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2. City Clerk's Office
   (712) 328-4616
4. Name of Business
6. Name of Owner/Manager
8. Mailing Address
10. City
11. State
12. Zip
14. Location of Business
    If different than mailing address
16. City
17. State
18. Zip
20. Please Note:
    Must follow guidelines as set out in Chapter 3.11 of the Council Bluffs Municipal Code. Before this application will be processed, you must also provide the clerk with a sample and pay the $25 annual fee.
22. Document Upload
    You may upload sample here
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field