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<br />I <br />I <br />I <br />I <br /> <br /> <br />- <br />. <br /> <br />City of Centerville <br />Best Practices Application <br /> <br />Business Address: <br /> <br />~11y :s- .erN&{, frlc. <br />9177$- C&c/h(tlj/( Id <br />Business Phone: "~I - t.~ :5 - }} l' / <br /> <br />All owners and operating managers please sign, date, and provide a home <br />p ne r other reliable contact number. <br /> <br /> <br /> <br />,)tJ-S,z -}ij~, <br />Phone <br /> <br />Signature <br /> <br />Date <br /> <br />Phone <br /> <br />Signature <br /> <br />Phone <br /> <br />Sqjnature <br />City Administrator <br /> <br />4~ iLd~-/1 / <br /> <br />SignaturEt J / v." / <br />Mayor (14""".:::> <br /> <br />Licensed establishments that choose not to participate in the Best Practices U21 <br />Program or are found in violation for a third time will follow the regular penalty grid. <br /> <br />FO~Of Cen <br /> <br />~/?'J <br />Signature <br />Chief of Police <br /> <br /> <br /> <br /> <br />, <br />~-------_. <br /> <br />Date <br /> <br />/~~ <br /> <br />Date <br /> <br />?.G" ~~ 7$1(- z~ <br />Phone <br /> <br />~. <br /> <br />Date <br /> <br />, ?alZ- <br /> <br />d.57- 1-29-32-32- <br />Phone <br /> <br />1/ -/1- Z-aJ2- <br />Date <br /> <br />'hfi-32~ <br />Phone <br />