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0Ntw aim%ss:tl.I IMP KATE OF COLORA 4 '
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<br /> IMPARTMENT OP REVEM !��
<br /> RENEWAL MPLICATIOW FON MALT.MODS rse I T
<br /> ASO�T uOLd$ FIRnT) LIQUOR ENFORCEMENT OfFICENIACTION IR
<br />•awl COAL CREEK ENTAPRSS APPROVED r' '
<br /> CI INC 1
<br /> 41 COL
<br /> a 'LOA. CREEK JUNCTION 411APFROYED
<br /> 1▪a 10Q4 WYMA1 r i •
<br /> er CJI$ ltLL( CO 40027 . .
<br />▪ e � wy, . " ' .• 4 ,
<br /> Miler"?MAT TRINE ARE NO CHANGES TO MY ORIGINAL APPLICATION
<br /> TAX t1Q Y PI 'S COPY
<br /> EXE/T CANaI OF MAAQRTRADE MANOR CORPO RATE STRDCTUhE.
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<br /> mew'MAO.own: .: i I ,i'.�
<br /> srONAT411t -_- - - --� Milk*Midvale
<br /> 41F THERE IS A CHANGE IN OWNERSHIP DO NOT USE THIS FORM.USE AN ORIGINAL APPLICATION.) •
<br /> ArlitlIaLCL
<br /> MANAQI In NAME MAKI GIIICIC OR MONEY
<br /> sal NaSTANCTi Ne IP APPLICANT IS A CORPORATION.PILL US RtvtRN UDC OIIDIR PAYAILI TO Tilt
<br /> ON TM AMASS 0111,DRADO DIPANTOSINT '
<br /> SKIL twINIII PPIONII NO . - _ OP RIIiVENUS. - 1
<br /> RENEWAL APUICA ON FOR LFQIfOR LICENSECIO FOR THE I'tAf ENDING-- TOTAL FEES
<br /> .. ri•^_tic•:::>r a1G:.'1aat,►:,;am.:,rvu2u,
<br /> It '•411 • . .4I s441 5813 3 01017 ' 123179 s 301.25
<br /> TYR 1 • • 6 4 • NAME AND DESCRIPTION OF LICENSE
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<br /> 30 roil Woe legal p Wat er the p kw%%Stich Ibisapplia.cion for noires Is rands? �S Q
<br /> Ar•*.MWnissil.airs of er wood? n.T�L) If rented.effective&expiration diets of lose' -1 9 — - - - --
<br /> ' �g _ 1
<br /> :.pp+kent(al a►ail offken of tf►e caryorspon,dthaentsl w tswfu+ty sdrnittsd of dui United States W America? - , ,
<br /> ~ 1
<br /> 1,tnsapyflorrt,Or serf N Ow dinners.K any of the Wow,stockholders or directors of rid npplicant(if It b a corporation). I
<br />•'snu/Iaye,ss of city mei.undo the aM of wvwtNvw,yem`d_ Yes - No- -•
<br />,4s+the wMosnt,or any of Ow
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<br /> ertnos„or eery of•t..)hewn,e1.—tholder$a dental of..id applicant(M k k a curpers- }' - 4r4
<br />,,an! 1aV baOn o..wlmaf of a 1Nony in Ms Serra of Colorsd.a been aG evicted of a crime elsewhere"Nth would constitute rw3� f
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<br /> worry If path aloe had boat oanwnlet0 In the Sato of Colorado?If to.Date full dwells YY ____NO__,"_.___ ,.I
<br />.•./1 the or lie•wc,or arty Of the pertain,Of any officer,director or Rack/aids of add aplicant Of It is a corporation/swat :
<br /> bout derSelf a II cis tinder this Liquor law? Yes _ NO , 1 r
<br /> 1
<br /> -- �� :rh :1i"!
<br /> ., had as Nmhelk beverage Domes awarded a revoked? yea No ; Alf' 'r,l,-
<br /> - .h.mow is yak endows fully tattach event*ewer.if Warded) • • '`�'
<br /> . ;��L. i
<br /> you or say wrwre s of your fsrnllr have a l'Ifl000loi~ea in arty other Liquor Houma?(Such Nuncio!Interest to include 1 tt In ..`
<br /> - ,AY„i.
<br />•,y squat, Interest or/send.If the wafter it yew,exhpiatn in detail Yes Y. N. •:}.•L`}nl
<br /> . — i '4 .,
<br /> .n..arty reran,fret.r corpont1on hew a financial interset.avidsncwd either by loans or equity oarryrslhip In the business '
<br />,,,whisk IOU ricers.b regulated?If the vow,it ask nate names andaddrs.award Imount of such fins ncIat intaratt asp-mad -
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<br />• •n. is*AN.et other learns of Ntw.such of Meanly,fur iiture.Ilrtwis and.quipment - Not �` �No ,_
<br /> 'T' ,i..
<br /> ..t cp.wall%.and od*essis.t oil by-wow*in which any of the pylons fro the prwlous question ors Interested.
<br /> Neese decent
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