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HomeMy WebLinkAbout20001970.tiff RESOLUTION RE: APPROVAL OF RENEWAL REQUEST FOR 3.2% BEER LICENSE ISSUED TO HIGHLANDLAKE, INC., DBA HIGHLANDLAKE, INC. - EXPIRES NOVEMBER 9, 2001 WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, Highlandlake, Inc., dba Highlandlake, Inc., presented to the Board of County Commissioners of Weld County, Colorado, an application for the renewal of a County Retail License for the sale of fermented malt beverages, containing not more than 3.2% of alcohol by weight, for consumption by the drink on the premises, and/or in sealed containers not for consumption at the place where sold, and WHEREAS, pursuant to Weld County Ordinance No. 6, Section II., C., said applicant has paid the sum of $57.50 to the County of Weld for the renewal of the existing license, and WHEREAS, said applicant has exhibited a State License for the sale of 3.2% fermented malt beverages for consumption by the drink on the premises only, and/or in sealed containers not for consumption at the place where sold, outside the corporate limits of any town or city in the County of Weld at the location described as follows: 16983 Weld County Road 5, Platteville, Colorado 80651 NOW, THEREFORE, BE IT RESOLVED that the Board of County Commissioners of Weld County, Colorado, having examined said application and the other qualifications of the applicant, does hereby grant License Number 2000-05 to said applicant to sell 3.2% fermented malt beverages for consumption by the drink on the premises only, and/or in sealed containers not for consumption at the place where sold, only at retail at said location; and the Board does hereby authorize and direct the issuance of said license by the Chair of the Board of County Commissioners, attested to by the Clerk to the Board of Weld County, Colorado, which license shall be in effect until November 9, 2001, providing that said place where the licensee is authorized to sell 3.2% fermented malt beverages for consumption by the drink on the premises only, and/or in sealed containers not for consumption at the place where sold, shall be conducted in strict conformity to all of the laws of the State of Colorado and the rules and regulations relating thereto, heretofore passed by the Board of County Commissioners of Weld County, Colorado, and any violations thereof shall be cause for revocation of the license. 2000-1970 LC0035 RENEW 3.2% BEER LICENSE - HIGLANDLAKE, INC. PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 16th day of August, A.D., 2000. BOARD OF COUNTY COMMISSIONERS Wr D COUNTY, COLORADO r _ ATTEST: I �� J. arbara J. Ki meyer, C air / Weld County Clerk to th:7:o- + d4, 1361 Q�� - /2 ' �/e.,, -- �� M. J. Cile, Pro-Tem BY: /76 Deputy Clerk to the U' Ges2L9e EC Baxter APPROVED AS TO FORM: yy' ?eJ-12a- D K. Hall Count Attorney Glenn ✓aad _()S 2000-1970 LC0035 THIS LICENSE MUST BE POSTED IN PUBLIC VIEW DR 8402(021991 STATE COLORADO DEPARTMENT OF OF REVENUE L quor Enforcement Division 1 375 Sherman Street Denver,Colorado 80261 HIGHLANDLAKE INC HIGHLANDLAKE INC 16983 CR 5 PLATTEVILLE CO 80651 AMENDE D ALCOHOL BEVERAGE LICENSE Liability Infotmet on Account