Contact Information Date * Month MonthApr Day Day26 Year Year2024 Full Name First * Middle Initial Last * Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024 Location you will be selling from: Street Address * Address Line 2 City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Code * Home Phone * Contact Email Product You Are Selling Name of Company Total Number of Sellers Number of Days License is Required List date's you are selling List Full Name, Address & Date fo Birth of All Persons Involved in Selling Pursuant to Village Of Mukwonago Ordinance No. 22After 72 hours, a permit may be issued.Investigation Fee* A $10.00 Investigation Fee Per Seller must be submitted BEFORE application will be processed. Price: $10.00 Quantity: Daily Permit Fee - Village Residentper day Price: $10.00 Quantity: Weekly Permit Fee - Village Residentper week Price: $50.00 Quantity: Monthly Permit Fee - Village Residentper month Price: $100.00 Quantity: Annual Permit Fee - Village Residentper year Price: $500.00 Quantity: Daily Permit Fee - Non Residentper day Price: $20.00 Quantity: Weekly Permit Fee - Non Residentper week Price: $100.00 Quantity: Monthly Permit Fee - Non Residentper month Price: $200.00 Quantity: Annual Permit Fee - Non Residentper year Price: $800.00 Quantity: Fireworks Ordinance Price: $250.00 Quantity: Total These permits are not transferable and shall be displayed or shown upon request of any Police Officer or citizen. Permits issued under these provisions of Chapter 22, may be revoked or suspended for just cause by the Village President. Any misrepresentation or incorrect statement shall be cause for a misdemeanor charge. Signature Leave this field blank
