b. Beer/liquor license-JackNick - Laserfiche WebLink

APPLICATION FOR RETAIL LIQUOR LICENSE 'Fo the Hon. Board of County Commissioners of County, North Dakota: The undersigned applicant hereby makes M01~lication for license to engage in the retail sale of alcohol and aleohollc beverages for consumption.(~c~..0.~_.~-_..{~ {or makes the following representations: I. Name of applicant._...~...O~.-...,-~.;.-~---.,.-.~ ................................................................ Age..._..~..J._~L ........ years. Address....q._.!.T&.....~.~__.--~-.-...~:;...04--5.O~ ...... ...~....~.. ........ ..~..~..q_. .......................... 2. Are you a citizen of the United States?..._.~k.~e-.~ ..................................................................................................... For how long past have you been a resident of the State of North Dakota? 3. If incorporated give date of crt.after ....... ._.?_.TZ~._.~..=L.O_.-~. .................................. ,_.. Is it a North Dakota cor- poration of authorized capitalization?._.~ .......... Amount of paid in capital $._1~_~.~ .................... Is it a subsidiary of any other corporation?._.~ ........... If so, give name and address ............................................ ............................................................ Purpose for which Give names gnd ad4res~of all o~cers, directo~dnd inflividt?}s hqlding 1% of sapital stoc~it~mount held by 4. Description of premises for whiFh license ii desired ........ , ........................ ,....,., ...... ~ b~ilding~ocated on ~. Name and address of owner ol t~e ousiness premises ........ ~...~.$ ....... ~._~,._~_.9~.~:~ ........................ 7. Are there any delinquent taxes against said premises?_._~_~. ............................................................................. 8. Have yon ever been engaged in the sale or transportation of liquor prior to this application? ...... ~ .......... !f so, give date and type of business and address ................................................................................................................. 10. }-lave you ever had a license rejected by any municipality, state or federal authorltyL._..~ ........... I{ so, give details .................................................................................................................................................................... 11. Have yon ever been convicted of any violation of any }a~v of the United States~ or t~State of North Dakota, or local ordinance governing the manufacture, sale or possession of intoxicating liquor? ...~O. .......... give date and details 12. }gave vou ev.e~had a license for the sale of intoxicating liquor revoked for any violation of any state law or local oral}nan&e? . ~Q ........ If so, give date and details .......................................................................... Ii. Ilave you ever ~ecn indicted or convicted of any crime other than that stated in (11) either in North Dakota or elsewhere~ ~Q ....... If so, g ve date and details ................................................................................... 14. Give names and addresses of all partners, silent or otherwise, interested in any manner in said business, or xvho will hav~ge~management, or control of the establishment for which license is requested ............................... 15. Has any person, other than applicant, any right, title, estate, or i[t~est in the leasehold~ or in the furni- ture, fixtures or equipment in the premises {or which license is requested?..._~ .............. If so, give names, addresses and details ........................................................................................................................................................................... 16. tlave you any agreement or understanding or intention to have any agreement or understanding with any person, parmershlp or corporation to obtain for any otherfi ~.r transfer to any other person this license, or to obtain it for auy other than the specific use of the applicantL....~ ............ If so, give names, addresses and details 17. }lave you any interest whatsoever, directly or indirectly, in any othe? liquor establishment within or without the State of North Dakota ?_...~.0. ......... If s% give names and addresses of establishments .......................................... ~. Give names a~addresses of at Icastkhre~busmess references~ including one bank, and state briefly extent usiness relations with each ......................................................................................................................... 20. Are you rated by any commercial agency? .... ~Q .......... If s% give names and details of rating ................ details of contract or arrangcmeut with person from whom purchases are to be made ......................................................