Number .i LICENSE EXPIRES AT MIDNIGF? Gou y .atv d 't. ?ypr i.bility Date 14-27324-0000 03 107 5941 C 111087 NOV 09, 2001 Type Name end Description i t License Fee 2123 3.2 PERCENT BEER RETAIL I$ 50.00 LICENSE (ON/OFF PREMISES) III 2190 COUNTY 85 PERCENT OAP FEE $ 42 .50 Torn_FEEISI..t 92.50 — i This-license is issued subject to the laws of the State of Colorado and especially under the provision of Title 12, Artices 46 or 47, CRS 1973, as amended. This license is nontransferable and shall be conspicuously posted in the place above described. This license is only valid through the expiration date shown above Questions concerning this license shop-d be addressed to the Department of Revenue, Liquor Enforcement Division, '375 Sherman Street,Denver,CO 80261. In testimony whereof, I have hereunto set my hand. 2/ A/2 SW w,,4 SEP I MOO Division Director Executive Director ONLY 3 .2 % BEER SOLD HERE !!; -- a> - <:• , s� .a i v ara •r s ....�, i 1� ss 5`: !!;3 t r] 'tor s''tS'. r . ,� 4 r ii• '+; �.� ffr k- ," F' t c r tilt. 5 $41A-, M \ '] r _ \. , :rl r Y i4tc.,. .4::,,, . t\ ;:, /I ':i .r,?,I ' i s I P ,�,. s"' �: ].., 0- \ 'r ,ti 'o .04 o E ,J, \ � i - !it \�1.. !ir \ , Ire i s/rI -..,, A IIv�.4!�\4 A ;SrIr7 i\�i , s/ gay*4.. r\�., i. m .t ir' �� iI fi i\S\+llAr �r!r r x\ ,. ill gb iei rH ee I t. '7 ,it \ tt' llb S_ / ZA l ?::7- � 'i/ p EM» tfi4r/ i„t 1..MA.a/q'"lNi �'A/,H/fyII\qt d ',{A •FM 4 ] `I y fit] s yfM? / = s - -.4' ? p�k 'T I'.'r j� .�� A W ,�,a x F 2 '�A` , ',N et` 1 L r s f fT Q. '.s, ty �„. r ..- - ♦ . s4 ��y,.,�� .� � . A ,�"S'� A7,----�".�r _ �• �'� �'e..�t �si�♦t it r a {� - y :A) (1/4.,...... STATE OF COLORADO szJai- c a �'A� �, COUNTY OF WELD + it`h _-�. e, • 1. c� , ,� e BY AUTHORITY OF THE BOARD OF COUNTY COMMISSIONERS / �.. ' T'• Fermented Malt Beverage License � / x4:170/711s C ..: � \ ;�? 'i ]t0 RETAIL •a= ��- _� J ot8 is to TPYtLf1J, That Hiphlandlake, Inc. a dba HiAhlandlaket Inc.____ %6 of the State of Colorado, having applied for a License to sell FERMENTED MALT BEVERAGES at retail and having ti, . 1 a> ,_ ,a paid to the Treasurer of �Vcld County, the sum of Fifty-seven and 50/i00 Dollars therefor, the above applicant is t,� � ,,It� hereby licensed to sell FERMENTED MALT BEVERAGES containing not more than 3.2% of Alcohol by weight at i 16983 Weld County Road 5, Platteville, Colorado 80651 ��its, I in the County of `Veld, Colorado, for one year from the 10th day of November , 2000 , *, q to the 9th day November 2001, A ofunless this License be sooner revoked 1 as provided by law. s a y�� ? . ! tee.. s,a,r: x '. '.1/21141C:-; ` :, This License is issued subject to the Laws of the State of Colorado, and especially under the pro- 1; : ',11,4!g "y i § ' '`` " visions of Article 46 of Title 12, Colorado Revised Statutes, as amended. t 3 .`i 'or '''.-;^4'''''''-e- Y Y'"S YY 'Y k'' ,E � . 41: IN TESTIMONY WHEREOF, The Board of County Commissioners has hereunto subscribed its ,.as-, _ \§ s 16th day of August 2000 ? „ na y I s fi5 r ly thorized,this I w �zt -5�. # .. -rt w_ .,i. psi/n .visti� t z�.x z x3 " 3tjt r . �et /' _r �:9R, a .₹, 1- .± a . ,M^..?;5.f �P, Jaf( ' \ v -722;---.,7,-", x.,dr, ya #'"f ,. xT`Y3i § wlc 4 as - 3xA-A Airy 1 tat Sa WI*"x 4i ek. t.