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Application for Occupational License, City of Roeland Park, Kansas

2. Date:
   Date:

4. License No.:

   for office use only

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

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

8. 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.

   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.

10. City of Roeland Park, Kansas

12. Company Name*

13. Contact Name

15. Physical Address*

16. City*

18. State*

19. Zip Code*

21. Phone Number*

22. Email Address*

24. Type of Business:*

28. If mailing address is different than physical address, please indicate below:

30. Mailing Address

31. City

33. State

34. Zip Code

38. Type of License*
    -- Select One --Home Occupation $40.00Massage Establishment $150.00Non-Domicile Business $80.00Retail & Administrative Offices (see sq ft chart)Massage Therapist $50.00

39. Fee Chart for Retail & Administrative Offices
    Retail & Admin Sq Ft Fee Chart

    click on the link to see the license fee chart

41. Compute your annual license fee and file your application with payment before November 30th. You can pay online (see link below) or make check or money order payable to City of Roeland Park and mail to the City Clerk at 4600 W. 51st St, Roeland Park, KS 66205.

45. 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.

49. 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.
51. Electronic Signature*

Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit Submit and Print

* indicates a required field