AUTHORIZATION Pursuant to city of Maple Plain license requirements, per the MN State Statute 299C.72, West Hennepin Public Safety is authorized to conduct a criminal history check. I declare that the information I have provided on this application is truthful and I authorize the City of Maple Plain and West Hennepin Public Safety to investigate the information provided, including completing a MN Computerized Criminal History search, a record check of license and contacting the persons named on the application. my driver’s I agree to operate such business in accordance with the laws of Minnesota and the ordinances of the City of Maple Plain. The foregoing statements are true and correct to the best of my knowledge and belief. INVESTIGATION . Date referred to Director of Public Safety Background Check Completed by . Date Completed . Recommendation of West Hennepin Public Safety Approve. Deny. Reason for Denial: OFFICE USE ONLY Background Check Fees Permit Fees Background Check (Paid upfront. Per Person) License (Per Company) $50 $100 Amount Paid: . Amount Paid: . Date Paid: . Received By: . Received By: . NOTICE Items to submit with application Notice to applicant Credentials establishing relationship with company. The City will try to process applications as soon as   Company handouts, brochures, order forms, etc. possible; 5 business days may be required.  Photocopy of license, state ID or passport. Each applicant must submit his/her own application driver’s   Non-refundable background check fee. and pay all applicable fees.  (Checks payable to of Maple License fees are collected after approval is received. “City Plain.”)  Licenses are obtained at City Hall. All applicants must carry a copy of their license at all  times while working in the City. Updated 3-6-2018
AUTHORIZATION Pursuant to city of Maple Plain license requirements, per the MN State Statute 299C.72, West Hennepin Public Safety is authorized to conduct a criminal history check. I declare that the information I have provided on this application is truthful and I authorize the City of Maple Plain and West Hennepin Public Safety to investigate the information provided, including completing a MN Computerized Criminal History search, a record check of my driver’s license and contacting the persons named on the application. I agree to operate such business in accordance with the laws of Minnesota and the ordinances of the City of Maple Plain. The foregoing statements are true and correct to the best of my knowledge and belief. INVESTIGATION Date referred to Director of Public Safety . Background Check Completed by . Date Completed . Recommendation of West Hennepin Public Safety Approve. Deny. Reason for Denial: OFFICE USE ONLY Background Check Fees Permit Fees Background Check (Paid upfront. Per Person) $50 Amount Paid: . Date Paid: . Received By: . License (Per Company) $100 Amount Paid: . Received By: . NOTICE Items to submit with application Notice to applicant  Credentials establishing relationship with company.  Company handouts, brochures, order forms, etc.  Photocopy of driver’s license, state ID or passport.  Non-refundable background check fee. (Checks payable to “City of Maple Plain.”)  The City will try to process applications as soon as possible; 5 business days may be required.  Each applicant must submit his/her own application and pay all applicable fees.  License fees are collected after approval is received. Licenses are obtained at City Hall.  All applicants must carry a copy of their license at all times while working in the City. Updated 3-6-2018