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<br /> <br />enitervi[[e <br /> <br />) <br />..,/C' 'Estaflisfiecf 1857 <br /> <br />1880 gy{ain Street ~ Centen>i[[e, :M'Ji{ 55038 <br />(651) 429.3232 :} 'JIJ;( (651) 429.8629 <br /> <br />CITY OF CENTERVILLE <br /> <br />APPLICATION FORM FOR SAUNAS OR MASSAGE PARLORS LICENSE <br /> <br />TRADE NAME <br /> <br />DATE OF APPLICATION <br /> <br />LICENSING PERIOD <br /> <br />FULL NAME OF APPLICANT <br />OWNER IF INDIVIDUAL <br /> <br />PHONE NUMBER <br /> <br />ADDRESS <br /> <br />CITY <br /> <br />STATE <br /> <br />DATE OF BIRTH <br /> <br />PLACE OF BIRTH <br /> <br />ADDRESS OF BUSINESS <br />LOCATION <br /> <br />LIST OWNERS OF BUILDING OR PREMISE TO BE LICENSED: <br /> <br />NAMES <br /> <br />ADDRESSES <br /> <br />DATE OF BIRTH <br /> <br />MANAGER'S NAME <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />Page 10 of 12 <br />