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<br />UST THREE (3) CHARACTBRREFERENCES <br /> <br />NAME <br />~~ ~hffilO6) <br />~w~ ~~ <br />~ ~c.u..c\.cj <br /> <br />ADDRESS <br />, <- liS- C....lc.tr9-t'\ 0 0 "?. t <br />"b'" Fb.u.l m '" ~ / 0 ~ <br />LlS!q PaAh.t1\ ~ \ {PSt -l(~()-~S~ <br />V~ ~ 'fh1V -gs/2.7 <br />'4ft E."t'h4 M pic h ijt.d...- (os- / - rs<f - }. e 10 <br />~''Sb ~ '$l-...P~ h'\1V ~/1~ <br />HAS APPUCANT/OWNER IDSIHER. DESIGNEE EVER BEEN CONVICTED OF A CRIME, <br />OTHEll THAN A TRAFFIC VIOLATION? <br /> <br />PHONE <br />trI=q -/),2-~~t.\.. <br /> <br />DYES ~ <br /> <br />IF YES, GIVE EXPLANATION ON A SEPARATE SHEET OF PAPER, INCLUDING TIME, <br />PLACE AND NATURE OF BACH CIUME OR. OFFENSE AND DISPOSlTION'IlIEREOF. <br /> <br />UST ALL CREDITORS INVOLVED IN THE CONSTRUcnON AND MAINTENANCE IN ANY <br />WAY PROVIDING DEBT OF EQUITYFlNANCINO TO SAID OPERATION: <br /> <br />UST CORPORATE OR PARTNERSHIP TITLE, IF ANY ~ <br />CORPORATE OR PARTNERSHIP ADDRESS: rll~ <br /> <br />UST AIL OFFICERS, MANAGERS OR. DIRECTORS, IF CORPORATION: <br /> <br />NAMBS <br /> <br />ADDRESS <br /> <br />DATE OF BIRTH <br /> <br />Please submit accurate 8Dd complete business records showing II8IDe8 and addRsses of aU individuals <br />having an interest in business including partners, officers. owners and crediton fumisbing credit for <br />est8b1isbmeDt acqJliRition 8Dd maintenance and tbmishing of said businfl!lHl. <br /> <br />Please furnish ~ documentation establishing the interest of the applicant and any other person <br />having interest in the premises upon which the building is proposed to be J.ocated or tbmished thereot: <br />The dooumentation shall be in the fonn of a lease, deed, contract for ~ mortgage deed, etc. and any . <br />