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Service Request Entry - Operating Without Business License

Please complete as much information as possible and click the Review button.

( ** Mandatory fields have red labels. )


Location:  

Supporting Information

Is this a commercial or residential location?
Where is the activity taking place?
If other, please describe.
What type of business activity is being conducted?
When does this activity primarily occur?
(Multiple answers allowed)
What hours does this activity occur (best time to investigate)?
Input cell # to opt-in for text updates. If opted-in, add cell # to caller info.


Caller / Contact Information
First Name Last Name
Street Address
Address 2
City
E-Mail Address
Contact Type Contact Number   Extension/Comments


Business Information
Name
Street Address
Address 2
City
E-Mail Address
Contact Type Contact Number   Extension/Comments