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Port Coquitlum, B.C. V8C 2A8
941-5471 - Local 238

APPLICATION FOR BUSINESS LICEN

4 25S.
FILE wo Kt 22 8

Application 13 made herewith for a Business Licence: in support of which. the follawing information concerning the applicant and the
business 3 submittca:

Business Trade Name: (Corporation or Personal)

RALE! GI YG 14 Aw 1

{€ Corporation:
“Name of President: Address of President:

Business Location:__ 2649 4A ECUGHEE Huy, Lhnr auirurmeegnone HEY G/B
Business Mailing Address: sh 2 OD BOL ge. ; \
Applicant's Name tn Full: FRANIA -MULLIE Ad Home Teléptuane:__*6 7 3/£ 3
Applicant's Home Mailing Address: 255 3- 22 PH sr DIAPLE RIDGE Bc,

Position in Conpany. - Date of Birtix: BL 2 Lok A Sie Zoed S/2P css
Fut! Description of Business Activity intended: Seze- Seeve oA 2 Sa fs Cpe CERRY Sure Ss

"Have you held 2 Licence Previously? Ye 2 Vinere:Agous Leen Tigh When: Cu RRENT (E: BEY 3)

Has Licence aver been canceiled or refused?._ AO
NUMBER OF PEASONS ENGAGED IN BUSINESS.

Principals:__. ED, _ Regular (Full Time) Part Time =
‘A. ‘ PRESIDENT BUSINESS: wo . ‘ j a

: r .
‘_Floor Area: (square feet). fate: Commencement Date: __ Certificate #
NON-RESIDENT BUSINESS: (Contractor, etc.)
Commencement Date: Certificate «

RENTAL UNITS:

New Licence:...2_ Ale-apntication: Transfer:
Type and Number of Rental Units: .
Rooms: Hotel/Moter
Suitas:
Bachelor 1 Bedroom Bedroom Bedroom —_

Other . , .

Name ef Manager: . Telephone:

Address of Manager.

Barbers & Beauty Parlours: No. of Chairs: - Noa, of Operators:

Pool Roons & Bowling Alleys: No. of Tables: No. of Alleys:

Vending Machines: 1¢ Only Machines: Other Machines

Wivic hareby make application for aticonc ev in accordance with te particulars as above stated and avckare that the above statementss true
‘and correct, and fl uncerstand that iftam granted the licence apphed tor. must comply with eacn ang every Colngation contained matiLaws and

By-iaws now in force, of which herealte: come into force in the City, —_F , f
Py f. fe ‘
vate: LP LIL 9, GO SIGNATURE OF APPLICANT Klint Bel hilegueee..

IT 1S AN OFFENCE TO MAKE A FALSE OLCLARATION

Tb oases VE OMLY:

CLASSIFICATION: . FCG: saeewe. TRANSEER CHF LICENCE NO oo. access

DATE: .s — APPROVED:

Licence ttspector