HomeMy WebLinkAboutBusiness License License 1990-4-23 (2)
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STATE OF OREGON . Return To:
OREGON LIQUOR CONTROL COMMISSIOP
APPLICATION
GENERAL INFORMATION
This appllcaUon fonn costs $5.00. A non-refundable processing tee Is assessed when you submll this completed form to the Commission
(except for Druggist and Health Care Facility Licenses). The tiling of this appllcallon does not commlllhe Commission to the granting 0'
the license lor which you are applying nor does It permit you to operate the business named below.
No. 22194
(THIS SPACE IS FOR aLCe OFFICE USE)
Application Is being made for:
o DISPENSER. CLASS A
o DISPENSER. CLASS B
o DISPENSER. CLASS C
o PACKAGE STORE
till RESTAURANT
1] RETAIL MALT BEVERAGE
o SEASONAL DISPENSER
o WHOLESALE MALT
BeVERAGE & WINE
o WINERY
OTH~A' l\ S".1" u APR Z 3 1990 BY
f,r11'O".' ,- (Slgrwlure)
f4l c..J.,l'rtP '1:2-.1'1-' LAlOR~ fIElD SERVICES TITLe
_ )h...;;;J:" /2Qe.JlL - r.E.:U:_,.c ,.,c,\ONAl OffiCE - __ ____ - _'
CAUTION: your operation of this business depends on your receiving a liquor license. Olee cautions you not 10 purchase. remodel, or
start conslrucUon unUl your license Is granted.
o Add Partner
o Additional Privilege
o Change Location
o Change Ownership
fa Change of Privilege
tJ Greater Privilege
o lesser Privilege
R~~'VED
(THIS SPACE IS FOR cm OR COUNTY USE)
NOTICE TO CITIES AND COUNTIES: 00 not consider this applica-
tion unless It has been stamped and signed at the left by an OlCC
representative.
THE CITY ~9U~Cll. COUNTY COMMISSION, OR COUNTY
COURT OF .
(Name 01 City or CounlYI
RECOMMENDS THAT THIS LICENSe BE: GRANTED
DENIED
DATF
1. Name of Corporallon, Partnership, or Individual Applicants:
1) EJ k/050;) f!,o-;Y/1//r/lN'l/ Tt./C. 2)
3)
4)
5)
6)
(EACH PERSON USTE:D ABOVE MUST FILE AN INDWlOUAL HISTORY AND A FINANCIAl. STATEMENT)
.P/ "e-;,,,,.c-:,,,", ~ I<IC
2. Present Trade Name
3. NewTradeName r ~
.k""/n.c, r,?
4. Pr.ml....ddr... / f' 1? 9 "?.<7..-__hf;;
(Number, SINet, Rural Roule) (City)
5. Busln...mallln.addr..._/ 9C? "/ -""'> ~.:'....-$ .&-
(P.O. 80_, Number. S'reel. Rural Roule) (City)
6. Was premises previously licensed by OlCC? Yes~ No_ Year /990
7. llyes.lowhorn: _EL I('"/o,,;cr:> ~'f?~'<:r:?;-,-_..7qv'rypeolllc.n..:_RR;J;</2 rn~
~~
NO...L Nam.
....'-
... .I(\:<:
sflld
LoN'
oR
(S'lle)
oA~
Year liIad
wllh Corporelion CommJulonet
97....07
(ZIp)
q 7<>t:77
, . (ZIp)
(County)
<~~,......
(Sllle)
B. WlIIyouhaveamanager: Yes_
(MantIg'Il" mull WI oul lndlvldull HI,lory)
9. Will anyone else not signing this application share in the ownership or receive a percentage 01 profits or bonus from the
business? Yes_ No...L'"' .
10. Whalislhelocalgoverningbodywhereyourpremlseslslocaled? C(,.,.~ ~ e?Pt!?!?-t .
'''0- (Name'1:!fCUrorCounlr)
11. OlCCrepresentatlvemaklnginvestlgationmaycontact: !::,</~.....~.- ~/.4~/j..f?....,.,~.-- ./~YO/; {;"er>-'
C/ (Name)
..2. 9 7:2. C<9-<:"""V1..--~' L.M PC-.( 6R/E. 97'1/01' dg,>S-~So. 7W.2.005'
(Add....) (Tel. No. - homlI~ ""'1_. mn-vel
CAUTION: The Administrator of the Oregon Liquor Control Commission musl be notified if you are contacted by anybody offering to
Influence (he Commission on your behalf.
DATE
f- 7/.2:' . '7,0
~.'" hO-"t-
Appllcant(s) SlgnattJ'e I j)'f, 1)
(In case of corporallon, duly By
aUlhOrized officel" thereor) ~
-I-~.P.t""/o6C:o !?P,"-"-U/"--",---"" rA/f"'
Y7- --./~tJ--._.,. .r/u'-I>?-_/"'~<'~MO
07 o_c/~--r-
3)
4)
5)
OrIgtn.l-
.......
Form &4S4S40 (8-a2)
6)