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t <br />��� <br />CN <br />� <br />H n <br />'+tl M '9 <br />N�C4 �p <br />HC <br />On� <br />4� <br />ry� <br />ppW <br />f'1 � N <br />HQ� <br />� <br />� <br />: C� <br />� <br />� <br />� <br />� <br />t?DaZ <br />City of Everett <br />3002 Wetmore Avenue <br />Everett, WA 98201 <br />206-259-8610 <br />-���� �7aoo <br />�1��� <br />PUBLIC: DANCEHRLL LICENSE APPLICRTION <br />�>o i <br />DL <br />everett <br />A licant Name• o�ifi3�viFo.Eo z Co. ,.zNCi <br />-PP ------�---------�e3lf___ �E%ZS �eST�3cr�a.v'T <br />Home Address: r1Zo N. ����w�1 ___�u. wa <br />Rione:---2�12���t1__ • <br />Eusi.ness Address: O( /G6 HL�OGE55 — /So8 f/CcUiT.� <br />� Z� _ <br />Phme:--�SZ-1e639_,• v E'v�.G� tuo'. <br />Applicant is a Sole Proprietor: <br />Applicant is an unincotpotated association, partnership, or <br />Corporation: C'pPP .(Attach list of names and hane and business <br />addresses and phone numtx rs �f all officers, limited partners, and <br />dirPctors thereof.) <br />Operator (Man3ger's)Name: "���� _ � • �T���a'�p <br />Homc Address: i 33 S. �%�✓� t s � p L ArCP SreVE�/S, wa • <br />Phone:_ ���8 <br />Business Address: 9,�I.o N. �� ao�..� a y C t� . t.�d <br />Phone: a S 8- S.Pi/ _ � <br />Propert Uwner Name: Se�c� rf� �c7u<�� �*J� <br />-- --Y----- g-- --- ----- <br />hi�me Address: Mati a2a,.,c� Se_�.n,LE_ _ <br />Phone: � _• (p2/- �9/B <br />Business Address: <br />Phone: <br />MPLICANT MUST PROVIDE THE FOLLOWING I�FORMATION, IVHICH MUST BE ATTACHED <br />TO AND MADE A rART OF THIS MPLICATION: <br />].. A written statement setting forth all measures used to i�sure <br />adecuat� traffic control and crowd protection, both within and <br />without the �;remises, will be maintained; <br />2. Proof of indertnification and insurance is required by Section <br />5.20.150 for public dancehall licenses for teen dances; <br />3. A statement from the applicant that the premises are in compiiance <br />with all city laws includi.ng, but not lirr�ited to, building, <br />zoning, noise and fire codes. <br />(PLEASE CONTINUE ON BACK) <br />df '�� e.es <br />'�iQ�-5. - oT•9ri�gs -�TArI//�21� 333 S.7Tda�ES •ebo�4 <br />�3.� /aa8 �qfCe ST6[iEn�s u�a <br />c�C',72e� - ��P_E.0 S7An' i�� .e,o - 05 9�'Yr c <br />