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APPLICATION FOR BEER LICENSE To the Hon. Board of County Corem ss oners of ~..~}L~ -~ ~' County, North Dakota: The undersigned applicant hereby makes appl[catlon for license to eugage in the retail sale of beer off of (and on) the premises hereinafter described, and as a basis therefor makes the following representatlons: 1. Name of applicant.~3~'e.:~ 6~-~.~..~-~;~x£e{ ~'~.~{)~[:/~.o-- t .~OJ ~' ~o¢~r$~.~ Age . Z?(~..... years. Citizenship . . .{dA.~.L ................. Place of residence/C[~/L...,5~:7 ~-. 5 Z~ /~f'f:~f~<!,L..([I..~.. For how long past have you been a resident of the State of North Dakota ?. ~/(0t7 .~. . ......... 2 State wheth ...... pot a t e d0~..?~) · ~)~!/-~ I f so, in what State hlcorporated ? /J~ ~_1~ Date of charter Name and address of each officer: 3. State whether partnership .............. If so, state name, age, citizenship and place of residence of each partner 4. In what business are you now enga ed? taoa~r-~.~ ~'c~.~. ~; c. Description of prernlaes for which license is desired: ......................... ~dLM.~Z ........................ floor of building ocated on ot n block ....... in ............. Addition to said City 6. Have you pleaded guilty to or been convicted of a crlmeL_.~..... If so, what cr me ? ....................... In what Court? ...................................................... When? 7. Will you personally conduct the business on premises hereinbefore described and for which license is ap- plied ? ~.~...... If not, state nam% age, citizenship and place of residence of person wbo will be in charge thereof $. Have you rTceived a license to engage in the retail sale of beer at said premises from the Federal Government? ben d? ...... ~tqf~ ........ ! I .Numberof~ 9. Have you received a license to engage in tbe retail sale of beer off of (and on) said premises from State of North Dakota?.~f~td.~ ~.~) .. When issued? ............... Number of license ...................... 10. Do you promise and agree not to permit the violation of any law of the State of North Dakota on said 11. Do you promise and agree to abide by the rules and regulations passed by the Board of County Com- 12. Do you promise and agree not to sell or permit the sale of beer on said premises to a miuor~ incompetent person, or a pexson who is an inebriate or habitual drunkard, or to any one thereof? . 13. Do you understand that any license granted upon this application will not be transferable except by specific authoritv of said governing body, and will authorize tbe retail sale of beer as herein applied for only at the t~lace and on the nremises designated in this a~pllcation and in sucb license? The applic~.nt herein doeg hereby consent that the Chairman of the Board of County Commissioners, the Sheriff and any volice officer of the County of . .~:~.%5 aforesaid, or any person or persons duly authorized by the Board of County Commissioners of said county may enter upon the premises described in this application at any hour of the day or night, and that they and any one of them shall have free access to the said deserlbed premises and every part thereof for the purpose of inspecting the said premises and the records of this applicant relating to the purchase and sale of beer~ and applicant does hereby xvalve any and all rights that he may have under the Constitution of the United States and the Constitution of the State of North Dakota relative to searches and seizures without issuance or use of a search warrant~ and the applicant does hereby agree that such immunities shall never be claimed by him, and that such search~ selzur% and inspection may be made at any time without a search warrant. Do you agree to each provision of this paragraph? ~ ........ The amount of the remittance accompanying this application is $ Dated at ........... f~VJ~ No.b Da~ota,.n tbls '~'0v~ . day / Applicant.