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Scrap Metal Dealer /Junk Dealer /Recycling Operation License Application <br />Page 2 <br />IC. Are premlses: teased by applicant owned by applicant? <br />If teased: Name of owner <br />Business address <br />(it. PERSONAL DATA <br />A. Appftmf s Legal Name ,wr- ' Gswp <br />S. Residential Address 1t' -r-1 W t� "mfr <br />City - state i Zip . !%S 30 <br />C. Residential Telephone Number <br />D. sm 3t'3`t3�?ZZf� E.DateofBirth �•2s :R <br />IV. INCLUDE, WITH APPLICATION, A SITE PLAN OF THE FACILITY SHOWING <br />PROPERTY LINES, BUILDINGS, PARKING SPACES, LOADING DOCKS, FUEL <br />STORAGE, AND LANDSCAPING. <br />V. INCLUDE, WITH APPLICATION, A $5.00 PROCESSING FEE <br />VI. AFFIRMATION <br />i, hereby, certify and affirm that all of the information I have given in this. application Is true and <br />accurate to the best of my knowledge. I Anther certify and affirm that I have in no way <br />attempted to mislead the City In this application by omitting facts known to me. I have read <br />and understand the regulations of the Scrap Metal Dealer /Junk Dealer/Recycling <br />Operation/Transfer Station license found In the City of South Bead Municipal Code, Section <br />Date <br />