Application for a scrap metal license or renewal of a scrap metal license shall be made on a form for this purpose, furnished by the department of licensing, and shall be signed by the license holder or his or her authorized agent and shall include the following information:
(1) Name and address of the person, firm, partnership, association, limited liability company, or corporation under which name the business is to be conducted;
(2) Names and residence address of all persons having an interest in the business or, if the owner is a corporation, the names and addresses of the officers thereof;
(3) Certificate of approval of the chief executive officer or chief of police, or a designee, if the application is for a license within an incorporated city or town or, in any unincorporated area, the county legislative authority, the sheriff, or a designee, certifying that:
(a) The applicant has an established place of business at the address shown on the application;
(b) There are no known environmental, building code, zoning, or other land use regulation violations associated with the business being located at the address; and
(c) In the case of a renewal of a scrap metal license, the applicant is in compliance with this chapter: PROVIDED, That an authorized representative of the department of licensing may make the certification described in this section in any instance;
(4) Any other information that the department of licensing may require.