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<br />RoJ.~4F 1(}/<30ft;~ 1r3lq <br /> <br />55G-CO - APPLICATION FOR BEER LICENSE. County <br /> <br />BVRNlE'S <br /> <br />ApPLICATION FOR BEER LICENSE <br /> <br />To the Hon. Board of County Commissioners oL..__..?.1..!1...____..____..__........____...m...__....._____....__.__...oo...______..____.m.. <br />County, North Dakota: <br />The undersigned applicant hereby makes application for license to engage in the retail sale of beer off of (and on) <br />the premises hereinafter described, and as a basis therefor makes the follo;vJ~g,.reP:esentat~~fd. ~V' tvu~ Wine~'j <br />1. Name of applicanL.fi6.IJ.IY.~t....~,JUJ~.6(&--..f(~/l.^l:tJ5..f:?m.. Age...Sl__.........years. <br />Citizenship__..JiSIt..........__......__..........__..__..__... Place of residence2-1J/~.ft;!I~~1i~. f'1~" '~~j'OO"__ ..- <br />For how long past have you been a resident of the State of North Dakota. .m.__oo...__..______..__..__..____..__../...oo..__..__oo__.__..... <br />2. State whether incorporated..........y.[J..__..__..____. If so, in what State incorporated ?m..lt.D...m...__.__...m__...... <br />Da te of charter.1te.!:.J~j.....~.f.I.rl!__m.__m__...______..__...m______.m__._____...m________________mm Name and address of each officer: <br />--? dlN'( 1?l'lll/V6f~ /J1l~J.I1itF~ <br />)0J!liA/ g/llll/v/fvl- V-/JI Jf'C <br /> <br />3. State whether partnership__y~--?:__.m... If so, state name, age, citizenship and place of residence of each <br /> <br />partner <br /> <br />SUSAN 8Alll...vtfi€-/SJ UIA- SII/I1f....- <br />I I <br /> <br />.4. In what W8coreis- .2~Y~1 ~~.WltY:tf--.--.--..------..--.--.j;--.--....--...--oo----..---------...oo...oo.--...00.________. <br />Busmess address.:..__________..... .....__....__.__.....__... .__.. .--.--..;.--....6.. ...." tV__.N..4 11ft! y <br /> <br />Description of premises lor which license is desired: ...__.______.....~..L!!:.oom..........________..____....__..__...__.floor of building <br />located on lot.~.~..~~__...__.f'::~blbct~__~.:.~.~~.~...i~:.__.CtJ_ff...t:.(!.L__.__.....__...__....__....__....__.A.ddition to said City. <br /> <br />6. Have you pleaded guilty to or been convicted of a crime?..h.O__.__.. If so, what crimeL...__oo..____.____...____.....__... <br /> <br />In what Court ?........................__....... ..... ....____.... ........ .__. .______ ________... When?.. __.......... __... ...__..__.__m. ____.... .__........... <br /> <br />7. Will you personally conduct the business on premises hereinbefore described and for which license IS ap- <br />plied ?ml.fS..__.. If not, state name, age, citizenship and place of residence of person who will be in charge thereof <br /> <br />8. Have you received a license to engage in the retail sale of beer at said premises from the Federal Government? <br /> <br />When issued ?____.______..........______............__..__..... ......__...... N umber of license... ____ ___ ...__.__..... m..__. .__..__..__.... __...._ <br /> <br />9. Have you received a license to engage in the retail sale of beer off of (and on) said premises from State of <br /> <br />North Dakota L..........____.........__. When issued L____m.______m__..____..______..... Number of license________......__.__m...__..__.oo__...____oo._ <br /> <br />10, Do you promise and agree not to permit the violation of any law of the State of North Dakota on said <br /> <br />premises ?..)'.f..S.......__.. <br /> <br />11. Do you promise and agree to abide by the rules and regulations passed by the Board of County Com- <br />.. ? lJ~r <br />miSSIOners. ....!/..L~.....______....... <br /> <br />12. Do you promise and agree not to sell or permit the sale of beer on said premises to a minor, incompetent <br /> <br />person, or a person who is an inebriate or habitual drunkard, or to anyone thereof?.__Yfs________.____.________..____oo__.oo..__.__.__ <br /> <br />13. Do you understand that any license granted upon this application will not be transferable except by <br /> <br />specific authority of said governing body, and will authorize the retail sale of beer as herein applied for only at the <br /> <br />place and on the premises designated in this application and in such license ?oo__vt..s.______...m__. <br /> <br />The applicant herein does hereby consent that the Chairman of the Board of County Commissioners, the Sheriff <br /> <br />and any police officer of the County of..______(fi:~J....__.........m....oo____..__....__aforesaid, or any person or persons duly <br />authorized by the Board of County Commissioners of said county may enter upon the premises described <br />in this application at any hour of the day or night, and that they and anyone of them shall have free access to the <br />said described premises and every part thereof for the purpose of inspecting the said premises and the records of this <br />applicant relating to the purchase and sale of beer, and applicant does hereby waive any and all rights that he may <br />have under the Constitution of the United States and the Constitution of the State of North Dakota relative to <br />searches and seizures without issuance or use of a search warrant, and the applicant does hereby agree that such <br />immunities shall never be claimed by him, and that such search, seizure, and inspection may be made at any time <br /> <br />without a search warrant. Do you agree to each provision of this paragraph ?...f.fJ..__...______.. <br />Th f h. . h' I" - a :J \ (/ J <br />e amount 0 t e remltta,nce aC9\mpanymg t IS app IcatlOn IS .p.........?:..__...__................. <br /> <br />Dated aL.r...4..I2..cfC!........AJ//.....__............., North Dakota, on this__...__.__.~.mm..__.__...__..__..__..__..__.__...__..day <br /> <br />of__..__....__....... ..t-..Q............... __..__......... ......__. m. __.. 20.. r. <br /> <br />~~ppii;~~;:.... <br />