�..,„ r i 4• }y _ $ rt. a E'i Sig 5' �s a.�"e 7., , -- ` ., t .�.` I 3�i I $ s r ♦ S �' t I .. C :I 1%r 3 :_. Y\ /1:4 . i. \\\4; ✓ 'P\LS%%.. \\�/%I ., i ."` s << � t\ r% t\ / • ' \ 'PA.:. bt\i/� t! /1 . * " V.":1161;', A, Arr A r/a q r,✓ C fr ,' � �A , I rfi ,AA trf \l lI ,A f/1 tAA II (.. i h_ Iy ,i 11 N 4 ,•,,,,,t,,,,„,,,Al: ,,,,,,,,„;..,,,.„44,,,,,..: t J� � C! ,:,•,.'„,..3::,,,r..;,, ]v1t i,k ,t i,dr sv e,.. -•ii r a� L'cense Number _ c '' Se ' COLORADO DEPT OF REVENUE LIQUOR OR 3.2 BEER LICENSE 14-27324-0000 •DR s4O0 110;951 12 X375 SHERMAN ENFORCEMENT DIVISION1. ST RENEWAL APPLICATION Liability Information DENVER CO 8O211i 03 095 00594 (,, 1 � 1 O C q � Ei' Ill lullnulrlull ILlulnluln11111 Illuulluill Business Location 17029 WELD CN -Y RD 5 HIGHLANDLAKE INC MEAD CO 717 5TH AVE i LONGMONT CO 80501 -5420 •C:,rrent License Expires NOV 09 , 2C30 PLEASE COPY FOR YOUR RECORDS: -I This renewal reflects no changes from the last Application for renewal must be filed with your LOCAi. applicarion. Complete page 2 and file now' LICENSING P AUTHORITY at least 45 DAYS PRIOR to the p There are changes from the last application. expiration date of your current license. Complete and attach page 2 (DR 84011 and if a Exception: Wholesaler, manufacturer, importer, and puE:lic corporation, DR 8177 - Corporate Report of transportation system license renewals co not need Local Changes; or if a Limited Liability Company (DR Licensing Authority approval and must b€ returned dire( tly to 8405). All other changes of ownership require a the Colorado Department of Revenue at least 30 days prior to transfer of ownership application. See your Local the current license expiration date. Licensing Authority immediately. _. FAILfJHE i O I-iTE irliSRENEWAL AT LEAS Li Delivery Permit requested? Retail Liquor Store, DAYS PRIOR TO THE EXPIRATION DATE OF YOUR Drug Store or 3.2% Beer - Combination On/Off LICENSE MAY RESULT IN YOUR LICENSE NOT Premises Licenses ONLY. Check the box if you BEING RENEWED. want the permit to be issued _ _ _ __-.___._ . OATH OF APPLICANT I declare under penalty of perjury in the second degree that this application and all attachments are true,correct,and complete tc r e best of my knowledge. Authorized Signature / I Date B,s:ness PI'one °`7 i'''•(-1---1-4..--4 ` '1. r I, '--------- ----- -- �.1 - D`) ,:..:27_._'._ �i. i a'I-- �Jar -�. Title of Signer(if corporation) ,Y (J ales Tax Number I. - 1 1/ - 1 f,:3 a1..1...,-,,_-. _. REPORT AND:APPROVAL:OF LICENSING AUTHORITY • The foregoing application has been examined and the premises,business conducted and character of the applicant are satisf actor, - ard we do hereby report that such license, if granted,will comply with the provisions of Title '2.Articles 46 and 47.C.R.:i, i '' THEREFORE THIS APPLICATION IS APPROVED. `,. '� . 1� ''rte; Local Licensing Authority for Da / 'r f<lr. To Nn/City C C ty i • 7ture Weld County, Colorado ! / • ,..-22._ -'� e a ITeChair Weld CountyOT DETACH ' DO NOT DETACH - -..mss A' , OR 8400 OF REVENUE LIQUOR OR 3.2 BEER LICENSE 21 1375 SHERMAN ST RENEWAL APPLICATION DENVER CO 80281 EEusinessName LICENSE NUMBER lUse for all refer,mce> I RENEWED LICENSEE(PIPES AFTE HIGHLANDLAKE INC 14-27324-0000 I 1 1 -09-01 __--- .