§ 10.5-93. Same—Form, contents of.

The completed application shall contain the following information and shall be accompanied by the following documents:

(1)

a.

If the applicant is an individual, the individual shall state his legal name and any aliases and submit satisfactory proof that he is eighteen (18) years of age; or

b.

If the applicant is a partnership, the partnership shall state its complete name, the names of all partners having either direct, managerial, supervisory, or advisory responsibilities for day-to-day operations of the adult use, and whether the partnership is general or limited;

c.

If the applicant is a corporation, the corporation shall state its complete name; the date of its incorporation; evidence that the corporation is in good standing; the names and capacity of all officers, directors, and stockholders having either direct, managerial, supervisory, or advisory responsibilities for day-to-day operations of the adult use, and if applicable, the name of the registered corporate agent and the address of the registered office for service of process.

(2)

If the applicant intends to conduct the establishment under a name other than that of the applicant, the establishment's fictitious name and a certified copy of the applicant's registration with the Division of Corporations of the Department of State under Section 865.09, Florida Statutes (1990);

(3)

Whether the applicant or any of the other individuals listed pursuant to subsection 10.5-93(1) have been convicted, within the five-year period immediately preceding the date of the application, of a specified criminal act and if so, the specified criminal act involved, the date of conviction, and the place of conviction;

(4)

Whether the applicant or any of the other individuals listed pursuant to subsection 10.5-93(1) have had a previous license or permit suspended or revoked or have been required to cease operation by court order, under the ordinance from which this division is derived, or any other ordinance regulating adult uses, whether said court order is from the State of Florida or any other state, including the name and location of the establishment for which the license was suspended or revoked, as well as the date of the suspension or revocation, and whether the applicant or any other individuals listed pursuant to subsection 10.5-93(1) have been a partner in a partnership or an officer, director, or principal stockholder of a corporation whose license, under this or any other ordinance regulating adult uses, has previously been suspended or revoked, including the name and location of the establishment for which the license was suspended or revoked, as well as the date of the suspension or revocation;

(5)

Whether the applicant or any of the other individuals listed pursuant to subsection 10.5-93(1) hold any other licenses under the provisions of this division and, if so, the names and locations of such other licensed establishments;

(6)

The single classification of permit for which the applicant is filing, provided that the applicant may obtain more than one permit for the same establishment;

(7)

The location of the proposed establishment, including a legal description of the property site and a legal street address;

(8)

The names of the employees for the proposed establishment, if known, or if presently unknown, a statement to that effect;

(9)

The applicant's mailing address, residential address, and residential telephone number (if any); and

(10)

A site plan of the proposed or existing establishment. A professionally prepared diagram in the nature of an engineer's or architect's blueprint shall not be required; however, each site plan should be oriented to the north or to some designated street or object and should be drawn to a designated scale or with marked dimensions sufficient to show the various internal dimensions of all areas of the interior of the premises to an accuracy of plus or minus six (6) inches. The site plan shall include, but not be limited to, the following:

a.

All property lines, rights-of-way, and the location of buildings, parking areas and spaces, curb cuts, and driveways;

b.

All windows, doors, entrances and exits, fixed structural features, walls, stages, partitions, projection booths, admission booths, adult booths, concession booths, stands, food service equipment, counters, and similar structures;

c.

All proposed improvements or enlargements to be made, which shall be indicated and calculated in terms of percentage of increase in floor size; and

d.

A designation of any portion of the premises in which patrons will not be permitted;

e.

If a proposed establishment is constructed in a manner that varies from the site plan submitted, a supplemental site plan showing the existing facility shall be provided once the certificate of occupancy or final building permit inspection is completed.

(11)

A recent photograph of the individuals listed pursuant to subsection 10.5-93)(1); and

(12)

Either the driver's license number or the state or federally issued identification card number of the individuals listed pursuant to subsection 10.5-93(1).

(13)

A valid adult use permit signed by the director of the division of development services or his designee pursuant to this division.

(14)

A sworn statement attesting to the accuracy of the information provided in the application and to the fact that the applicant, as licensee, will own, possess, operate, and exercise control over the proposed or existing adult use establishment.

(Ord. No. 92-25, § 8(B), 9-1-92; Ord. No. 01-05, § I, 2-13-01)