Before any applicant may be issued an adult live entertainer license, the applicant shall submit on a form to be provided by the city manager, or designee thereof, the following information:
(A) The applicant's full name and any other names or aliases used by the individual during the last ten years;
(B) Age, date, and place of birth;
(C) Height, weight, and color of hair and eyes;
(D) Present business address and telephone number;
(E) Proposed business address and telephone number;
(F) Present residence address and telephone number;
(G) State driver's license or identification number;
(H) Social Security Number;
(I) Evidence that the individual is at least 18 years of age;
(J) A statement describing the business, occupation or employment history of the applicant for three years immediately preceding the date of the filing of the application;
(K) A statement detailing the license or permit history of the applicant for the ten years immediately preceding the date of the filing of the application, including whether such applicant has ever had a license, permit or authorization to do business denied, revoked or suspended, or had any professional or vocational license or permit denied, revoked or suspended regarding a business in this state or anywhere else. In the event of any such denial, revocation or suspension, state the date, the name of the issuing or denying jurisdiction, and describe in full the reasons for the denial, revocation or suspension. A copy of any order of denial, revocation or suspension shall be attached to the application;
(L) A statement listing all criminal convictions or pleas of nolo contendere, except those which have been expunged or sealed by court order, or authorized or required to be kept confidential pursuant to Welfare and Institutions Code Sections 600-900, and the disposition of all arrests of the applicant, individual or other entity subject to disclosure under this chapter, for ten years prior to the date of the application. This disclosure shall include identification of all ordinance violations, except minor traffic offenses (any traffic offense designated as a felony shall not be construed as a minor traffic offense), stating the date, place, nature of each conviction or plea of nolo contendere, and sentence of each conviction or other disposition; identifying the convicting jurisdiction, and sentencing court providing court identifying case numbers or docket numbers; and
(M) Attached to the application form as provided above, two color photographs of the applicant clearly showing the individual's face. The application form shall be signed under penalty of perjury.
(N) A signed and notarized authorization and waiver authorizing the chief of police, the Corona Police Department, or any law enforcement body or authorized law enforcement contractor to verify all of the information on the application.
(O) A statement in writing, signed and dated by the applicant, that he or she certifies under penalty of perjury that all information contained in the application is true and correct.
Notwithstanding the fact that an application filed hereunder may be a "public record" under Government Code Section 6250 et seq., certain portions of such application contain information vital to the effective administration and enforcement of the licensing and/or permit scheme established herein which is personal, private, confidential or the disclosure of which could expose the applicant to a risk of harm. Such information includes, but is not limited to, the applicant's residence address and telephone number, the applicant's date of birth and/or age, the applicant's driver's license and/or Social Security Number, and/or personal financial data. The City Council in adopting the application and licensing and/or permit system set forth herein has determined in accordance with Government Code Section 6255 that the public interest in disclosure of the information set forth above is outweighed by the public interest in achieving compliance with this chapter by ensuring that the applicant's privacy, confidentiality or security interests are protected. The City Clerk shall cause to be obliterated from any copy of a completed license application made available to any member of the public, the information set forth above.
(Ord. 2708 § 1, 2004.)