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CITY OF MOUNDS VIEr <br />LICENui Aii <br />�.r•T i uri 7On" <br />Page Two <br />ANUSENBMT DEVICES ONLY: <br />Number of Amusement device' <br />BOWLING ALLEYS ONLY: <br />Nusbor of lanes -- <br />DANCE Y1LL1 ONLY: <br />Now long in oper'tlon at given oddrea' <br />GARRAGH COLLECTION ONLY: <br />E,Iuipssnt to be used <br />+ br disposed <br />manner in which garbage wl .. <br />Place <br />served ID Noun <br />lndicsting customs r�. do Vleu or list thereof. <br />Attach gap <br />GASOLIMR STATIONS ONLY: ' <br />Number of Pumps ofe storage tanks <br />Number A capacity 80 <br />ILENNELS ONLY <br />Rtaldrn[lel <br />Chock ono: Co uerclal <br />Number 01 doge <br />.,1RSTAURAMTL ONL:: per dsy <br />Numb*, of noura open <br />Occupancy load u <br />Hsesues'eesestetteett•eu ueees�eutteeetONLY <br />sseuuerrs ueueueeeee <br />FOR OFFICE USE <br />fee <br />Date -' <br />Receipt Number <br />Maw Renewal <br />Police Chief: ApProvsl <br />Date of Council Approval <br />Disapproval <br />License Number `� • <br />