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<br />DJe, JU\~ lot fv' (Jux\ct\ JO\y 2'5 fv\ ~\lJA <br /> <br /> <br />FEE: <br /> <br />PAID: <br /> <br />RECEIPT #: <br /> <br />TRANSIENT MERCHANT, PEDDLER INFORMATION/APPLICATION <br />SHEET <br /> <br />In an effort to provide the public of the City of Centerville with the best quality of life within its <br />corporate City Limits, the City has determined that the following information be received :from <br />any and all persons or firms wishing to conduct door-to-door sales and/or setting up a temporary <br />sales site: <br /> <br />1. <br /> <br />Name and description of applicant: (If more than one person, attach the following <br />information on: a separate sheet) <br /> <br />Name: f\sVlla.v\ <br />(First1 <br /> <br />Eyes: ~ <br /> <br />Weight & Build: <br /> <br />t,{ lZ01~ <br />(Middle) <br /> <br />Hair: _~ <br /> <br />\\~\b lOt~~ <br /> <br />2..4 q 3\~~ <br />(Include a copy of Driver's License) <br /> <br />- <br /> <br />~jeJV6 <br />(Last) <br /> <br />Height: 5 l I <br /> <br />Date of Birth: ~ <br /> <br />Drivers License #: <br /> <br />2. <br /> <br />Permanent Home Address: <br /> <br />1. J~~WlCYhlVO ~d pYl~ <br />~6tJ\1, I.t-~ '7 ~ 1 sB <br />-P~~-~~ als+- <br />cD 12 ~~\PJ '~~tl~' <br /> <br />2. ~~~. <br /> <br />Dates of Occupancy: <br />tI'elephone Number: <br /> <br />43 <br />