Does the business have a physical location inside the city limits of Dothan?*field type radio button
Does the business have a physical location inside the city limits of Dothan?YesNo
Is it a residential or commercial location?field type radio button
Is it a residential or commercial location?ResidentialCommercial
Will utilities need to be transferred into your business's name?field type radio button
Will utilities need to be transferred into your business's name?YesNo
field type richtext
Planning & Development approval is required for a home-based business. You will receive an email with additional instructions for this requirement.
Will renovations, alterations, repairs, or any other construction activities be done at the business location?field type radio button
Will renovations, alterations, repairs, or any other construction activities be done at the business location?YesNo
If so, please explain what construction activities are planned for the space (i.e. an addition, installation of a grease trap, paint, new flooring, etc).field type multi line
Physical Address*field type address
Please be sure to include a suite number, if necessary.
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Mailing Address*field type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country

Applicant Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Applicant Title*field type radio button
Applicant TitleOwner/Co-OwnerManagerEmployeeOther
Applicant Phone Number*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Applicant Email Address*field type email

Owner Names

List any owner information not already provided as the applicant.

	Namefield type single line	Titlefield type single line	Phone Numberfield type single line	Email Addressfield type email
Row 1×	Namefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Titlefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Phone Numberfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Email Addressfield type email	×

Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) the document will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
*field type checkbox
I agree.
Signature*field type signature
Date*field type date
DateTime captured on form submission

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City of Dothan Business License Application