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Application <br /> Scrap NjletalDealer Junk Deeder/Reovding Operation Licefli$eA <br /> Page 2 <br /> '-�Owned by applicant? <br /> K. Are prarr ses: Leased by applicant <br /> If[eased. Name of owner <br /> 13tisiness address <br /> III. PERSONAL DATA <br /> A. Applican's Legel i',larra <br /> S. Reside Nial Address 7 i-c- <br /> �o 'State �:7AJ_ Zip city <br /> C. Residenlial Telephone Number <br /> alp <br /> D. SSN r E Date of Birth <br /> I V. INCLUDE, VVITH APPLICATION, A SITE PLAN OF THE FACILITY SHOWING <br /> PROPERTY LINES, BUILDINGS, PARKING SPACES, LOADING DOCKS, FUEL <br /> STORAGE,-AND LANDSCAPING. <br /> f INCLUDE, VVITH APPLIC <br /> ATiON, A MCC PROCESSING FEE <br /> - <br /> V1. AFFIRMAT ION <br /> 1, <br /> hereby, certify and affirm that all of the information I have given in this application is true and <br /> accurate to th a best of my knowledge. I further certify and affirm that I have in no way <br /> attempted t0inislead the City jr, this application by omitting facts known to me. I have read <br /> and understa6d the regUlations of the Scrap Metal Deaier/Junk Dealler/Recycling <br /> Operation/Transfer Station license found in the City of South Band Municipal Code, Section <br /> 4-51. <br /> a i e <br /> Si�,,,natUrS <br />