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Home My WebLink AboutBusiness License Application 1989-10-3 ~ - - -~rj~_: ~~;<<"I:~_..""L""'-''''' .:':~ . -~: ...... ::..:~:_ ':-..~1;'~~~:::"l...,~ '.-, '"'~". "'...... i",~;'t..,.;'~~ NOTE: FAILURE TO ACCURATELY COMPLETE TMIS FORM WILL CAUSE UNAVOIDABLE DELAY PLEASE TYPE OR PRINT LEGIBLY WITH INK CERTIFICATE NO: 1 I~. ORPORATION AND!2BAS~ED BUSIN,ESS NAME) BUSINESS TELEPHONE T Jt2..J,-~ \::...~l~...~1(."...A 1L/7-18'-1L/ 21 MAIN BUSINESS LOCA:peN ISTREr;T A~~ N~B""" Cln. ZIP-CODE COUNJY A IR~l .5. A_S+,' 'J.' SPri0bf1elcl 97477 ~Ne....- 3IZb~~DN, \A-" ~ S:~~J sTIeR- ZIP'?/7Lf7g A SEPARATE SUPPLEMENTAL APPLICATION (FdAM 372) MUST BE COMPLETED FOR EACH ADDITIONAL LOCATION FROM WHICH YOU OPERATE YOUR BUSINESS. A 1 CHECK ORGANIZATION TYPE: 1 IF CORPORATION. LIST THE STATE UNDER WHOSE LAW BUSINESS IS INCORPORATED "I' 0 INDIVIDUAL ~ PARTNERSHIP 0 CORPORATION DO YOU SELL THESE VEHICLE TYPES? APPLlCA'ON FOR TYPE I BUSINES~ERTIFICA TE ~ ORIGINAL D RENEWAL * AS A DEALER OR REBUILDER OF VEHICLES, \~rn[U]w TR \VE!.. TP,.~.!L~RS MOTORCYCLE/MOPEDS CLASS I A 1VS "'" ",., LB ,\I...... SNOWMOBIL~S ~ ;) MORILE H()MF5 MOTOR HOMES CAMPERS CJ YES ~ "10 DYES [l;1 NO DYES ~ NO DYES DYES DYES ~ NO [E NO DO YOU REBUILD VEHICLES? r-, ',.-,.. L....J It;;", DYES ~, NO [gNO 61 ARE YOU A FRANCHISED DEALER? 0 YES \2f NO IIF "YES", NAME THE MAKEIS): I LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS 71 'OOM. C1~ ~tt?.l-~N<.;l'>l.,\ TITL~)AI!.lrf\.lev D~t,E,?3B~~'1 Rn~~1NlcE~,;/i:';.0~7'1' 8 I REto~~~DR~ \, A ~ S..- c~p~'\wcl ST'i)E V" ZIP CODE'17 Y 7 ;B 91 NAMEI2o~I-.\:>>...Vd) Sie""'..v~uN TliCE P~1-1JV/ DA1[JI!lfl'; s-o Rn~1~c~L~~0~'?<lD 10 I RESID':!!fi~~LsS P A-ILI<. IfJA<<r .\")/t. CITYL/l{)~ STAT&. ZIP CODE ':17,31 11INAME(?I~NN~ F~e Wlc IJA~{ TITLE PftR..TM'--v DATE OF BIRTH R(;~~lCE.!fiE~H~Nl.s-'15l 12IRESID&N9'tD?RESS (\j"A" 'E>, 0rp/<.'N-<.,~,dc:!. STATb-v- ZIPCOD't) Jl./11 I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESENTATIVE AND THAT ALL INFORMATION ON THIS APPLICATION IS ACCURATE AND TRUE, I CERTIFY THAT THE BUSINESS DOES OR WILL DEAL IN VEHICLES, OR REBUILDS VEHICLES AND IS OR WILL BE ESTABLISHED ATTHE LOCATION GIVEN. 31 NAME I I TITl'f I.l. 1 VJM., G~IU., ::> TQ,W1-'l'\.bu!\J r A(lT IV v.r - '1~t, . 141 ZbR~S?fITY;V~TE.~C~,DE 57 S ivJ.'