HomeMy WebLinkAboutTransient Merchant App.
FEE:
PAID:
RECEIPT #:
TRANSIENT MERCHANT, PEDDLER INFORMATION/APPLICATION
SHEET
In an effort to provide the public of the City of Centerville with the best quality of life within its
corporate City Limits, the City has determined that the following information be received from
any and all persons or firms wishing to conduct door-to-door sales and/or setting up a temporary
sales site:
1. Name and description of applicant: (If more than one person, attach the following
information on a separate sheet)
Name:
(First) (Middle) (Last)
Eyes: Hair: Height:
Weight & Build: Date of Birth:
Drivers License #:
(Include a copy of Driver’s License)
2. Permanent Home Address: 1.
Dates of Occupancy:
Telephone Number:
2.
Dates of Occupancy:
Telephone Number:
3.
Dates of Occupancy:
Telephone Number:
4.
Dates of Occupancy:
Telephone Number:
5.
Dates of Occupancy:
Telephone Number:
3. Description of vehicle(s) use for sales purposes:
Make and Year: Model:
License Plate # & State of Issuance: Color:
4. Place where the business is to be conducted:
5. Brief written description of the business, a description of the goods to be sold (including
photographs or brochures) and the applicant’s method of operation: (Employees must be
listed on reverse side).
6. If employed, name and address of employer:
7.Length of time applicant intends to do business in the City, with approximate dates:
8. If a fixed site is used for display and sale of goods, written permission of the property
owner must be provided.
Date: Signature of Applicant:
Check by City Clerk:
(Signature) (Date)
Check by Centennial Lakes Police Department:
(Signature) (Date)
Council Action:
(Approved) (Date)
Council Action:
(Denied) (Date)