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m <br /> <br />1) Applicant's FULL Name: <br /> <br />2) <br /> <br />m 4) <br /> <br /> CITY OF RAMSEY <br /> <br />PEIXILERS AND $(I~I¢I'I91~ LIG!iNSE <br /> 1986 <br /> <br />6) <br /> <br />m <br /> <br />.m <br /> <br />I12) <br /> <br />Last Fi £st Middle <br /> <br />'1 <br /> <br />Phone No., ~2/- ~?L / ..... 3) Date of Birth: <br /> <br />Driver's Ltc. No: /7-[~'~.' 717-~t~ ~.~ ~l?f- ff~l--~Y~/ <br /> ,,,--:', 5) Soc. S~c. No.: _ :_ : ,, <br /> <br />~ ~aares~ 6~za isq~, ~,~-z-~< ~h~m_. /7~~' <br /> ...... .... ' <br /> <br />8) Brief description of nature of business and goods to be sold: <br /> <br />9) ~e of ~pl~er: . r~/'- ~.'~F~.~/10) Phone No. <br /> 11) Business Address: '~L (~ ~/r.~ ~'/'~ ~ ~/.~tA~ <br /> (Street) (Ci~) ' (~t~) (Zip)- <br /> <br /> ~rtod of ti~ tn whi~ activities will ~ conducted: <br /> <br />13) Source of supply of goods or property proposed to be sold: <br /> <br />16) <br /> <br />ld) Method of delivery.: ~fye4~. / ,~c Z~-~ , . ....... <br /> / <br /> <br />15) List below any felor~ies or gross misdemeanors or -any crimes of theft or <br /> issuance of s worthless (~heck, of whi~ you were convicted within the ten <br /> (10) most recent years ad the nature of the crime or crimes of which you <br /> were oonvicted ~ <br /> ............... <br /> <br />l~ave you taken advantage of any State or Federal bankruptcy or insolvency <br />law or proceeding as a .bankrupt or debtor within the ten (10) most recent <br />years? . ~/0 If yes, explain: - _ ..... <br /> <br /> <br />