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Pedd r vli it r ar Transiert r hint <br />Li en A 11a�.0?an :W . <br />Cii�r of Gem Lake, Minnesota <br />4200 Otter Lake Road, Gem Lake; iVIN 55110 <br />651747:2790192— fax 651747-2795 <br />d . M akemm_Q1&. <br />Peddler License Solicitor License Q Transient Merchant License <br />❑r Renewal Application <br />initial. Application A r 5Aq <br />Dates you intend to conduct business in the City of Gem Lake: <br />Number of days you will.conduct business in the City: <br />APPLICANT (Please print): <br />(Full legal name): <br />A Aiit.h <br />Any other names/aliases under which you conduct bushness or officially answer. <br />Driver's License of MN ID Number; <br />Physical Description. <br />Weiht <br />l <br />Hair Color I _ f Height � g <br />Eye Colo, r� -I <br />Residence PhoneNuimber <br />Permanent Residence address <br />. <br />Circle one: I Have/Have:not been convicted within,..the last five year of a felony, gross <br />inisdexnearior, or misdemeanor for violation of any state or federal statute or any focal <br />ordinance (other than misdemeanor traffic offenses). <br />VEHICLE INFORMATION: (Please include information for all vehicles to be Used in <br />conjunction with the license. Attach an..additional sheet if necessary).. <br />#ref' Year <br />Make Model 1 <br />,d <br />l <br />Color License Plate Number/State Vehicle Identification <br />ation Form Page <br />Peddler,.SoIicitor orTransient Merchant Ucense Applic1 <br />