(1) submit to the Board an application on the form that the Board provides; and

(2) pay to the Board a nonrefundable application fee set by the Board.

(b) In addition to any other information required on an application form, the form shall require:

(1) the name and address of the managing agent; and

(2) a notarized statement that the managing agent is an employee, an owner, a director, an officer, a member, or a partner, as applicable, of the entity seeking a permit.