TATTOO/BODY PIERCING LICENSE APPLICATION
Source: www.ci.moorhead.mn.us
Topic: Tattoo
Sort Desciption: Tattoo needles and piercing needles are not reusable under any circumstances. ... Immediately before a tattoo is applied, the quantity of the dye to be used ...
Content Inside: C:Documents and SettingslarsoncDesktopTattoo - Body Piercing Application.doc 500 CENTER AVENUE, BOX 779, MOORHEAD, MINNESOTA 56561 (218) 299-5301 TDD 711 TATTOO/BODY PIERCING LICENSE APPLICATION Business Name: ______________________________________________________________ Business Address__________________________________ Phone #____________________ Applicants Name: ____________________________________________________________ Applicant’s Address________________________________ Phone # ____________________ List name & birth date of individuals who will engage in the practice of tattooing:_____________ ____________________________________________________________________________ ____________________________________________________________________________ Brief description of the place or location at which the business is to be conducted:___________ ____________________________________________________________________________ ____________________________________________________________________________ Bond $5,000 License Fee $ 35.00 (Renewal) 100.00 (New) I agree to abide by the laws, ordinances and regulations pertaining thereto. SIGNATURE__________________________________ DATE_________________________ (For Office Use Only) C HECK N UMBER ___________________ R ECEIPT N UMBER ______________________ B OND N UMBER ___________________ B OND E XPIRES _______________________ L ICENSE N UMBER ____________________ L ICENSE E XPIRES ______________________ F INAL A PPROVAL _____________________________________________________________ of 23 CERTIFICATION OF COMPLIANCE WITH THE MINNESOTA WORKER’S COMPENSATION LAW In accordance with Minnesota Statutes §176.182, everystate or local licensing agencyis required to withhold the issuance or renewal of a business license or permit until the applicant presents acceptable evidence of compliance with the worker’s compensation insurance coverage requirement. Applicants are required to provide the name of the insurance ...
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