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License #
Application Date: Applicants Name: Applicants Address: Telephone Number: Property Owner if other than Applicant: Owners Address: Telephone Number: Date(s) of Sale: Rain Date(s): Dates and Nature of any Past Sales within Current Year: Hours of Sale: Email Address:
Fee: $10.00
By signing below, the applicant affirms that the information contained above is true, correct, accurate and known to the applicant to be so. The applicant also acknowledges that he/she has read extracts of Section 127 of the Code of the Township of South Orange Village (See back of this application) and agrees to abide by the provisions of same.
If approved, license can not be issued for more than four (4) consecutive calendar sale days.
Signature of Applicant ____________________________________________________________________________________________ Office Use Only Application Complete $10.00 Fee APPROVED ________________________________ Authorized Signature ___________________________ Date