Agenda - Council - 08/10/2004 - Laserfiche WebLink

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~.b below any felonies or gross misdemeanors or any crimes of theft or issuance of o worthless check of which you were convicted of within the ten [10) most recent years and the nature of the crime or crimes of which you were convicted: Have you taken advantage of any State or Federal ,b?.nkruptcy or insolvency law or proceeding as a bankrupt or ae~or within the ten (1 0) most recent years? t~; ~' . 'if yes, explain: 8} List below FULL names, dates of bi'rth, and driver% license numbers and State of Issue of all employees other ' than the.above applicant who will be selling these goods in the City of Ramsey: 1 9) Do you reside in Ramsey and hove your home as a base for your business? Yes: No: If yes, what is the present zoning of the properly? If you reside within the city limits of Romsey and your principal place of Ousiness is at your home, you may be subject to certain zoning regulations and you may have to apply for o conditional use permit. 20) Please list other cities you have Conducted business in: .._,4'?', ¥ Z 6¥,.x ~ 22) PIease fill out COMPLETELY the attached forms that are required for the Minnesota Deportment of Revenue and Department of Labor and industry, Some of this information may be repetitive, but it is required by Minnesota Statute Sections 270.72 and ]76.!82. Applications will not be accepted until these forms ore filled out completely. In order to permit the verification of the information required by City Code, any person required to submit information os herein set forth snail not engage ir-, selling or in making calls as described in the City Code until seven (7) days have elapsed offer submitting the opolication. Licenses ore good for the catendor year and must .be renewed each year. The HCENSE FEE OF $100.00 shall be poid at the time of application. Also requirec; is proof of insurance for your company. i hereby certify that the foregoing statements are true and correct to the best of my knowledge and that the giving of false information or the failure to give pertineht information constitutes cause for revocation of this permit. ~urther, I agree to comply with all the provisions of the ordinance under which this license is granted. Applicant's Signature: *' ,~,'-"7~~ Date: This license will take effect as early as January 1, 2004 and will expire on December 31, 2004. The license fee of .$100.00 must be paid at the time of application. DO NOT WRITE BELOW THIS LINE - FOR CITY USE ONLY Received on Receipt # Approved on Zoning Approval Comments: -84-