Business Information:

Business Name:*

Owner Name:*

Physical Location – List Street, City and State:*

Mailing Address:*

Mailing City:*

Mailing State:*

Mailing Zip Code:*

Phone Number:*

Email:*

Description of Business:*

Type of License:

Select all applicable license types:*
General Business – $10 for each business being operatedTrailer Court – $25 (up to 5 spaces, $5 for each additional)Amusements – $10 each (Juke box, pinball, pool, etc.)Beer (not consumed on premises) – $50Beer (consumed on premises) – $150Wine (not consumed on premises) – $50Wine (consumed on premises) – $100Liquor by the drink – $225

Applicant Certification:*

By submitting this form, I certify that the information provided in this application is true and correct and I agree to comply with all city ordinances. Furthermore, I agree with City of Weippe’s privacy policy statement, which can be found in the footer of this page.

I consent to having the City of Weippe collect my name and email to receive occasional announcements and newsletters. The City of Weippe will never sell your information, and you are welcome to opt-out of our mailing list at any time.
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