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Wrecker Permit Application <br />List Vehicle Xeedintx a Permit <br />)Cd -Twiv- <br />Yeai Make del MoMr/T T) <br />'Ou)�3 woan4�j <br />License 4 <br />If Vehicle is not oymed by the Applima me and address: <br />f, list vehicle owner's mange <br />1) <br />2) <br />3) <br />Name Address City/State/Zip <br />Name Address City/State/Zip <br />Naine Address <br />City/State/Zip <br />Page 2 of 3 <br />NOTE- H tile towing vehicle is operated under the terms of a contract with some company <br />other than the owner, a copy of the contract shall be attached to this application. <br />I hereby agree to obey the provisions of the City's rules and regulations, ordinances and smtatcs <br />applicable to motor vehicles and understand that upon my failure to so obey such laws that my permit may <br />be revoked or suspended without notice. <br />I understand that all changes of'.officers or partners shall be reported to the City Secretary within <br />ten (10) days after the change, and such new officers or partners small individually file applications <br />certifying to their individual qualifications wiflAn such time. The failure to certify vidthin such time or to <br />possess such qualifications required of such persons under Article R Section 78 -297, shall be cause for the <br />suspension of all permits hold by such corporation or partnership. <br />I hereby certify that all the statements contained in this application are tare and correct to the best <br />of my knowledge, <br />Individual Partnc;'I, <br />xk�o X <br />Corporation President attested by )Corporation Secretary"* <br />***If Corpoiaticin, affix corporate seal to this application <br />SWOBN AND SUBSCRIBED to before me, the undersigned authority, by the above <br />riarned person, this the ) I day of —1()VUL, j bt <br />NICHOLERICHARDS <br />Notary Pubk, Stato of Texas <br />My Commission Expires: <br />01/30/2016 <br />X 4uk� <br />Notary Public for the State of Texas <br />