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OCT 25 '93 10:19 BIG WHEEL PPOPIOTIOHS <br />P. 22 <br />CITY OF HOUNDS vIEW <br />2401 HIGHWAY 10 <br />MOUNDS VIEW, HN 55112 <br />Date of Application In n si9a <br />BUSINESS NAME Tr_ wuncr cammnTTnrTc TNr Phone -2ja=2ZL-j32,L <br />BUSINESS ADDRESS 7Q79 W a;r„nrr R1,A <br />(street) <br />u....�*,.,. Ty 77n71 <br />(city) (state) (zip cone) <br />OWNERS/CORPORATE OFPICERS/ASSOCIATES/PARTNERS (name and title:) <br />Jimmie n- WbPfler President/CEO <br />HAVE YOU EVER HAD A LICENSE REVOKED? No If yes, attach <br />explanation. <br />REFERENCES: CITIES WHERE PREVIOUSLY OR CURRENTLY LICENSED FOR <br />SAME ACTIVITY (name of city and years) licensed) <br />Ray Rt. T.oUis. Mississippi <br />R110xi. Mississippi <br />Applicants for the following license(s) must complete the <br />applicable section on the reverse side of this form: <br />amusement devices, bowling alleys, dance halls, garbage <br />collection, gasoline stations, kennels, and restaurants. <br />r r r r r r r r r r r r r r r r r s r r r r+ r r r r r r r r r r <br />I hereby certify that information provided on this application is <br />true and correct and understand that any misrepresentation made <br />herein may be grounds for denial of this application. <br />Applicant's name WHEELER, JIMMIE DALE <br />(please print) Last first Full Middle <br />Date of birth 03/ 18/ 57 <br />me day year <br />Applicant's signature <br />o <br />