-.. --, 'YPE OF LICENSE ISSUED CASH FUND STATE FEE 3 . 2 PERCENT BEER RETAIL : COUNTY 85% )AP LICENSE ( ON/OFF PREMISES )I 2330- 100( 999 ) 2123- 750 ( 999 ) ' 190- 100( 9 )9 ) I i $ 25 . 00 $ 25 . 00 $ 42 . 50 TOTAL AMOUNT DUE $ 9 . 50 • 21000-1970 Make check payable to:Colorado Department of Revenue L__e.C D 35 DR 8401 (0797) COLORADO DEPARTMENT OF REVENUE UQUOR ENFORCEMENT DIVISION 1881 PIERCE ATTACHMENT TO LIQUOR OR LAKEWOOD,CO 80261 303'205-2300 3.2 BEER LICENSE RENEWAL APPLICATION . This page must be completed and attached to your signed renewal application form. Failure to include this page with the application may result in your license not being renewed. Trade Name(:ofEstablishment / f., State License Number . 1.Operating M nager Home Address Date B • <kifieafe r /1 ,t-e..-..ti t /c." c j �t Vii._ e..". ./ �3._,�•-- `. 2. Do you have'leg I possession of the premises'or which this application for license is made? L Yes No Are the premises owned or rented: _ . -If rented,expiration dare of lease: _ _.... _ __ I I 3, Has there peen any change in financial interest(new notes,loans,owners,etc.)since the last annual application?If yes,explain in Yes No detail and attach a listing of all liquor businesses in which these new lenders or owners,(other than licensed financial institutio 1s. are materially•nterested. L 4. Since the date of filing of the last annual application,has the applicant,or any of its agents,owners,managers,principals,or I•:r'a=rs i Yes No (other than licensed financial institutions),been convicted of a crime?If yes,attach a detailed exp anation, �—J t 5. Since the date of filing of the last annual application,has the applicant,or any of its agents,owre•s,managers,principals,ar I�rice•rs (other than licensed financial institutions),beer denied an alcoholic beverage license,had an alct holic beverage license susp•rel.d or Ye' No }} revoked.cr had interest in any entity that had an alcoholic beverage tieense denied,suspended a revoked?If yes,attach i;i U. :ai:Fc ❑ explanation. 6. Does the applicant,or any of its agents,owners,managers,principals.or lenders(other than licensed financial institutions;,breve•. ' Ye;-, ac., direct or indirect interest in any other Colorado liquor license(include loans to or from any icansee,or interest in a loan t',air' i ❑ I licenaae)?If yes,attach a detailed explanation. 7. Sole owners or husband-wife partnerships answer this question.Since th a date of filing of if a last annual license applics'rr'ti Has ownership changed in whole or in pal,from a sole owner to any other person.partnership,corporation,or limited:rani!t\ I {'a'' tic company other than the licensee listed on your state liquor licen:.e? If yes.this license moo! )e transferred to the new oK 1.