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APPLICATION FOR BEER LICENSE <br /> <br /> To the Hon. Board of County Commissioners of ~ ..~.~.. ............................................... <br /> <br />County, North Dakota: <br /> <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 ofappl cant .~e~..../~.~.. ~7.~._~_.~._..~..[].~. ~.~ .~.~$-.% .... ~.. Age'~(_....:~ ............ years. <br />Citizenship ............................................................. Place of residence ................................................................ ].: ...................... <br />For how long past have you been a resident of the State of North Dakota? ...................................................................... <br /> 2, State whether incorporated ........ ~ .................. If so, in what State incorporated ? ............................................ <br />Date of charter ............ ~..T.ll~..d~O.~.....~ .............................................................. Name and address of each omcer: <br /> <br /> 3, State whether partnership ..................... If ~o, state name, age, citizenship and place of residence of each <br />partner <br /> <br /> Description of premises for which license is desired: ........ ..~./.C~i...-]Z.. ................................................... floor of building <br />located on lot .................... in block .................... in .................................................................... Addition to said City. <br /> 6. Have you pleaded guilty to or been convicted of a crime ? ...... ./4....0. ..... 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 />pliedL..~...~.~.. ....... 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 />When issued? ........ ?..7.dZ....O..~ .................................. Number of licenseo/0.O..3/8.~'...-..P...g..O...-.....O..~.9..... <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?.....~..~..~ ............. When ' ed? /-,,,q.f~-~,o~5).~ l cense .~.~.._.-..~..~...~..~......~. ........... <br /> ~ssu ..................................... Number of <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 ?....y~..~ ........ <br /> I1. D~ you promise and agree to abide by the rules and regulations passed by the Board of County Com- <br />missioners <br /> ? <br /> 12. Do you promise and agree not to sell or permit the sale of beer on said premises to a xninor, incompetent <br />person, or a person who is an inebriate or habitual drunkard, or to any one thereof? ............ {~,.~ ..................................... <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? ......... ~...~.. .......... <br /> The applicant herein does hereby consent that the Chairman of the Board of County Commissioners, the Sheriff <br />and any police otficer of the County of ........... .~f.O.~;],~i .................................. 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 ? ......... ~t..¢...g. ............ <br />The amount of the remittance accompanying this application is $ ........... .//~..O. ............... <br /> Dated at...~.~:~.O.O~..~. ........................................... North Dakota, on this ............... ~ ................................... day <br />of. .... ............................ c .00 ....... <br /> <br /> <br />