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<br />, <br /> <br />, <br /> <br />CITY OF LI'1"l'LJ! CAlIIADA <br />APPLICATION FOR KASSAGE THERAPy ESTABLISHMENT LICENSE <br />(Must be accessory or incidental to properly aoned beauty salon.) <br /> <br />License Fee - $100.00 <br /> <br />_NEW <br /> <br />RENEWAL <br /> <br />Please oomp1ete the following. It the applie~tion is by a <br />natural person, by such person; it by a corporation, by an <br />ofticer thereof; if by a partnership, by one ot the partners; it <br />by an unincorporated assooiation, by the manager of managing <br />officer thereof. <br /> <br />1. Name Of Applicant (name of individual, partnership, <br />corporation, Or association) : <br /> <br />(If Individual) LAST <br /> <br />FIRST <br /> <br />FULl. MIDDLE NAME <br /> <br />:2. Name Of Beaut" Salon under which applicant w.i 11 be doing <br />business, business address, and telephone nUlllber: <br /> <br />Full Name <br /> <br />Business Address <br /> <br />Business Telephone <br /> <br />3. Type or Applicant: <br />__Individual <br />Association <br /> <br />I'artnership <br /> <br />_____corporation <br /> <br />other <br /> <br />4, A. It applicant is an individual: <br /> <br />Nama <br />LAST <br /> <br />FIRST <br /> <br />FULL M!DDLE NAME <br /> <br />Date or B1rth <br /> <br />Residence Address <br /> <br />Residence Telephone <br />Business Address <br />Business Telephone <br />Social Security Number <br />Driver's License Number_ <br /> <br />1 <br /> <br />;~ <br /> <br />Q~CbbQbICQ 'n~ VH, <br /> <br />HnH.~0 ,11 li1 .n ll10 <br /> <br />T?' b 1 unIT I n-C7_lJHl.1 <br />