{ L l) Dv 17</ B I ~GNATURE 1- .-AGREEMENT rOACT AS AGENT: (y&e~Ui"~;GN THislAGREEME~ YOU SELL SNOWMOBILES OR CLASS I ATV'S) II (WE) WISII TO BE DESIGNATED AS A LIMITED AGENT FOR THE MOTOR VEHICLES DIVISION, I (WE) AGREE TO COMPLY WITH ALL APPLICABLE LAWS AND ADMINISTRATIVE RULES AND AGREE TO HOLD THE DIVISION HARMLESS OF ANY LOSS OR EXPENSE RESULTING FROM ANY ACTS OR REPRESENTATIONS IN EXCESS OR IN CONTRAVENTION OF AGENT'S AUTHORITY, AND FROM INCIDENTAL EXPENSES DUE TO TERMINATION. 15 ~GNATURE I TITLE I DATE I RESIDENCE TELEPHONE (50", }7t.f6 -1571 APPROVAL: t CERTIFY THAT THE LOCATION SPECIFIED ABOVE COMPLIES 1 6 WITH ALL LAND USE OR BUSINESS REGULATORY ORDINA~CES OF THE ~ CITY 0 COUNTY OF ~ r6-(\.C\~...,J (I II CERTIFY THAT I AM AUTHORIZED TO SIGN THtsJAPPLlCATION AND AS EVIDENCE OF SUCH AUTHORITY DO AFFIX HEREON THE SEAL OR STAMP OF THE CITY OR COUNTY. 171 NA'AE '1 TITLE r.- C.VlV'i+h:lc-.. L. MCl* \"'11 h"nl.Y\C1. I erl.... 18 ~GN~7 DATE ~ BUSINESS CERTIFICATE FEE (INCLUDES ONE PLATE) $96.00 ADDITIONAL LOCATIONS @ $30.00 EACH (SEE ATTACHED SUPPLEMENTAL APPLICATIONS) ADDITIONAL PLATES @ $11.00 EACH TOTAL: $ * IF THIS IS A RENEWAL OF AN EXISTING CERTIFICATE USE THE ATTACHED BILLING LIST TO CALCULATE PLATE FEES. . APpl(M_,\,I; _HIAMeUR~.ALHEREI I KUVtU THE BILLING LIST MUST BE SUBMITTED WITH YOUR RENEWAL APPLICATION Clns&fr.iPIlNIGEIaiDN ANI SURETY BOND WITH ALL REQUIRED SIGNATURES AND FEES TO: BUSINESS LICENSING UNIT, 1905I,.ANA AVE. NE, SALEM, OR 97.3.14-2350 - "';~""~"NS"~bl<'....,..~.~;';':'::;~_;l.l:h_.!.U.;;~-,:;-d~'C.:~",-~~.;:'::"I-.r~;~"""I~ ~ ._.-.:..".., '- ~'",i,. ~ ..i.....,.:.,;...-, . '. ., . - ..--..~ , .-, .'"'' -~:;:~""-- NOTE: PLEASE READ INSTRUCTIONS ON PAGE ONE BEFORE COMPLETING THIS FORM. FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE UNAVOIDABLE DELAY, PLEASE TYPE OR PRINT LEGIBLY WITH INK. . . APPLICATION FOR TYPE I BUSINESS CERTIFICATE D ORIGINAL D RENEWAL* PAGE TWO AS A DEALER OR REBUILDER OF VEHICLES (See bottom right corner 01 page) CERTIFICATE NO: 1 NAME (CORPORATION AND/OR ASSUMED BUSINESS NAME) T.R1- C::::O /..,( J:: I--.\..)~ 'tQP~ \5. F <: ~l)o3-114("-(SI'1 2 MAIN BUSINESS LOCATION (STRE!:T AND NUMBER) CITY .(. ZIP CODE COUNTY I S(~ \ 'S. PI S4. SP,\V\g ie Id CI...'1'-n l lo-.V\e.. I MAILING ADDRESS CITY STATE ZIPCODE 3 (o(p Lf S- I\J. '11" 5 J. . 