2002-07-02 P & Z Agenda - Laserfiche WebLink

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Personal Information . Part 2 4. If you have ever used or been known by a name or names other than the true name given on the preceding page, list such name(s) and inlonnation concerning dates and places used: 5. Address(es) at which you have lived during preceding five years. (Begin with present or last address and work back.) (Street AdQr.:q~ (City, State,Zip) (Oat..) (Street Addlllu) (City, Stale,Zip) (Oetes) (Street ADdreu) (Cily, Slate, Zip) {D.t..~ (Street AcldrelSj (City, S~e, Zip) (Date3~ (SlreeIAddress) (City, State,ZipI (Cites) 6. Kind, name and location of every business or occupation you have been engaged in during preceding five years. (Begin with present or last occupation and work back.) (Business Of oec:upatiOn) (Slreet.AQdrell.) (City, Siate,Zip) (Businesl or occupation) {Stree,Ad<1teft) (City, State,Zip) (Business or oa:upahon) (S\reetAODreIS) (City, State. Zip) (Buairw.., or occupation> (SlreeIAddreu) (City, Stale,Zip) {Busl1'\&s1 or OCCl.lpaticm) (StreeIAdaress) (City,Slale, Zip) 7. Names and addresses of your employers and partners, il any for the preceding five years. (Begin with present or last address and work back.) (NAMES: Employers or P1l1l1nefll) (51ml Addr...) (CIty, Slate, Zip) (NAMES; EmplOyer. or Partrle~) (Street Address) (City.St8.te,Zip~ (NAMES: Employers Of Partners) (Street MetreD) (City, State. ZIp) (NAMES: Employers or Partl"ler$) (SlreillAi:ldreasl lCi\y,S\illta,Zlp) (NAMES: E.mployers or Partners) ($treetAaaress} (Cily, Stalll,Zip) 8. Have you been convicted for any crime other than a traffic offense during the past year? Yes _ No If yes, give information as to the time, place and offense for which convictions were had: (2)