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Lity of St. A,nfliony Liquor &_ Wine License Application <br />'Cc[iei � )o _d be cornpleied y cavil. ind vidual, Inn vor, Mcn manager, propribLor 01other <br />in c, a, £ c ; and e ah imson who by combined ow a rship or control has an intcrest in a <br />Corporation or association in excess Of lavepucelit (J%� <br />1G ti�S <br />:. Zip—_ <br />Some <br />!C ANA? <br />,,, ; )u; v a nglowd <br />voter? <br />Ljdanca Address or <br />W <br />Place of Birth <br />of Rn'h <br />[\ppi ant-. <br />�dt)z 10 dj 741:s cT >G <br />?;v z�,c , <br />/b�' yr /w �J <br />Lei <br />o m1 a0 uvW 0's <br />��w ----� <br />✓r�h,�1(lJ �✓/ 1� <br />�� <br />drG sc� add P)lone Number of Soouse's <br />Divorced. <br />No 1 Spouse - <br />�(% ;Locaciion: <br />No <br />a, artt ni Spouse, or 1 parent of sib'. ng of child ever been conn ct d 0, a; y, crime or <br />i , c'cl , a raise othertan Mile? I1 so please fe nish tu`_bsmation as to the tcne, place <br />_._ssn An Web convictions werehad: <br />Ow �- <br />----- _- - --- <br />- t''�?:11e a- dL.:.S and b1:51ll3SS address 0� ea^.Ch person 8110 1� eAd-lded 11111�17I7�18�Ota ll1 'ih8 <br />,cs of scldn& rcanutacturing or disl.ibuting liquor and who is nearer to Icin to the applicant or <br />,se tnan second consul, whether of be whole or half blood, computed by the rules of civil law, <br />o is,, brothc L a -law o, s s er-ir i1w of the applicant or the applicant's spouse. <br />be askad tc rrcvidc dischngc <br />8 <br />IBM <br />