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CITY OF GEM LAKE, MN <br />4200 Otter Lake Road <br />1 - _ Gem Lake, MN 55110-3227 — <br />Telephone 651-747-2790 <br />E-mail Cityr&P_emlakeMN.ore <br />BUSINESS LICENSE APPLICATION I <br />Name of Business: ! 4 7 <br />Address:,C� <br />Owner Name: <br />P-e( -.ou0 Sa�toSC_kowe� <br />Address_ 63 r Cc v``�r� <br />Business Phone: Home Phone: <br />Cell Phone: <br />Type of Business Conducted: A'In olvLoV -4e <br />Number of Employees_ <br />s -k 't� e. <br />ENCLOSED IS THE SUM OF $75.00 REQUESTING THAT A BUSINESS <br />LICENSE BE GRANTED 101 IRSUANT TO CITY ORDINANCE NO. <br />t-�-R -Zalo <br />Applicants Signature Date <br />♦ Licenses are valid January 1st to December 31st of each year. <br />To Be Completed by Staff: <br />Date Request Received; ~ c� 9y <br />By: _ ;l I !1 I fit; 1 u �Jl t L O t', $75.00 Fee Paid Yes <br />❑ No <br />License Approved: ❑ Yes Date <br />❑ No <br />Look for us on the World Wide Web at gemlakemn,org <br />