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<br />City License # <br /> <br />CITY OF RAMSEY <br />APPLICATION FOR AMUSEMENT CENTER LICENSE <br />1988 <br /> <br />1) <br />2) <br /> <br />(' G{ e. -II Fl-1 f 8/ )II~ .,..d_,- <br /> <br />r//-??.4 ~- rJ-t.oS (' '1' <br />(City) (State1 <br /> <br />4/1/ S-~:3 0'3 <br />( ZIP) <br /> <br />~ Name of Business: <br /> <br />Business Address: 4- u e r S? 8.e /?d <br />(Street, Box, Route) <br /> <br />3) <br />4) <br />S) <br /> <br />Business Phone Number(s): <br /> <br />Hours of Operation: tJ 4/7 - 7/z 4. "".s /:;) ~n, - /.:?,&)/rj Fr;" 047 /~~ -.3,.,;1-'?7 <br /> <br />Applicant: ~J(1P5#/ 3d//'h(f/!~ O~/~// ..(, t;- <br />(Last Name) / _ (First Name) (Middle ~~itial) l~o7 <br /> <br />Applicant's Address: /YY/,P Jr ~"./.f /p,rrC:JS 6~ j/LJ ~/7/:?5'{ ~1/14 S-S:3'tJ <br />_ (Street, Box, Route) (City) (State) (zI10 <br /> <br />Applicant's Date of Birth: 4/7',3' S o"?-"'?7- '5..z. <br /> <br />Applicant's Position With Company: d u)//'P r - /hA/Z/q q..e /.-. <br />/. <br />If corporation, list below the names, residences and birthdates of those <br />owners hol<ling more than S% of the outstanding stock of the corporation: <br /> <br />6) <br /> <br />7) <br />8) <br />9) <br /> <br />10) Manager: <br /> <br /> <br />Initial) <br /> <br />~ <br /> <br /> <br /><2 <br />(Last Name) <br /> <br />ll) Manager's Date of Birth: ~~ /p-, <br /> <br />-?~ <br /> <br />12) Number of Devices to be Used: ~~ <br /> <br />13) Types of Devices to be Used: ~O <br /> <br />~ 0/ -7/lLf'L'F, <br /> <br />0, <br /> <br />C'/ / D~() <br /> <br />9/'7 /7? e " <br />./ <br /> <br />14) Other cities or communities where you've applied for or held a license to <br />operate a similar type of business: <br /> <br />lS) Have you, or in the case of a corporation, the owners of more than 5% of <br />the outstanding stock of the corporation, been convicted of a gross misde- <br />meanor or felony r~lpting to the operation of amusement centers and related <br />activities? /[.,,/~ If yes, explain: <br /> <br />/1 <br />