Agenda - Council - 05/09/2017 - Laserfiche WebLink

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16) List below any felonies or gross misdemeanors or any crimes of theft or issuance of a 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: _ 19'9 (e, Go 4- `,1--k_--h7 A -0 ct Li. 4— Pi e (.4-y rD LAe s L1 C -e_ ilAe,y toe sr,. �� Y 17) Have you taken advantage of any State or Federal bankruptcy or insolvency law or pro eeding as a bankrupt or debtor within the ten (10) most recent years? A.3 ii . If yes, explain: A 18) List below FULL names, datesof birth, and driver's 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: 19) Do you reside in Ramsey and have your home as a base for your business? Yes: No: 1G If yes, what is the present zoning of the property? /UM If you reside within the city limits 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. 20) Please list other cities you have conducted business in: i/e D K—`. . ' I k- _ i ; 21) 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 to permit the verification of the information required by City Code, any person required to submit information as herein set forth shall not engage in selling or in making calls as described in the City Code until seven (7) days have elapsed after submitting the application. 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 to give pertinent information constitutes cause for revocation of this permit. Further, I agree to comply with all the provisions of the ordinance under which his licens- is granted. Applicant's Signature: Date: O'e_ C a r Q Q 1 Ci This license will take effect as early as January 1, 2015 and will expire on or before December 31, 2015. Transient Merchants are permitted for a maximum of 60 days in a calendar year. The license fee of $100.00 must be paid at the time of application. The $35 per person fee applies to Peddlers & Solicitors only - not Transient Merchants. DO NOT WRITE BELOW THIS LINE - FOR CITY USE ONLY Received on I, — I--. / (.4 - Receipt # aLtS0a r bt. V(� Approved on Zoning Approval Comments: Our Mission: To work together to responsibly grow our community, and to provide quality, cost-effective, and efficient government services