Municipal License Application

Filling out your application

A municipal license is a privilege, not a right. Any false answers or omissions may result in the denial of your application.

This application must be filled out accurately and completely.
If you are unsure about how to respond to any questions on this form, check with the City Clerk for clarification.
Your application will not be processed until you pay the application fee(s).
You can obtain information regarding arrest and conviction records from the Wisconsin Circuit Court Access website. (Note: CCAP may not provide a comprehensive list of ALL arrests and convictions).

Attachment(s)

Applicants applying for a Tree Cutting License must submit a copy of your CURRENT certificate of insurance with a minimum $1,000,000 liability insurance. (These certificates expire each year so you must submit a new one each year.)
Applicants applying for a Taxi License must submit a copy of your certificate of insurance with a minimum $1,000,000 liability insurance.

Review of your application

The Richland Center Police Department will perform a background check to verify the information you have provided.
The city may require that additional information, appropriate to the specific type of license requested, be submitted with this application or as a supplement to this application prior to consideration of license issuance.
If you are asked to appear before a committee but choose not to do so, your application may be denied.

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License You Are Applying For *

Abattoir - $75 Fee

Arcade - $50 Fee

Tree Cutting - $25 Fee

Taxi - $100 Fee + $2/driver

First Name *

Middle Initial *

Last Name *

Resident Address *

Street Address

City, State & Zip Code *

Phone Number *

Driver's License Number *

Other Identifying Data

[maiden name, aliases, etc.]

Business Name for License *

Do you have any felony or misdemeanor charges presently pending against you? *

Yes

List any PENDING Citations, Tickets, or Criminal Charges

Include Year, Court Location, and Charge

Have you ever been convicted of any felony or misdemeanor? *

Yes

List Any Citations, Tickets, Municipal/Ordinance Violations and Criminal CONVICTIONS (Excluding parking tickets)

Include Year, Court Location, and Charge

The undersigned, by signing this application, hereby authorize and consent to such inquiry and/or investigation as the City of Richland Center deems necessary to determine whether this applicant and/or the application meets all requirements of the ordinances of the City for the issuance of said license. I further certify I understand that any material falsification in the application may be basis for denial of the application or the revocation of any license issued by the city pursuant to this application.

Applicant Virtual Signature *

(Please type your full name to indicate your understanding of the terms and conditions of this application)

SUPPLEMENTAL INFORMATION REQUIRED FOR TAXI LICENSE APPLICANTS ONLY:

Taxi license requires Police inspection of all vehicles and certificate of insurance with a minimum of $1,000,000 liability insurance.

Names, addresses and birth dates of all persons who will drive taxi under this license:

Driver 1 Name *