-. -rod ( U may lot be renewed.Contact your Lora!Authority immediately. • -- f B. Partnership applicants must answer this question.Sir-ce the date of filing of the last annual lit ense application: Yes Nr' r (a) Are te'e,or have there been any gerecal partners added to,or deleted from the partnershii?If yes,this license must lotLi —_ transfer red to the new partnersnip anc may net he renewed.Contact your Local Authority immediately. (b) Are tnere,ce have there been any limited partners wl:h a 10%or more interest,added or deleted from the partnership?If ye$ this r -t ---• licen:;e moot be transferred to ine new partnership and may not be renewed.Contact your _}cal Authority immediately. L 9. Corporate applicants must answer this question.Sirtc:s the date of filing of the last annual license applical:on• Yes No (a) Are tiere,or have there been any officers or directors added to,or delete i from the corporation?If yes,complete and attach r� DR 6177 and submit to your Local Authority immediately. LJ (b) Are here,or have there been any stockholders with 10%or more of the i:rsued stock,adder to,or deleted from the core.)ration? i If yes.:omplete and attach DR 8177 and submit to your Local Authority immediately. ❑ (c) Date of filing last annual corporate report with the Colorado Secretary of State:_ q - Y'' 9'7 y1C. Limited Liability Company applicants must answer this question.Since the date of filing of Fire last annual license applictrticrn. Yes No • (a) Are there,or have there been any managing members added to,or deleted from the compa,ty?If yes,complete and attach ❑ : DR 6177 and submit to your Local Authority immediately. • — (b) Are there,or have there been any members with 10`0 or more membership irterest,added lo,or deleted from the comprtny? _ If yes.complete and attach DR 8177 and submit to your Local Authonty immediately. ❑ -' (c) Date or filing last annual LLCO report with the Colorado Secretary of State:______ -- _— -- 11 Bed and Breakfast applicants must answer this question and certify comp•iance with 12-47-118.5 C.R.S.,to the state lice 1sirl:l authority by initialing the following listed questions: _.._.- That it has no more than 20 sleeping rooms,and —__._- That it provides at least 1 meal per day at no charge other than for overnight lodging,and __—____ That it does not sell alcoholic beverages by the drink or in seared containers,and That it shall not serve alcoholic beverages for more than 4 hours rss In any one day,as follows: _ MONDAY HOURS TUESDAY HOURS WEDNESDAY HOURS THURSDAY HOURS I FRIDAY HOURS I SATURDAY HOURS SUNDAY HOURS From: m. From: m- From: m. From: re. From: m. From: R'. i ` -2•1'. To: m. To: m. I To: m. To: rat. To: m. To: m.__i T:>. LIQUOR/BEER RENEWAL REVIEW FORM Date: August 1, 2000 TO: Deputy Mils l-1 y a s FROM: Kim Fliethman SUBJECT: Liquor License Check In accordance with the new procedure for Liquor and/or beer license checks, please review all records on the following establishment for any associated reports during the last year and return your report to the Weld County Clerk to the Board's Office within two weeks. Your report will be used by the Board of County Commissioners in considering renewal of the liquor and/or beer license. PLEASE RESPOND NO LATER THAN: AUGUST 11, 2000 ESTABLISHMENT: HIGHLANDLAKE, INC. DBA HIGHLANDLAKE, INC. 17029 WELD COUNTY ROAD 5 MEAD, CO 80501-5420 Current license expires: NOVEMBER 9, 2000 *****.,,<....,.***************************************************,......,,.,..<....,,«>.....>,....... «.,..