JUNK / SECOND HAND DEALER LICENSE APPLICATION

Fee: $50.00

(Title II, Chapter 6, Section 6)

NAME OF BUSINESS: _______________________________________________

ADDRESS OF BUSINESS: ____________________________________________

FULL NAME OF OWNER/OWNERS: _____________________________________

ADDRESS OF OWNER/OWNERS: ______________________________________

BUSINESS PHONE: _____________________HOME PHONE: ________________

DRIVER LICENSE# ______________________BIRTHDATE: _________________

STATE SALES TAX LICENSE # ________________________________________

_______________________________ DATE: ___________________

Signature of applicant

DO NOT WRITE BELOW LINE

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___________________________________ _____approved

Chief of Police _____denied

Date: _____________

___________________________________ _____approved

City Treasurer _____denied

Date: _____________

___________________________________ _____approved

Zoning Administrator _____denied

Date: _____________

___________________________________ _____approved

Fire/Prop. Maintenance Inspector

Date: _____________ _____denied