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<br />CITY OF LAPORTE <br />APPLICATION <br />(Fee Changes per Ordinance #05-2837~ Eft: 10-01-05) <br />(,/f Emergency Auto Wrecker Ammal Permit <br />() Towing Vehicle Annual Permit (Non-Emergency) <br /> <br />Re,..,... <br />'- '1 /, \,1' ',-' <br />-"'~'''-D <br />" <br />AUf' 0 ... <br />"'~ ~ t) 20Do <br /> <br />Annual Fee*: $75.00 Per Vehicle <br /> <br />Ownership Transfer Fee**: <br /> <br />$25.00 Per Vehicle <br /> <br />~~ <br />^~~ <br /> <br />* <br />** <br /> <br />Note: Permit fee gm be Pro-Rated by the Month.; $6.25 per month) <br />A per:mit issued is personal to the owner and is not: transferable between owners <br />without the express approval of the Wrecker Committee. <br /> <br />Permit Application Deposit Fee for New Auto Wrecker Permits: <br /> <br />$150.00 <br /> <br />ALL PERMITS EXPIRE ON DECEMBER 31ST OF' EACH YEAR <br /> <br />CompuyNametobeShownoDPermit: ~./fjJ()lLf€ IDW{ ~J If"" <br />(If other than Applic8:ot Name shown below) <br /> <br />Individual ( ) <br /> <br />Individual. Partnersbip <br />Or Corporation Name: <br /> <br />Partnership ( ) <br /> <br />Corporation 0 <br /> <br />Telephone: <br /> <br />I-A;/J D(l2.:fe /D (,1,[ I ~I' ~ <br />2DZ- U, /lrA <br />It) AD X ff'7 <br />2q'! -170 -200 c.f <br /> <br />Physical Address: <br />Mailing Address: <br /> <br />List Name! Address: (a) Of all Partners OR (b) Cotporation President and SecretaIy. <br /> <br />1) /J/hv 5;{,c <1M <br />f N <br />JA. Nff S/;Cc.JP\ <br />Name <br /> <br />Name <br /> <br />Address <br /> <br />41,(tJ/zk - ry 77')-7 ( <br />0!Y~~~ <br />J.!!t..f!~P 'ry 17:>7 ( <br />City/StatelZip <br />City/StatelZip <br /> <br />,~~ <br /> <br />/()({39 )1(/!fJeA2-y <br />Address <br />/o<g3Q It tJ/~V <br />Address <br /> <br />2) <br /> <br />3) <br /> <br />1) / q qg <br />Year <br /> <br />List AD Vehicles Needin2 a Permit: <br /> <br />h~ ~ 70<172..6 <br />'odel MotorlI.D. '# License '# <br /> <br />2) <br /> <br />Year MakelModel <br /> <br />MotorlI.D. '# <br /> <br />License # <br /> <br />3) <br /> <br />Year MakelModel <br /> <br />MotorlI.D. '# <br /> <br />License '# <br />