«n** No concerns Deputy's Initials _ The Sheriffs Office had a concern and the deputy has mutually worked with the licensee to correct the concern. (Complete Attached Worksheet) Unresolved concerns exist requiring a Probable Cause Hearing scheduled by the Board of County Commissioners. (Complete Attached Worksheet) Please notify at Extension of the date and time of the Board of Commissioner's renewal hearing. 41)\Clan MEMORANDUM To: Esther Gesick, Deputy Clerk to the Board August 4, 2000 From: Bethany Salzman, Zoning Compliance Officer, Dept. of Planning .service: COLORADO Subject: LC0035 Review of the following liquor license renewal by the Department of Planning Services shows the folio"ing Highlandlake, Inc. dba Highlandlake, Inc. 17029 Weld County Road 5 Mead, CO 80501-5420 Zone District: A (Agricultural) This use has existed prior to zoning and a Nonconforming Use File (NCU-14I) has been set up by the Planni'Ie Department. No violations are occurring on the property at this time. SERVICE,TEAMWORK,INTEGRITY,QUALITY to IFedE.: ::Itt.r.:. 1-.444:...A t1..►;11)c' I :N,�.,: 5 2 a 9500 112 SOO n° ► s li- Ili III From)p'ar'se print) Express Package Service Package:unde•15011n r Y"tj:n'Irm n pe; :. 1253-1948-`3 FerExPnc iiy0vernlghl [1-1 FedF:x lanrlerdOvelnlght edl-x2Dny {gall: • 8/24/2000. . ... Sander's FedEx Account Number _.. ..... .. . ... L_ ;Nan Wsinea<ranungl INr,.lhwaaala :r.00nl I- -.... eraK lnionna dart/ I .I $nuclei's Clerk to the B { ) -41;11 FedEx First Overnight •II-r •n_,4u te•i',ber,.. Name .. _Q.ard_.._.. .. 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InAl:ralt6nly Recipient's { ) ineras,ous Coeds"groan?:Oerbu•,rn no lenaatd. Name _ Liquor_ Enforcement Division Phone.303_,..20.5-2300 ........ ..--IlE ---- Dept/Feo'Suile/Ruum Payment Gall al Bill k Sender Racipaem lima lea l' :Edam aid ' Cash' n w . .C.o l.orado_Department. of Revenue . ._ in, -J bAcr>,r,..., I--' , L_ � I t- (Check c:<e",r Ml In her:1: L..,._._.Fmneeedl•a n..� Ico...: .1 o;'prin. in'aAddress _1881....Pierce _Street. Room 4108 _ ..- _ ".,.noel No r,niüi Cat Fed&Innannn,Mint FedEo address hare' IWo C-.i.c !ipkcpr Ii.'la.,I(JIM.,or PD?ip • i;ethyl cr,Ill 1a, .. ._ Ic, - Ciy . Lakewood. . .... . .Slatu CO .... ZIp 80.21.4..___.. .._. ,. Toad Packages Total might Total Declared Value* intro Charges For MID at FedEx Location check here For Saturday Delivery check here s .00 • EjHold Weekday Hold Saturday Mt a%e lade es.kl,carlil•e: 'Extra Cling.Not avail.ha to al,Ineelesisl i5.t.vai one with �!NM...d.WM with radrarx<Ioe.,nehrr' III!Nal available wile Fans host prnielet 'eS•r dater kg a nelne l,;,ex than SIM ter OnUA Ui!r,..u•a•.na.e,.b..., ,re:SI4111er —__—_._._._ !dna Ilea leearnshn r.ib Mended°wieieln nr FadErt Standard 7vernleh•I MeI(IONS.°EGIARED VALUE ANe LIMIT 0,LIA.UIy so:m.0.i.nrai•e:•rnrau Service Condrliens.Declared%km and llnka Liability By long figs Atoll. 'chi:dlnos ri alarn,Vmania.Your reed In iecever hoons for all loss includes nrortsic Releas' 'nature •.., .,.,::.I. , ., you air ec to the servi,:e conditions in ow current Service Guide rn U.S vak.e ul the package,kesc,•Iseles,duresr,prole,ananeysfees costs and edger turn's GUW iMnrnl Sees9ra Mild', Both are evallebkr en rnq nnsl SEE RACK DF of awn.ge,wlrothnr direct.incidental,consequential,re special,and is landed le the SENDER S COPY OF THISAIRBILt FOR INFORMATION AND ADDITIONAL TERMS grantor of Sumo(the declared value led carmor exceed actual locrmetad loss.the -'.