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f a•'' - RENEWAL-APPLICATION FOR MALT VINOUS r
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<br /> ?R AND SPIRITUOUS LIQUOR LICENSES L1ptWR 11NFORClMlNT OFFICER'S ACTION
<br /> iitto(GET APPROVAL OF LOCAL LICENSING AUTHORITY FIRST)
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<br /> � _ SIl9 la�ALOG' __t Arriov o
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<br /> 81 Ails -,. . ..,. OfIAIP OV/10 .
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<br />- - � ' : atilLt.eerQ; ;. .: "80027 . . ', .,.,_•- -.
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<br /> t- ,:t,•- .-`,.i 'fir. a '♦ .L't•.+ f
<br /> ECEItLIFYTNATTMERPARE NO CHANGES TIT lire ORIGINAL APPLICATION t •
<br /> EXCUPTCHANGE:OSMANAOEII,TRADENAYEORCORPO RATE STRUCTURE, ' `'A,,ti,
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<br /> s E♦TM' E 7k MANGE N D1NNE HIP 0' NOT USE THIS FORM:USE kN tGINAL APPLICATION.).
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<br /> — ,aM0*TAMT '' MAXI CMRCK ON MONIY -
<br /> IP-A t) A1ITA A - ofto/R PAYA$LE 70 TW(
<br /> SE.HrTRYCT10/1/+_11f4A1NLICANT NIA CORPORATION.FILL IN NIVIIR3E 31011. apLWt PA SUI 7 e1TNT
<br /> Cx T P- DIV.—R[Vr(rltf. 0 0.0 F/WM11 NC. y' OF R[Y/NVll.
<br /> '.!1IAt APPtiIC Film LIQUOR SIC NSE )F R 7ME YEAR ENOIMrf
<br /> TOTAL FEE(*)
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<br /> 41.4 4111•11.40•01 41Ier l' • arur.Met
<br /> 1cr 2385r?t1('.I!'I"',.,a,07 041 •592L. £--070779 • - 070679 177.5.4
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<br /> TYPE �+
<br /> �_. '' t<< 4 NAME AND DESCRIPTION OF LICENSE
<br /> D F.I ".61..11 '9(.jl TORE LZCENSF - KILT. VI 4OU57 AND
<br /> •1;?J '1 1 )'•- $ 5_D.00 t -
<br /> i•C_Irei �- C 4'1 OAP FEE • - . $ 177-50 ,
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<br /> — .'.0 fur.. _,1.r. of''' lees far welt' this appltt:stson for Imam it made p
<br /> •.ha� ffr.nted.effective aexpiraton date of lama. 074
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<br /> .:3l.eawt(al or at,oI�iaH'bt;d/a eo•rwation,daanl.)of the United Suds o/Amitita>
<br /> .'•ap 4.W7t,or any of the Partnwa.or arty O<the oH.c.s.atockhWdars Or directors 01 Mid ebbllCant(1f it is e carom. extort.
<br /> - erneleatim of arty suck.Wndar•'the so of twantyor.e rein? " ' • Yee - - ♦lo
<br />- .!M apioSKant.or any of the tharereig,or any of the officers.ato rs ckholda or thirteen of said 1pplicant(.4.t H•Corpora- —
<br /> )aver Wan Con.iet.d Of•MOny in-die Stare of Cobrado or been convected of it corne.Isawhere which would ean+hrut. -
<br /> Hong it veldt.tone had been ea/nntittid In the Su s of Cobradot It so.stet.full despot- . . . Ytts - 'a too. - ••
<br /> - •la tppl.eaftt,or any al doe partners.or any officer,director or ssockh0ldar of said appheent Id.4 i1 a eurporstion/owe
<br /> - r,an denied a Imam.under this I.gNOr Iawef Vas fa0 T
<br /> "•ad an alcoholic prone,.Ii0M40 sato..dad or mirrored' Yes )f0 r',,r :'
<br /> -.w....r.s y.1...pl.m fully(attach..orate lf..t.if needed+ I 1. •�
<br />- ,ou or any m,.,001 Of your f.rnily hem a financial interest in any other liquor otiose?(Soca financial...trim to.nclud. 11( • A,(r
<br /> _-cu•fr tr writ or loans).11 O...nl...r is re..axpla.n.n dart,' Yes No rr.:.:.,4:, ti
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<br /> — -.any parson.I.rm Or COrPOr•t,On h••••f.n.nc..i.nh..st.•..d...e.d•■rho,by loans 0,•g.i ty own.tth.p.n th.bul.n.s1 _-
<br />_ . ..n.ch;has heal•n.agu.stedf If the answer sit y„.state norms and.dd,•sse.and amount of such f.rwaM■nto,aat..0.....6 __
<br /> .-.n 0017...O•other,tarns of va'u•.fuel►s••••td.V.furniture.,1.a felt'ell Ind•a...ome ; Yes 410
<br /> •....•name,and 3,161.144*of alt b....n....s.n w••Ch cry of the°anon+to the prev.o..s aual4O1 are.n sd -
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