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� <br />�re t�e tax�s, assessn�ents a�d ���er clair�s of �he C�ty on �he ��o�er-�y de��nque�t: ❑�es ��io <br />Are �o� a�e in pc�ssess�or� of a re�ai� dealer's ide�ii�'ica�io� card �ssued b� �he liq��r cor�troi <br />�c���is��t��er w��� an ex�iration �ate o� Dec�n�ber 3�S� o� t��s year`? <br />��es; Id�nti�'ica�ifl� Nu���r: �V�A for Of f�a �� 3. 2 8e�� <br />�3 �io <br />Does t�e a��iica�t ���e�d �t� sei� in�ox�ca��ng �i�q�flr to peop�� other t�an t�e consuiner? <br />� �es; E�p�ain: � A <br />� �� <br />�oes t�e a�plicani i��er�d �o pflss�ss, operat�, or �er�i� t�e pflssessi�r� or operati�� �f, or� t�e <br />�icensed pre�ises o� �n ar�y adjai��ng room t�� t�� lic�ns�d pr�r�is�s, an� s�o� �na��ine, dice <br />�a�bling de�ice a�d a��ara�us, or �er�i� ar�� �'pe of g�.rn����g t�erein`? <br />� 'Yes; �xp�ain: __------ <br />�_--___._.__.________..__...._....____._.___.....__._----------�-.-.-----........------._....___..._..__..._..._.._..._..._...__..------- --------__ _ -----.--- .- --�-.---- --.------.- --.-- <br />� No <br />Does an� venc�ing or mecha�ical a�userne�t device �ornpany have a�y machines on ��e licer�se� <br />��-e��ses? <br />� �es R�d Sox � �3DV i � ren ta � s � � o�a �ed o� �s � de <br />�] No <br />�re t�e pre�ise� novv occup��t�, o�r to be oc�upied, b� th� applica�� enti�-e�y separate and <br />excl�siv� f�-��m �ny ot��r b�siness esta���sh�e�t? <br />�7 Yes <br />� �o <br />State ��ie �a�e(s) of person{s) who vvi�� opera�e ��� esta.b�ishment: <br />��st�r� K�a���, Ge�era� M�r�a+c�erz �oss K�to and Chr�s�ina T�o�as. Ass����nt �a�agers <br />�as or �vi�l ��e appli�ant be granted ar� off sale �i�uor lice�se or ar� on-saie "�on-ir�toxica�ing <br />��lt beverage" �icense in con��nction vvith ar� ��-sa�e a�p�ication and �f i� �s for the sa�e <br />. <br />�rer��ses? <br />� Yes; `�'y��= _._.__�_.___ � � � -..----------.---._.__._.----.---...---..---------...__--------.------_..._._._...._.. . _....--..---._..._._._.._..---.._.... _ _... ---- -- --.--�- - -� - ...... ..... ... __.. ._......._.__...._ ...--- .--�--- .-----. --- <br />� �� <br />2� � (� City �.i�u��- Li�ense A�p�ica��on <br />Page � of � 5 <br />