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DIPARTMINT OP REVENUE <br /> • MMIEINAL APPLICATION MR MALT. MOM -..__. -wills-wi'nH s dice- _ 0. <br /> AM MTII0IIR IMO MGM 0P CM1 ACTIOM • .!}' <br /> (GET APPROVAL M LOCAL UCIIUMS AITMOMTY ROM) <br /> i4ANZANARtS T E APPROVED mg - <br /> NANZANARES CAKt,LYA M <br /> ,Jo SENOR T S DISAPPROVED 0 a <br /> •ot 132 MAIN ST e.df - 99 .4 <br /> LOUISVILLE CO bf.C27 'may n+o <br /> ,0 ..p. ,- _. <br /> . - • otncElr><san+A . .. <br /> -'•sir THAT THERE ME NO CHANGES TO MY ORIGINAL APPLICATION [3[ 11jJ[3(J J[JD .-U@ P Y+ <br /> •: CHANGE OF MANAGE#,TRAD NAME OR CORPORATE STRUCTURE. <br /> > 1/VAA- 151kahLi • <br /> (IF THERE IS A CHANGE IN OWNERSHIP DO NOT USE THIS FORM.USE AN ORIGINAL APPLICATION.) <br /> -'•PQ°_s8NI MANAGER'S NAME MAKE CHECK OR MONEY • <br /> ••.5i RUCTIONS V APPLICANT IS A CORPORATION,FILL IN REVERSE SIDE. ORDER PAYABLE TO THE <br /> IL REVERSE COLORADO DEPARTMENT • <br /> NEW TRADE NAME _ . _ .... • . - - - - - • Of REVENUE. <br /> .-wAL APPLICATION FOR LIQUOR LICENSE(S)POI THE YEAR ENDING DECEMSER 31----•, TOTAL PEES) .. <br /> .-wl+rn wows Am - wow rros>~stta.r • .. . <br /> .0 unnwcc . _.__-_caort' cat► . wow _Po4 .s..aun oar • . <br /> 1:-L13395 ' 0T 041 5d12 5 030573 1974 $ 25.G ) <br /> ,;c NAME AND DESCRIPTION OF LICENSE - FEE <br /> et-ER, WINE, ANC LIQUGk LICt(ISE (h6TCLe REST.) 4 15.,j1 ' , <br /> ',.glowing affdovit M be signed and ockaowfadpod by Individuals and each member of partnerships end by corporations)(rf appCcation it for <br /> .,tar's license,insert;tote of business residence. )g <br /> .'1 OF COLOR <br /> •ry ofd-+ SS <br /> • <br /> c ..r '`a ngr i4V-4'being by one first duly sworn.if for Nowell.dhows end**mikes he Is the opplt.M above <br /> • -d.or that%a it / of the oboes nomad for ,Thot be het nod his original application end <br /> •i,knows the cements thereat and that ell marten ea things therein wt forth ore true hit own knowledge,and he press to ce*hrt*I.td, <br /> red regvset*M prv,*v:jrrsd by Ote M!A1TMPNT Of REVENUE JN CONWPCTION THEREWITH. <br /> • asCRI�R tirifIN TO WORE ME INDIVIDUALS AND ALL MEMWS OF PARTNERSHIP OR NES.OR SECY. <br /> .,.�` .1. , '■jit r OF CORP.MUST SIGN am ,• <br /> • �_ , • - -- -DAY y? • .• „er,4"•. 14..". AISPol N. IS <br /> } st0lw+r n C � I <br /> ust+ coeroaAn SEAL}e ti i <br /> ■ :Or:tM?SSION UPiRER / 976 RY - - _ KQMQRATE M <br /> .rr'1; t,d (M11+0lt+r oe aecRErAStI <br /> tttrs'r...,,s.. • <br /> REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY . -- . <br /> r+s....s.fl leIS.vrttosamllloe.iwoin**MO RALLWADS DIOREGMD tH4 UCTIOtq <br /> inel application has been eronsIn d and the prw.ises_inusstigoted and we do report that the proposed premises will comply with t$to prase. <br /> .of CM.75.MT.2,CRS,1963 as on+eeded.role M styes license,oud we do further ehh that the clmoroctsr of the .ppficoM is satiefsciwy <br /> I that such ken..,if rented,will mast the reatenlNM requNIMMh of the neighborhood and the desires of th.inhabitants. <br /> •,r rEFORE THIS APPLICATION IS HERESY APPROVED. <br /> I!D AT THIS DAY OF ,A.D. 19 <br /> :••.IL OF TOWN,CITY OR COUNTY) <br /> IIY, <br /> (AAYOR 01 CHAIRMAN Of 10Aso Of COU$+TT CO•M4WOwti Ore ODdI faTgt OF tsaf+swa AuTPIORITY.) <br /> ATTEST. <br /> lCUM Oe MOW ARY oil OT++E4 OWES SAVING THE 0f0ICIAL SEAM Ot THE UCENSevG AUrnOSITY4 <br /> - ,•premises ore located within is sow*or ally,the above oppraroi thoyld be signed by the warm end clerk;if In a caanty,then by the choimmes <br /> • hoard of county commitwwers and the clerk to the board.11,by ordinance or otherwise. Mw local Beanie,. avtho.:ty it some sdrer official,' <br /> .oca approval should be given by ,,,cI. o#t.6a1) <br />