Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
<br />MAR-26-0i MeN 1:55 fM <br /> <br />"'1: C" "O,"^~ L"K" <br />','. 1 r I ..'0 j A t <br /> <br />"X "0 <br />n :I,. <br /> <br />651 464 4968 <br /> <br />D <br />.. <br /> <br /> <br />Pat-It" Fax NOl' 7671 <br />To <br />00./010" <br /> <br /> <br />APPLlCA nON FORM t'OR SAUNM OK MASIfA(J.I!: l' A./:U..OHS Uc.;ENSE <br /> <br />INITIAL INVESTIGATIVE FEE $2.50.00 <br />LICENSE PER YEAR $300.00 - (NOT PRORATED) <br /> <br />DATBOF APPLICATION <br /> <br />TRADE NAME <br /> <br />LICENSING PERlOD <br /> <br />FULL NAME OF APPLICANT. OWNER <br />IF INDIVIDlJAL <br /> <br />PHONE NUMBER <br /> <br />ADDRESS <br /> <br />CITY <br /> <br />STATE <br /> <br />DATE 01' BIRTH <br /> <br />PL.",CE OF BIRTH <br /> <br />ADDRESS OF BUSINESS <br />LOCATION <br /> <br />LBGAL DESCRIPI'lON OF BUSINESS LOCATION: <br /> <br />LIST OWNERS Of BUILDING OR PREMISE TO BE LICENSED: <br /> <br />NAMES: <br /> <br />ADDRESSES: <br /> <br />DATE OF BIRTHS: <br /> <br />MANAOER'SNAM! <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />L <br />