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11-21-11 Council Agenda
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11-21-11 Council Agenda
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11/21/2011 10:18:49 AM
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5. A. If applicant is a Partnership, state full name_ residence and business addresses, telephone <br />numbers, and interest of each member in the partnership: (If more than three, include them <br />on a separate sheet.) <br />Name <br />LAST FIRST FULL MIDDLE NAME <br />Date of Birth Interest <br />Residence Address <br />Residence Telephone <br />...- ...... <br />Business Address <br />Business Telephone <br />.................... <br />Social Security Number <br />Driver's License Number <br />2. Name <br />LAST FIRST FULL MIDDLE NAME <br />Date of Birth Interest <br />Residence Address <br />Residence 'Telephone <br />Business Address <br />Business Telephone ... <br />Social Security Number —. --_ <br />Driver's License Number —_ <br />Nance <br />LAST- FIRST FULL MIDDLE NAME <br />Date of Birth Interest <br />Residence Address <br />Residence Telephone <br />Business Address <br />Business Telephone <br />2 <br />3 <br />
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