2002-03-12 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 information 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.) (Slreet Addrus) (City, SIate,ZiP) (Datu) (SlreeIAddres.) (Cjty.S~..ZlP) (Oates) (Street Addre..) (City, StatC!l, Zip) (DIln) (5lr'" Addren) (City, SllIle.Zlp) (Oates) (Street Address) (City, Slille,Zip) (Dale.) 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 or occupation) jStreel Addrehl (City, SWite, Zip) (BUlinl!lSSor oocupation) (Street Addreu) (City, Slale,Zip) (Businels Of occupation) (StrHl Address) (City, Stale,ZIp) (Business or COCUPlltion) (SlnNt Address) (City, Slale,Zip) (Business or occupalibn) (Sltee. Addre..) (City, State, Zip) 7. Names and addresses of your employers and partners, if any for the preceding five years. (Begin with present or last address and work back.) INAMES: Employers or Partners) (Street Addtllu) (Clty,State, Zip) lNAMES'. Emplcyers or Partners) (Street Address) (City, State, Zip) (NAMES: Employers or Partners) (Street Address) (Cily, Slate. Zip) (NAMES: Employers Of PanneJ"$) (SlreetAddress) (City, SWill, ZIp) (NAMES; Employers or Partners) (Sires' Address) (City, State,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)