylaws now inforce or which may hereafter come into force in the City of Maple Ridge. FORM COMPLETED BY : _________________________
_______________ SIGNATURE:________________________________ POSITION IN BUSINESS:________________________________________ DATE:________________________________
Business Licence Application Form Page 3 of 3 City of Maple Ridge April 2016 11995 Haney Place, Maple Ridge, BC V2X 6A9 Tel: 604-467-7440 Fax: 604-467-7445 Email inquiries: licencesandbylaws@maplerid
ge.ca Web Site: www.mapleridge.ca FOR OFFICE USE ONLY BUSINESS LICENCE NUMBER: PAYMENT RECEIVED: □ YES □ NO □VISA □MASTERCARD □AMEX □DEBIT □CHEQUE □CASH AMOUNT : $______________ ZONING
APPROVAL DATE: ZONE: APPROVED □ YES □ NO IF NO, GIVE REASON: APPROVED BY (PRINT NAME): SIGNATURE: INSPECTIONS BUILDING REQUIRED: □ YES □ NO APPROVED: □ YES ELECTRICAL REQUIRED: □ YES
□ NO APPROVED: □ YES GAS REQUIRED: □ YES □ NO APPROVED: □ YES PLUMBING REQUIRED: □ YES □ NO APPROVED: □ YES FIRE REQUIRED: □ YES □ NO APPROVED: □ YES HEALTH REQUIRED: □ YES □ NO APPROVED:
□ YES BCLCB REQUIRED: □ YES □ NO APPROVED: □ YES ISSUANCE APPROVED BY (PRINT NAME): SIGNATURE: ISSUED DATE: DATE MAILED: