2004/06/01 - LAND USE - CUP - Conditional Use Permit - 1213

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MOTOR VEHICLE DEALER Wisconsin Department of Transportation Dealer Section TWO YEAR LICENSE APPLICATION FOR OFFICE USE ONLY 4802 Sheboygan Avenue MV2186 1/2001 Ch.218 Wis.Stats. 1 Issued Expires P.O.Box 7909 Submit in duplicate. I I Amending Current Madison,WI 53707-7909 License Information Legal Name Area Code-Telephone Number Dealer License Number 3. I(Z .iL) h.c97-1-01\Szo&c S sN C- 71S =?`11,-7S7W Trade Name(s)or DBAs Federal Employer Identification Number Street Address or RFD Post Office Box Number City State Zip Code Coy,_where business located 'RO 9 4S -C P i Rory 70 . k(z.�t.) lk,i 5`I 5C7A -o(z 1 t. Type of Vehicles to be Sold Business Entity If Corporation or LLC, ❑City ❑Village Xi Township Date Licensed in Wisco sin N •utos Name: l i.-.EN ❑Sole Proprietorship Association p. 4 Trucks ❑Partnership NrCorporation 1 i ICA QL State of Incorporation or Organization ❑Motorcycles 1 ❑ LLC • List makes of new vehicles to be sold 1\....1 D t Address of NONADJACENT Sales Location in SAME MUNICIPALITY' `` I Vq Branch: Q IVC- Sublot: Name and Title of Owner,Partners,Association Members,Corporation Officers snd Shareholders,LLC Managers and Members Complete an Entity/Owner Statement(Form MV2844)for each individual listed. _Qk.' ,_ (:)-1,--Vo r-5?- es>„-k L.)LE-::cc- .... owt.Dec)., /?&E4, k. )..)-1-- Completely describe other business,if any,engaged in by your firm Same location? License Numbers of Additional Dealerships CD t`•-:)C ❑No ❑Yes Was there a licensed dealer at this same location previously this year? - Do ou own and op ate ur own service department? XNo ❑ Yes,Name dealer Yes No,Attach completed service agreement Complete ONE of the followin whichever a av you,as an it ividual and your above-nam d fir ,been licensed as a dealer before? p g( pplicable YES NO Is business real estate owned by: No Yes,Same location? No Yes om Owner of sole proprietorship ❑ ❑ If no, Ha your motor vehicle dealer license ever been denied,suspended or revoked? ❑ ❑ No ❑ Yes,When and what state? One partner of partnership send copy "E..Corporate dealership El lease. ou licensed as a motor vehicle salvage dealer at same location? re k ❑ No El Yes,Give license number LLC • AUTOS TRUCKS MOTORCYCLES OTHERS(specify) SALES TAX Number of New Used New Used New Q Used New Used SELLER PERMIT NUMBER vehicles sold Retail in last 12 month period 0 O 0 0 Wholesale Please check only ONE box that applies to your dealership. Dealer License(Required fee) $40.00 40, 00 Call 608-261-9555 if you have questions about these fees. 0 -0C, X1. During the next two years our dealership will sell all vehicles Branch License $40.00 on a cash only basis. Fee due is$20. Sublot License $2.00 0- 0° 2. Our dealership originates retail installment sales contracts Salesperson License Number 7— x$8.00 - aC) and/or consumer leases. (If test required,pay examiner) ❑a. All of the contracts or leases we originate are sold or Buyer ID Card(s) Number x$12.00 t7- 00 transferred to a third party. Fee due is$100. 0 Gc) ❑b. Some or all of the contracts or leases are retained by Dealer License Plates Required First 2 plates=$150.00 1 S our dealership. Fee due is$100. Number of additional plates . @$10.00 `rte : 00 ❑3. The total amount of installment contracts and/or consumer List letters of all missing plates leases originated and retained in the last 12 months was $ ,which is$100,000 or less. Fee due is$100. ❑4. The total amount of installment contracts and/orconsumer Replacement License Plates for lost,damaged, leases)originated and retained in the last 12 months was or illegible plates each plate$2.00 0. G 0 $ ,which is greater than$100,000. Do not .1 CHECK PAYABLE TO: REGISTRATION FEE TRUST $ - DO submit a fee. You will receive a separate bil Does your dealership write credit insurance? No ❑Yes ' CHECK PAYABLE TO: Department of Financ a nstitutions I,the undersigned,certify under penalty of s.345.17 Wisconsin Statutes,that(1)a lease agreement covering at least the licensing year has been executed,if premises are not owned by applicant,and(2)the answers and statemen- •- his-•.Ica •• -re u u ,n ik orrect to the best•f my • knowledge. C'� _ * �' �� dw: '. sl�WT I D 01 C'.)4 See reverse side. • — (Authorized D-.lership Agent,Title) (Date)