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• City of Falcon Heights <br />APPLICATION FOR CHRISTMAS TREE SALES LICENSE <br />TO: City of .Falcon Heights F e: $50.00 <br />2077 W. Larpenteur Ave. <br />Falcon Heights, MN 55113 Date: ~ ~ <br />651-792-7600 Expires: 1/15/2006 <br />Firm Name : ~b r ~S~ u~ ~~..i~ ~'~ l ~ f U ~.fS - ~ i c~ ~i ,ft n~ r> <br />Business Address: 13~ 51:p1~ ~ 11 ,,~~,~ 1~~,~~ Cx ~.. ~~ ~.c~ ~ ~ -y <br />s-Slo$ <br />Name of Owner: '~}~~.~,,~ i~+F_f'L~ , ~ p-~+Pl,'r_ '~~ ~..ti' ~ <br />Home Address: <br />Telephone: Business: <br />Address/Place of intended sale: <br />~~ <br />• Dates and hours of operation: i r ~p~- ( - - °~ 5th <br />~t~.•rn - ~1 ~-~ <br />List your experience, naming below municipalities in which you have had previous business: <br />1. 7-"e~v"~cx..t..S ~ ~ ~ aQ~~sr <br />LG~Y ~.~1~~.t.a' <br />2' ~C.('afl <br />FOR LICENSE: ~ ~~ 1 l~ <br />ITEMS REQUIRED S J <br />• State of Minnesota Tax ID Form (attached) <br />• State of Minnesota Workers' Compensation Form (attached) <br />• Falcon Heights Fire Inspector approval <br /> <br />Fire Inspector <br />I swear that the above statements are <br />true to the best of my knowledge and <br />belief. <br />_...... <br />Q.P,h. ,tQ ~ <br />Signature ~ , _ _ !, <br />`' ~r~ s~ d~,-~,~ <br />Residence: i~ l -SRC- - ~aS~ <br />