Laserfiche WebLink
10/17/2007 WED 15:17 FAX 6127823302 Canon 6870 <br />PART Uf— PERS ONALINFO I_01A''I N <br />Cif.p of St. AmInany Liquor & \d7ine Wonse application <br />Phis section should he completed A each In<heiduak Parma, (if c'e 11tna�n )iojei( tor or other <br />ag"t Ill ch IIS{C1, ino wrich poson who ly i'ondinud "vicyship+t connid OF dl urine I an it <br />;.(Ih(i13lItiI7(I IitiUU811 1 '�.CC`�li ll'P ih illl _'.'q) <br />True Name Garin Lee Stutz <br />Daw of f il 1 9/18/56 i place o1131rtll IC7ncinatti, OH - -- - <br />:-went 11umt Address <br />12541 W 118th Terrace <br />- - — - -- — - <br />Cil) Stan "/_ij1 Leawood KS 66211 <br />I Uthcl Nantes [J,cd..Ur,_. I rt6iiii maiden name <br />N1,11 113Status Sinl;le Xlv(u�ri;>,1 1)Irnitrrl <br />CCllse's n1\P7 <br />1_ -- -- IRodgSr Emmett Stutz_ <br />I_eofl3ni] 8/1/578ee_above .��n61111 1 --Aurora, 7T, -— <br />Ali you 01 `olil :I 1, t ;A �. <br />- -i,�`� <br />) �i ,n. Kansas ) , -„ ,11; Kansas <br />lcsl(ICI'll ACI 11+".i�l'f��,.+Jlil'il1 x.31: l <br />See Exhibit A attached <br />-------------- <br />ante Address .u1d Plionn Rum <br />bel of 11 JAdu �I h,m0o nInd rParr. 10 `,crus <br />See Exhibit A attached ----�----"�� <br />N8 <br />d resso, snd Phi „1 Vunthu o F tilnnt m1;1m11 Ind 1' II1 1 An f 1rced <br />- - <br />Exhibit A attached <br />10 YeirS' <br />Has all"icant 01 'p Ann 01 d ; AIM rl' Ihhny oi child P.vcl kni con+I 1,Cl 2') ill CrIn1C 01 <br />\ioltu on ofam, ordinance odter than hafflc" Ifso, please Furnish mfonnaron as to the tune, place. <br />and Mow i01Alch con', coon$'%wic had <br />None <br />No rte, home addre;; and ltl'Illc'.,SS MASS AkI(l+ p61'soll "ho I ell 'd. ..l ri ivhnnc>o a 111 the <br />)l_n lHleSs of selling, rnanu(ocnlrirl:<!v distrihuiuttt II(_luol "wd who is no; nol to km to the applicant or <br />spouse Am second consul. "Min in n1 die A& or half bloom , compimcd by A rule, q0n, law. <br />or who is a brothel -in-la+ of -Istel-in law of ehc afTphcaL oIBta I?Jba ant douse, - <br />IPfilltaly Service (Upon 1cu I st, you mop" be tusked Io provide. dis'h2lrgc papers) <br />Yes X. No <br />[0025/030 <br />0 <br />27 <br />