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NM any • events pertt+it Mom/woof to Veal this currant calendar Year <br /> '4 YES ■ • It"YES",how many derif <br /> s 1 Towww iiunt Maisel now•Cwe..de Out*Mow Ian Account. Q'w soceunt <br /> JEIO-26291 <br /> AFFIDAVIT <br /> 11.1 ,,e to • - • or• ration and • • ate ;,• ;cant'. ....` .. <br /> t AT!OP COLORADO <br /> BOULDER Ss. <br /> COUNTY OF <br /> DALE MARCOTTE <br /> i n,rtg by me first duty sworn,drposei and says:that he 11 trio. <br /> tale) PRESIDENT _ of the above named corporation or organization;that he has read the foregoing application and <br /> aitadtments,and that he knows the contents ttwreof, end that all matte*t and things therein sat forth are true of fiat;own knowledge <br /> and ha wren to conform to all the rutas and reputations promulgated by the State Department of Revenue in connection therewith. <br /> •.,t,scnbed and sworn to ma 5;;V HgRE • <br /> s _1_ '�d�y of �fl 19 .fi `_ COc1QRATE UR ORGANIZATIONAL NAME ' <br /> ..gnstu.rror Not y rata sty/ <br /> --' (Air IX SEAL/ _y <br /> `.1y cotnrtuts•on expires` 1Corporetsiarl <br /> fly Co+i ii scion Expires April 431984 <br /> By • R ./ .jl/►.+trt <br /> Tt�WO.„t,VFCF}reM+1Mt or Soorat.ry) <br /> REPORT AND APPROVAL OF LOCAL, LICENSING AUTHORITY <br /> The foregoing application has been exarriinad and the_pre►nisa.tininess conducted and charsctor of the applicant is satisfactory,and we do <br /> report that such license,if granted,will meet the raasonabte requiranent!of the neighborhood and the desires of the Inhabitants,and oOrttplia <br /> with the provisions of Title 12,Article 48.CRS tQ73 as arranded.THEREFORE THIS APPLICATION IS HEREBY APPROVED. <br /> IATEO AT this day of , rg <br /> A <br /> Mile• .wn. Ity tsM 04.1.11111 <br /> iY- • <br /> IMayor,Chairman 14 ire tel CewwfY C.rn+iwteMits.r*ther titan of she tiaanf.ne Myt teriry.) <br /> • <br /> 1TUT: <br /> Ina.Mir+tary k*oho a'leer turmoil tJ s orrkiee.eel et tfi•t144,4104 autfier.tr.J <br /> the prerrtisw are located within a town or city,the above approval Mould be signed by the mayor and clerk;if in a county,then by the <br /> rrman of the board of county commissioners and the clerk to the board.if,by ordinance or otherwise,the local licensing authority is some <br /> gar Olficiat,than such approval should be given by such official. <br /> noon <br />