5 fr"r1Q{" e iet 0 rZ q 1'--\1 R A SEPARATE SUPPLEMENTAL APPLICATION (FollM 372) MUST BE COMPLETED FOR EACH ADDITIONAL LOCATION FROM WHICH YOU OPERATE YOUR BUSINESS. 41 CHECK ORGANIZATION TYPE: I IF CORPORATION, USTTHE STATE UNDER WHOSE LAW BUSINESS IS INCORPORATED: o INDIVIDUAL a PARTNERSHIP 0 CORPORATION 00 YOU SElL THESE VEHICLE TYPES? BUSINESS TELEPHONE 5 MOBILE HOMES MOTOR HOMES CAMPERS DYES ONO DYES ONO DYES ONO TRAVEL TRAILERS MOTORCYCLES/MOPEDS CLASS I A TVS DYES DYES DYES ONO ONO ONO CLASS III ATVS SNOWMOBILES DO YOU REBUILD VEHICLES? DYES DYES DYES ONO ONO ONO 6 I ARE YOU A FRANCHISED DEALER? 0 YES 181. NO I'F "YES." NAME THE MAKE(S): I LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS. PARTNERS OR PRINCIPAL CORPORATE OFFICERS: 7 I NAME \A.) '^' ( ,JeI ..... ~ S f../ ( d, /A ~ f) l->- TITLE Pel >- ~ " e. v-- DJi~ <:':f'~Tg L( R~~~NIC~ T~L~~~N~, '1 al RESIDENCEADDRESS~~..(5 A/. A, ~_ CIT~ r /)"0,, -I ...e-I~ STAT'OJ-<- " ZIPCODEq, L( I~ 9 1 NAME f< () \0-<' y- f Oee u i d. <:;, f-{ tA~l-L ~o h, ~ITL~ )- h -<0 ~ DJz, ~ Z1l.HS- 0 Rf.\'!,!;~T.r-E!:,or~ L./ 0 1 0 I RESIOENCEADORESS .1'),1<.0 CIITZ 10 - STAT"" ZIPCQtl~..., ,..,a 62'2 3~ ,qJ:Llua..-I _ t. __ _Ct 1...c..ll....... (-1"1"--. '-1'-/ , <,-, 111 NAME G k "- ",,- ):qYL i"1C'. iJc, I ( TITLE~ ...f"-'-l- DATE OF BIRTH Rt~~{Wt.E~H2~l.(3 12 RESIDENCEAD.D',RESS II) CITy - L' U STAu;1 ZIPCODEQ.... L( 7 '" _./.iJ1.G>.1. N. . ",(J_ '2y,Y-/nO c./.f2 L../'r-"-__ ~ ( oJ -- t' .-,.-....--- I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESEN'JiTIVE AND THAT ALL INFORMATION ON THIS APPLICATION IS ACCURATE AND TRUE. I CERTIFY THAT THE BUSINESS DOES OR WILL DEAL IN VEHICLES, OR REBUILDS VEHICLES AND IS OR WILL BE ESTABLISHED AT THE LOCATION GIVEN. 131 NAME I TITLE I (ESIDEN,ETELEPHONE 14/ ADORESS.CITY. STATE. ZIP CODE I ~GNATURE I AGREEMENT TO ACT AS AGENT' Any dealer whowanls to bedasignatad.as a~Agenl of the Division must sign this agreement. By law, all Snowmobile, crass I ATV andelas, III ATV . dealers must act as Bllents and must SIIi" thiS apreemant. . I' (WE) WISH TO BE DESIGNATED AS A LIMITED AGENT FOR THE MOTOR VEHICLES DIVISION. I (WE) AGREE TO COMPLY WITH ALL APPLICABLE LAWS AND ADMINISTRATIVE RULES AND AGREE TO HOLD THE DIVISION HARMLESS OF ANY LOSS OR EXPENSE RESULTING FROM ANY ACTS OR REPRESENTATIONS IN EXCESS OR IN CONTRAVENTION OF AGENT'S AUTHORITY. AND FROM INCIDENTAL EXPENSES DUE TO TERMINATION, 1 5 ~GNA TURE I TITLE I DATE LOCATION APPROVAL: I CERTIFY THAT THE LOCATION SPECIFIED ABOVE 16 COMPLIES WITH ALL LAND USE OR BUSINESS REGULATORY ORDINANCES OF THE [?l CITY 0 COUNTY OF 6otUtch-J.f. II CERTIFY THAT I AM AUTHORIZED TO SIGN THIS -APPLlC..rl'ON AND AS I EVIDENCE OF SUCH AUTHORITY 00 AFFIX HEREON THE SEAL OR STAMP OF THE CITY OR COUNTY. 171 NAME~^.fWQ. L .Noff-~II111JiL;TLEf-U'L 1alSIGNATURE (, /J - L" I W4~ D~ X L)f^ 'f"lJ\ / 6._ . lL1.r! rt I APPROV~.If"~"AMPUH'''ALH'' E) CIT'i OF SPRINGFIELD BUSINESS CERTIFICATE FEE (INCLUDES ONE PLATE) $96.50 ADDITIONAL LOCATIONS ~ $30.00 EACH (SEE ATTACHED SUPPLEMENTAL APPLICATIONS) ADDITIONAL PLATES @ $11.50EACH TOTAL: $ * IF THIS IS A RENEWAL OF AN EXISTING CERTIFICATE, USE THE ATTACHED BILLING LIST TO CALCULATE PLATE FEES. THE BILLING LIST MUST BE SUBMITTED WITH YOUR RENEWAL APPLICATION ... """"'"'' Sl"lEPRlNTlNG /83/ Sf1 NOTE: PLEASE READ INSTRUCTIONS ON PAGE ONE BEFORE COMPLETING THIS FORM. FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE UNAVOIDABLE DELAY. PLEASE TYPE OR PRINT LEGIBLY WITH INK. 1 I NAME 1S9i.';~ATlO~ AND/OR ASJl'MEO BUSINESS NAME~ ~ (/'1t;.,?ir./4/.? {j,,~J'l.t/z./;)O ~.L(. 2 MAIN S-o-StNESS LOCATION (STREET'AND NUMBER) SU;Y lIP CODe J7f{ti.! ,~.,4 ,'?T"~) 0"o.<t.v&Pc::,,( 6 97-</77' 3 MAICI'f)03ss-&~-ji--';;- ~3-r ,gPrh~?L/6;: ^ s~,(C, 19~;;'7% A SEPARATE SUPPLEMENTAL APPLICATION (FORM 372) MUST BE COMPLETED FOR EACH ,ADDITIONAL LOCATION FROM WHICH YOU OPERATE YOUR BUSINESS. 41 CHECK ORGANIZATION TYPE: -.- . [IF CORPO~ION, LIST THE STATE UNDER WHOSE LAW BUSINESS IS INCORPORATED: D INDIVIDUAL D PARTNERSHIP a CORPORATION (f /6=- r-::/?.J DO YOU SELL THESE VEHICLE TYPES? APPLlCATIO~R TYPE I BUSINESS CE.ICATE AS A DEALER OR REBUILDER OF VEHICLES D D PAGE TWO ORIGINAL RENEWAL * (See bonom fight corner of page) CERTIFICATE NO: BUSINESS TELEPHONE 7?"~ . ..39.t/9 COUNTY ~A;k; 5 MOBILE HOMES MOTOR HOMES CAMPERS DYES DYES DYES 0'NO Cd'NO I6NO TRAVEL TRAILERS MOTORCYCLES/MOPEDS CLASS I A TVS DYES DYES DYES WNO CiNo ONO CLASS III A TVS SNOWMOBILES 00 YOU REBUILD VEHICLES? DYES DYES DYES G'NO erNO WNo ARE YOU A FRANCHISED DEALER? DYES - [3"NO llF "YES," NAME THE MAKE(S): 61 I 7INA~LP// ~/c)..?~.J ITITl~&? DJ)_~~~T,~~ (:r~CE~~!~.N~9~91 81 RESIDE EA'WRES~~ ->)/ r,.J 0'-- I CIA; .,-- I STATo.?'J ZIPCElD-E->/-""".p I ;,?,", 00",,,,, ._'',/ ,,:,,k'//J1f?