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4. Application for Non-Domicile, Home Occupation and Administrative & Retail Occupational Licenses

6. In order to obtain a Roeland Park Business /Occupational License, building trades must have a Johnson County Contractors License and roofing contractors must also have a Kansas Roofer Registration.

8. City of Roeland Park, Kansas
10. Company Name*
11. Contact Name
13. Physical Address*
14. City*
16. State*
17. Zip Code*
19. Phone Number*
20. Email Address*
22. Type of Business:*
26. If mailing address is different than physical address, please indicate below:
28. Mailing Address
29. City
31. State
32. Zip Code
36. Type of License*
    -- Select One --Home Occupation $40.00Massage Establishment $150.00Non-Domicile Business $80.00 (reduced to $40 after June 1st)Retail & Administrative Offices (see sq ft chart)Massage Therapist $50.00
37. If applying for a Retail/Administrative Business License, please indicate number of sq. ft. of your establishment:
41. Those seeking to license in-home daycare with more than three children, must complete a Special Use Permit Application and pay the associated fees and obtain approval from the City Planning Commission (Ord. 961, adopted 11/20/2017). Approval expires after five years. Annual renewals require a copy of the state licensure.
45. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application 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.

    1. I agree.
47. Electronic Signature*
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit Submit and Print

* indicates a required field