—- . - We vvdl not be'o::petnsih a ie,any claire in excess oiMerit pet package whether Inaxinear do eted valve tar any FelEx Len.and Fedfx Pak is$50J.Fatima'Express .on x without btahry gr.I adei ac l Bpi sa to delr.•m re, a Iha result d loss,dame a,or d non. n"n weheul less clog a s�gret•ess I acne!1n mitre, i ., _ g delay, calvary,Ittrsde6vary,or misinformation IIIeV,IepWt yore regnae.and with same hriMiont,"Blend all he rhargnspaid aa�hold 5.rmlaas ssdei:d rxpre.a hung a 4•r,lsr.ldrul•l:inn 7 .� unless you declare a highm value,pity an additional charge,and document you' See it,,RAF,.Snrvtl:e Ge[de her further details. 12'f Questions? _ IIaI•ErSe e '�T '� a �.,,••ul•Isa Call 1800 Go•FedEx i 1-800-463-3339) ,,t� E i 1, -, IOn y J IY�I e' • Is your aMillq ADDRESS completed on the reverse side'" D or in •■ . ■.•CI) r f 1—a ar vcl() iP D y g �zm—n c o re o N\ -reagac..133Z r`' CD a re 7 c cis Firm - V co fD '1 a . ` > 3j F,- mm rt.. P 387 471, 873 -� t� b � V e 0 9 5N ' RECEIPT FOR CERTIFIED MAIL .• ci v I Co S c t? V.. G, - 5. NO'NNURANCE COVERAGE P1HGvr.•: .p 73 m 3 .- �, ice• G"....• F^ re eta c- NI' FOR INTFRNATIONAI.MAII y • `"$ ` ` o ? ,� a c _ "See Reve.se) m `L ft' `s C tO;Cr I J Stn h r __ ....-- is O 1 .' t...v n k a• 3 a cn ' ' ,;/ r1 41/!14K. _,1/' ._-___ . .., ks e , ' �/ N ri P I).3:it.-arui ZIP Ccde • (.1 cat: C-...• ilt Nns,agi• ) 1\ an m n' o' _ 0. ' L's t lei F.!e �. I •3 " • •• m 2 u: 8 •iine::la'Ihe'Iv,•L,lee _ Ej m a 7 � n c' -i..•;nit1.ri r)rhvrly Fee ° •b O 'm p m c i:1 afA l� D se) hip[urn Isre•:21Tl .IrijVInG .. __.. _ co I, o 3 ro n c•' tr).vhnrll.rid ball,Deliverer,' v, is m "a ro �l1 z— _ _ ;_� Qtr o Cu1. .. tT m qa•E.n•,Els!:alit•e!wwtnr to wr,:,nt Ct N o r� r flat•.al.t Stl+trrgs co'Dteh vw: _! G m — r, 6 I tl m C ,.i1 c, ...t., z — c'. ❑ ❑ ° 1' ° '(':rAl I'r.•dta..)•';1rsd Pee.. ,:n i, ro m d `` ua \ Ci (Da_ •• v. 3 CL CD O P;0 Al',1'I. .,•11,.'(• ) C) .'J c=a. a '.IA V) CO �I C 6 is• �F,; -��, ! N °v', m m �; 0 -.' t' I \ m Q m m • ra ]) c. ❑ ❑ , is c� vi c rn a i j R.• u O vi J� Ep' rip n a v rt a r•7 C. (c Q m • 7: 1 a a t" , • .) Thank you tor•.,sing Return Receipt Service. Mail this postcard to businesses and people who send you mail. Please send marl to new address oegimmng- L 1 L_ I il__Li Month D y Year b1-. :y±7 ex_.1.,. /{._C._ I__,_'"-- _'fl_4:/ y 4- -_-L y,_4._,_I My Name 1La t name,first name.middle; 0 L : ' . .' 1-- L-' 7 OLD(omplen NI c u_Add s o PO B:x or Rural Route and RR Box Apt tSlate 11 - l ' l_. . I��- Li_ City or Post Ono_ State ZIP or ZIP +4 Code i 01 1 to —:fr- _ NEW -couplet, t tArI PO hox or Pi R 1 Route arid RR Box Apr•S.�t /t -� L.4pp. i. Cr" _ L City or Post Office --- _ I S L -— I ZIP or ZIP w4 Dod,. NEW Telephone Number Optional) i Act oun•, Number in applicable L / Lc ? 7-/ t4_ e;Ts� 'L -s r7, i 1 a te -on L a e-sr S namm. 1 x L Today s Date: Month Day Year Y s �� PS FORM 3S76 Siptembei 1999 ;l See httpgtwww.usps.gov/movtrsnet for more inform:lion. Hello