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11,ties any • - events peemHt been reared to r• In tie Current calendar yew, <br /> doer marry days? <br /> 12.Twa eperlleent Muir hie a Cerereele'rite Sari the AC[ount. Oh*aeeouret number. <br /> • JE 10-24692 <br /> AFFIDAVIT <br /> . f: .0 to • ., and eeftna . . . iiat oqt and -• • ate :• icants <br /> STATE OF COLORADO <br /> COUNTY <br /> • I ed. .• <br /> tieing by ma first duly sworn,deposes and says.that he is the. <br /> (title) � G .dc._..." of the above named corporation or organization;that he has read the foregoing application and <br /> attachments, and that ha knows the contents thereof,and that all matters and things therein set forth are true of his own knowledge <br /> dad he agrees to conform to all the rules end regulations promulgated by the State Department of Revenue an connection therewith. <br /> Subetribed and sworn to me SIGN HERE. <br /> �t <br /> this lay 1/ `� f of, ,, 1 g„ , , CORPORATE OR ORGANIZATIONAL.NAME: <br /> :,enatueaof t ac <br /> • �✓ VVV� <br /> (AFFIX.SEAL) <br /> • <br /> 1 1 ' . <br /> my commission expires: ' (Corporate tiaarl <br /> l e Coasatss#oi4 Expires April 4. 19U �� f <br /> By_ :�C) '(h,--�-� 4�12>cc to leuz <br /> eat.Vlce•Pr.. i.ntorJac/atarv) <br /> REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY <br /> The foregoing application has been euamrneid and the premises,business conducted and character of the applicant is satisfactory,and we do <br /> report that such license,if granted,will meet the reasonable requirements of the neighborhood and the desires of the inhabitants,and complies <br /> with the provisions of Title 12,Article 48,CRS 1973 as amended.THEREFORE THIS APPLICATION IS HEREBY APPROVED. <br /> .IATEA AT . _ . ,this_ day of _ ., 14_ -- _ <br /> aT <br /> meow of Town,err a and county) <br /> (Nuys•,Cwaintu re of slew et Csi'ty Cammltalerwrs w sow title of the IN09Wetr auU rlty.t <br /> (crude.taeretery N sow*Mew h•vina the sluel nai at Ilia Iitantky ae,thplty.) <br /> N the premises are located within•town of city,the above approval should be signed by the mayor and clerk;if in a county,then by the <br /> chairmen of the board of county commissioners and the clerk to the board.if,by ordinance or otherwise,the local licensing authority is aorta <br /> other official,then such approval should be given by such official. <br />