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ty ofAti NEW . <br /> BRIGI I`1ON <br /> the city that narks for you CITY OF NEW BRIGHTON <br /> 803 Old Highway 8 NW <br /> NEW BRIGHTON,MN 55112 <br /> (651)638-2050 <br /> 2011 BUSINESS LICENSE APPLICATION <br /> Applications must be completed in full. Middle initial or name is required of all parties concerned. If no middle name,please indicate by writing NMN. Sign and return <br /> application with the appropriate fee. Please advice the City of any change in status. A new license is required if a business changes location or ownership. Notification to <br /> the Cit of New Bri_ ton is r- uired if the business closes. <br /> PI.GASL'•'PRINT Olt TYPE CLEARLY • • - <br /> Business Name: it f u C/t( r tal MiJ4-r (1/1 0/w- [ 't)FiU t c;tl,�r. — co :01 twit t,-) -JL 5 &/ <br /> Business Location: l Si srt_ L, c Porcj) tip•«; la'LtU,�tZ�J H` IJ SSiI� <br /> Facility Phone: (05I -,4 -36— 43 1`t�- 24 h v'J r Phone:Y or N Facility Fax: f <br /> Mailing Address: P • () • A<1`f �S ��r rtJ off] t.e (-)51-'pc <br /> (if different than above) <br /> City: tL.tJT?-tt— State: 11\4I`` Zip: jam() <br /> Enter Below Names of Owners.Partners or Corporate Officers Use Additional Sheets'As Necessary <br /> Ownership: 1.11:•Corporition 0 Ltd Liability( orp El Partnership 0 Ltd Jartnership 0 Sole Proprietor ❑Trust <br /> Owner/Corp.Name: IZ.CM ' Uhl ( ilrY' PA10`-I 'rifle: eA i Plum e: BSI- L(3f/' ').$ <br /> Home Address: MiNik e c (1 h-A c&.1 Cell: .- <br /> City: State: Zip: <br /> Email: Driver's License No. <br /> Minnesota Tax ID or Federal Tax ID or Social Security No.(Required) ( 3 V.-kJ IS <br /> J n <br /> Owner/Corp.Name: Title: Phone: <br /> Home Address: _ Cell: <br /> City: State: Zip: <br /> Email: Driver's License No. <br /> Minnesota Tax ID or Federal Tax ID or Social Security No.(Required) <br /> Enter Alarm Company (if Applicable) <br /> Name: 'Title: <br /> Address:_ License No.: <br /> City: State: Zip: <br /> Flammable or Hazardous Materials Used or Stored on Premises? ❑Yes ❑No If yes,please provide list of materials&quantities <br /> Please check the License(s)for which the Application is helm;made.•Please note the licenses are catellorizeel by licensing;neriai. <br /> January 1 through December 31 <br /> Equipment Rental $200.00 <br /> New Cars $200.00 <br /> Used Cars $200.00 <br /> April 1 through March 31 <br /> Amusement Center $1,680.00 <br /> Electronic Game or Device Number of games: $17.00/game <br /> Garbage&Recycler Haulers:Please check what type you service: __Commercial Residential $250.00 <br /> 3.2 Percent Malt Liquor—On Sale $315.00 <br /> 3.2 Percent Malt Liquor—Off Sale $I36.50 <br /> 3.2 Percent Malt Liquor—Off Sale Temporary $94.50 <br /> Drink Set-Up $400.00 <br /> Tobacco Sales _ $290.00 <br /> June 1 through May-31 �1 <br /> Gasoline #of Pumps $220.00 A <br /> 30 Day Licenses <br /> Christmas Trees $80.00 <br /> -� Total Amount Submitted $ <br />