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<br />FEE: <br />PAID: <br />RECEIPT # <br /> <br />TRANSIENT MERCHANT, PEDDLER INFORMATION SHEET <br /> <br />In an effort to provide the public of the City of Centerville <br />with the best quality of life WlGillil its corporate City Limits, <br />the City has determined that the following information De <br />received from any and all persons or firms wlsillng to conduct <br />door-to-door sales and/or setting up a temporary sales site: <br /> <br />1. Name and description of applicant: (If more than one person <br />attach the following information on a separate sheet) <br /> <br />Name: <br /> <br />(First) <br /> <br />(Middle) <br /> <br />(Last) <br /> <br />Eyes: Hair: <br />Weight & build: <br />Drivers License ~: <br /> <br />Height: <br /> <br />Date OT Birth: <br /> <br />Include copy of D.L. <br /> <br />2. Permanent Home Address: 1. <br /> <br />Dates of Occupancy <br />Telephone Number: <br /> <br />2. <br /> <br />Dates of Occupancy <br />Telephone Number: <br /> <br />~ <br />0. <br /> <br />Dates of Occupancy <br />Telephone Number: <br /> <br />A <br />~. <br /> <br />Dates of Occupancy <br />Telephone Number: <br /> <br />~ <br />v ~ <br /> <br />Dates of Occupancy <br />Telephone Number: <br />