Business Renewal

Business Name *

Business Description *

Business Website

Business Telephone Number *

Business Email Address - for registration and renewal correspondence *

Business Address *

Business Mailing Address *

Owner or Manager's Name *

Owner or Manager's Phone Number

Property Owner *

Property Owner's Address

Property Owner Phone Number *

Property Owner Email

Fire Safety Information

Are hazardous materials used, stored, or manufactured on the premises? *

Do you have an automatic external defibrillator (AED) on site? *

If yes, where is it located?

Emergency Contact 1 *

Emergency Contact 1 # *

Emergency Contact 2

Emergency Contact 2 #

Emergency Contact 3

Emergency Contact 3 #

Name and Title of Person completing this form *

* - denotes required field