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GERALD S CORRICK 8042789483 P.02 <br /> City of Falcon Height <br /> CORPORATE LICENSE APPLICATION <br /> TO: City of Falcon Heights Fee: 50.00 <br /> 2077 West Larpenteur <br /> Heights, MN 55113 Date: <br /> 644 -5050 <br /> Expires: 12/31/93 <br /> Firm Name: 4 464 P c# a "&mac d4 Co <br /> I rieW5 <br /> Business Address: I 401 iAk.at 1-4be 'ttwr Aet. <br /> frantril ll In l rJ 55113 <br /> City State <br /> Name of Owner: f era ki S. COnrI Ck <br /> Home Address: 3321. Scarf Aden tom' <br /> getwiP)r+ Cd VA 23221 <br /> City State zip <br /> Telephone, Business %Z) Lq5 O38c Residence: go 27 9 33 <br /> Le�' s L ew;; lm_ <br /> Type of Business: <br /> List your experience, naming below municipalities in which you <br /> have had previous business: <br /> 1 1A <br /> 2. <br /> 3. <br /> ITEMS REQUIRED FOR LICENSUBE: <br /> State of Minnesota Tax ID Form <br /> 1 State of Minnesota Workers' Compensation Form <br /> Falcon Heights Fare Marshal Approval new business only) <br /> I swear that the above statements <br /> are true to the best of m knowl <br /> and bel' f. <br /> Ci u•► <br /> ign ture r <br /> Fire Marshal <br />