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2. Village of Swansea 1444 Boul Avenue Swansea, IL 62226 (618) 234-0044
4. Fee: $35.00 - Late Fee: $105.00
   To ensure that the purpose and intent of the Swansea Zoning Code is achieved, it is important that non-residential uses of property in the Village be identified. The Municipal Code/Section 20-402 require that such uses register annually with the Building & Zoning Department. Failure to comply is an ordinance violation, and is subject to applicable fines and fees. Effective December 15, 2008 the Village requires that all commercial properties be inspected to ensure compliance with Building, Fire and related codes for an existing structure prior to occupancy by every new occupant.
6. Business/ Organization Name:
8. Address
10. Email Address
11. Phone #
13. Owners Name
14. Owners Phone #
16. Owners Address
18. Billing Address(If different from business address)
20. Classification
    -- Select One --Commercial Use, retailCommercial Use, serviceCommercial Use, IndustrialCommercial Use, wholesaleGovernment UseEducational UseCharitable, Not for Profit OrganizationPrivate Club or Lodge
22. Is this Property/Building owned by

    1. Business Owner or Organization
    2. Leased
23. Building Owners Phone #
25. Building Owner's Name
27. Address
29. What is the total area (square feet) occupied by this use?
30. What % of the building on this property is occupied by this use?
32. How many separate buildings are occupied by this use on this property?
33. How many floors of the building are occupied by this use?
35. Do you have a business sign?
36. Do you have a dumpster?
37. Screened dumpster or fenced?
39. Do you have a grease trap? Please attach log
40. Do you have a storm water detention basin on your property?
42. How many Full Time individuals are normally employed by this use?
43. How many Part Time individuals are normally employed by this use?
45. Is this business operated from your residential premises?
47. Describe in detail what this business or organization does and how it is operated:
49. Do you use or store any flammable, combustible, explosive, or otherwise hazardous liquids, gases, or other materials on this property?

    1. Yes
    2. No
51. If yes describe:
53. Is this use a business which is required to register under the State of Illinois Retailer's Occupation Tax Act, Service Occupation Tax Act, Use Tax Act, or any similar act?

    1. Yes
    2. No
55. If yes, identify the Act and your registration number along with the date of issue:
57. Please provide any additional information you feel would be helpful:
59. Emergency Information Data Form
    For those uses, which wish to utilize the Swansea Police Department's Emergency Information Data Form, please call the office and request a copy. This information is not mandatory and is provided by you at your option. The form is kept separate from this registration and will not be a matter of public record. It is utilized only by our Police and Fire Departments to facilitate emergency services for your property.
61. BY MY SIGNATURE BELOW, I CERTIFY THAT, TO THE BEST OF MY KNOWLEDGE, ALL OF THE STATEMENTS CONTAINED HEREIN ARE TRUE AND CORRECT AS OF THE DATE ENTERED BELOW. I FURTHER CERTIFY THAT SHOULD ANY OF THE INFORMATION IN THIS DOCUMENT CHANGE SIGNIFICANTLY PRIOR TO ANNUAL REGISTRATION, I WILL IMMEDIATELY NOTIFY THE ZONING ADMINISTRATOR OF THOSE CHANGES.
63. SIGNATURE:
64. DATE
66. TYPR OR PRINT NAME:
68. TITLE:
Leave This Blank:


70. 1. Receive an email copy of this form.
71. Email address

    This field is not part of the form submission.

72. Submit Submit and Print

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