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550-CO-APPLICATION FOR BEER LICENSE-County BURNI'S <br />APPLICATION FOR BEER LICENSE <br />To the Hon. Board of County Commissioners of p1 SS <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 following representations: <br />1. Name of applicant R H d 4-EN <br />GG <br />Age 77 years. <br />Citizenship.... i'lLX.e.O _AM Place of residence...I./.R-?O <br />For how long past have you been a resident of the State of North Dakota? 77 <br />2. State whether incorporated ye5 If so, in what State incorporated? No ail D1TA <br />Date of charter S Name and address of each officer: <br />RodNE y <br />r ST3;4-4 r <br />FAizemo NO 58(°'- <br />3. State whether partnership If so, state name, age, citizenship and place of residence of each <br />partner <br />4. In what business are you now engaged?.2•+t.11..n.s a-- A.SLirt tiV 444k` grove 4'040 J <br />Business address---3510..1-`1-2).-AQe-.5.r 5u. 6(1 <br />Description of premises for which license is desired:TAtal ( pit Jia`' Raw" +Jl..1rrdi N.Rivitoor of building <br />located on lot in block in.5¢0 33-1 yam' `f Addition to said City. <br />6. Have you pleaded guilty to or been convicted of a crime? W0 If so, what crime? <br />In what Court? When? <br />7. Will you personally conduct the business on premises hereinbefore described and for which license is ap- <br />plied?...yR.5 If not, state name, age, citizenship and place of residence of person who will be in charge thereof <br />8. Have you received a license to engage in the retail sale of beer at said premises from the Federal Government? <br />When issued? yvOi Number of license <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 />North Dakota? \(L5 When issued?...1:-.1.- Number of license.-it1/4)-00..21 <br />10. Do you promise and agree not to permit the violation of any law of the State of North Dakota on said <br />premises? /'ES <br />11. Do you promise and agree to abide by the rules and regulations passed by the Board of County Com- <br />missioners? "IE S- <br />12. Do you promise and agree not to sell or permit the sale of beer on said premises to a minor, incompetent <br />person, or a person who is an inebriate or habitual drunkard, or to any one thereof? y S <br />13. Do you understand that any license granted upon this application will not be transferable except by <br />specific authority of said governing body, and will authorize the retail sale of beer as herein applied for only at the <br />place and on the premises designated in this application and in such license? yes <br />The applicant herein does hereby consent that the Chairman of the Board of County Commissioners, the Sheriff <br />and any police officer of the County of BASS 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 any one 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 />without a search warrant. Do you agree to each provision of this paragraph? YES <br />dd <br />The amount of the remittance accompanying this application is $....a.50. <br />Dated at.... C ° ,,,,)), North Dakota, on s I -1 day <br />of t st..1 20.`.Ui. w <br />Applicant.