Agenda - Council - 08/24/2004 - Laserfiche WebLink

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16) List below any felonies or gross misdemeanors or any crimes of theft or issuance of a wodhless check of which you were convicted of within the ten (10) most recent years and the nature of the cdme or crimes of which you were convicted: NONE 17) Have you taken advantage of any State or Federal bankruptcy or insolvency law or proceeding as a bankrupt or debtorwithln the ten (10) most recent years? No If yes, explain: 18) List below FULL names, dates of birth, and driver's license numbers and State of Issue of all employees other than tl~e above applicant who wlll be selling these goods in the City of Ramsey: Ramsey Women of Today, qeneral members. 19) Do you reside in Ramsey and have your home as a base for your business? Yes:X reside, not for p[ofit orqanizatlon If yes, what is the present zoning of the properly? N/A If you reside within the city timits of Ramsey and your principal place of business is at your home, you may be subject to certain zoning regulations and you may have to apply for a conditional use permit. 2o) Please list other cities you have conducted business in: N/A Please fill out COMPLETELY the attached forms that are required for the Minnesota Department 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 176.182. Applications will not be accepted until these forms are filled out completely. 22) In order fo permit the verification of the information required by City Code, any person required to submit information as herein set fodh shall not engage in selling or in making calls as described in the City Code until seven {7) days have elapsed after submitting the applicatian. Licenses are good for the calendar year and must be renewed each year, The LICENSE FEE OF ,~100.00 shall be paid at the time of application. Also required 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 ta give pedinent information constitutes cause for revocation af this permit. Further, I agree fo comply with all the previsions of the ordinance under which this license is granted. 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. I~O NOT WRITE BELOW THIS' LINE- FOR CITY UsE'ONLY - Received on Receipt # Approved on Zoning Approval Comments: Form SP:Cr LICENSE APPLICANT: Pursuant to Mhmesota Statute 270,72 Tax Clearance; Issuance of Licenses, the licensing anthoxSty is required to provide to file Minnesota Cormdssioner of Revenue your Mhmesota business tax identification number and the Social Security Number of each license applicaut. Under the Mhmesota Government Data Practices Act and the Federal Privacy Act of 1974, we are requked to advise you of the following regarding the use offltis info~nation: