Laserfiche WebLink
Wrecker Permit Application Page 2 of 3 <br /> • <br /> List Vehicle Needing a Permit: <br /> doo For. C h 94 <br /> Year Make/Model Motor/I.D. # License # <br /> If Vehicle is not owned by the Applicant, list vehicle owner's name and address: <br /> 1) <br /> Name Address City /State/Zip <br /> 2) <br /> Name Address City /State/Zip <br /> 3) <br /> Name Address City / State/Zip <br /> NOTE: If the 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 statutes <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 shall individually file applications <br /> certifying to their individual qualifications within such time. The failure to certify within such time ar to <br /> possess such qualifications required of such persons under Article III, Section 78-297, shall be cause for the <br /> suspension of all permits held by such corporation or partnership. <br /> I hereby certify that all the statements contained in this application are true and correct to the best <br /> of my knowledge. <br /> X X <br /> I.44, Partner / <br /> X X AL_iA. • ;� ✓L G. <br /> Corporation President attested by Corporation Secretary* ** / <br /> * * *If Corporation, affix corporate seal to this application <br /> SWORN AND SUBSCRIB :a, to e, the undersigned authority, by the above <br /> named erson, this the /' 4 "" day of k p. c -iC, ( 6 . <br /> ViCK1E LAWRENCE <br /> %OF MY Commission Expires 41.-1.-/ <br /> Naito* August t, 2012 otary Public for the State of Tetras <br />