/-/t'>0 (1../4 <.~'/."/,, 9iNAM:..v..o ^.{J, ~;;,os",J T~~~r 7/,:;..<IS D~:~_B~~ Rt~~~CE~~~~9#"9 I 1 0 RESIDENCE ADDRESS ~~(';,H",( ~ STATJr),,('" ZIPCODQ 7-/T.$.. I 11 NAME TITLE QATEOFBIRTH RfSIDEN{ETELEPHONE 1 121 RESIDENCE ADDRESS .C:,y._,___-"-'m' STATE .... .~~:~.~DE "__J I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESENTATIVE AND THAT ALL INFORMATION ON THIS APPLICATION IS ACCURATE AND TRUE. I CERTIFY THAT THE BUSINESS DOES OR WILL DEAL IN VEHICLES, OR REBUILDS VEHICLES AND IS OR WILL BE ESTABLISHED AT THE LOCATION GIVEN. 31 NAM.s--;, , [ TITLE 1 -X.4.L-~d '-:;r;~,,},go) 0~ 14[ ADDRESS,CITy.STA23.ZIP~_D~N' Q CJ, l SIGNAT",. 9i'?.:5 '-'0. Jc, lor:. <:11".('/,)0;'16 k\ ,X /"" I AGREEMENT TO ACT AS AGENT' AnYdealerwtlowaiitslObedeSlgnated.asa,!AgentollheDivisionm~nth' agre I . dealers must act 85 80an!s and must SI!in thiS a~reement. II (WE) WISH TO BE DESIGNATED AS A LIMITED AGENT FOR THE MOTOR VEHICLES DIVISION. I (WE) AGREE TO COMPLY WITH ALL APPLICABLE I LAWS AND ADMINISTRATIVE RULES AND AGREE TO HOLD THE DIVISION HARMLESS OF ANY LOSS OR EXPENSE RESULTING FROM ANY ACTS OR REPRESENTATIONS IN EXCoESS OR IN CONTRAVENTION OF AGENT'S AUTHORITY. AND FROM INCIDENTAL EXPENSES DUE TO TERMINATION. 15 SIG"l"TURE# ~;- / [ TITLE I DATE [ X.?K::I/7;~ (.J[.d/>bo-..-J ......9.:cr 12::-G<.S'. /CJ--5.('f9 ~TldN APPROVAL: l~RTIFY THAT THE lOCATION SPECIFIED ABOVE 16 COMPLlES~TH ALL LAND USE OR BUSINESS REGULATOF!.Y ORDINANCES BUSINESSCERTIFtCATE FEE (JNCLUDES ONE PLATE) $96.50 OF THE ~ CITY 0 COUNTY OF 6Mll~ J d II CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLlCATIJ ~\..AS I ADDITIONAL LOCATIONS @ $30.00 EACH EVIDENCE OF SUCH AUTHORITY 00 AFFIX HEREON THE SEAL OR STAMP OF (SEE ATTACHED SUPPLEMENTAL APPLICATIONS) THE CITY OR COUNTY. ADDITIONAL PLATES @ $11.50 EACH 171~~_~~1~jlLUIJ f'L.tI-7\J/\JiltX~)E TFCH.I Is ATURE ,1. ' ,-./ L DATE 18 _, :~~,-1,}1/f.t d. \J\liK,'lr\'lm /O-J,;J.-5)'Cf_ I U (PLACE ~TA"~P rln roc..... __, ' APPRO'ltS ' CITY OF SPRIIIGFIElD LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS: [RESIDENCE TELEPHONE (OC,(5) 7-'/C.-39.-/9 TOTAL: $ * IF THIS IS A RENEWAL OF AN EXISTING CERTIFICATE, USE THE ATTACHED BILLING LIST TO CALCULATE PLATE FEES. I THE BILLING LIST MUST BE SUBMITTED WITH YOUR RENEWAL APPLICATION P'Oduladtly ST"TEPAINTING