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Address Info: 1150 O Street, P.O. Box 758, Greeley, CO 80632 | Phone:
(970) 400-4225
| Fax: (970) 336-7233 | Email:
egesick@weld.gov
| Official: Esther Gesick -
Clerk to the Board
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880338.tiff
RESOLUTION RE: APPROVAL OF RENEWAL REQUEST FOR TAVERN LIQUOR LICENSE ISSUED TO VALLEY HAYLOFT, INC. - EXPIRES JUNE 26, 1989 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, Valley Hayloft, Inc. has presented to the Board of County Commissioners of Weld County, Colorado, an application for the renewal of a Tavern Liquor License for the sale of malt, vinous and spirituous liquors for consumption by the drink on the premises only, and WHEREAS, Valley Hayloft, Inc. has also presented a Change of Corporate Structure removing the name of Clara Moore and adding Shirley J. Boyd as Secretary of said Corporation, and WHEREAS, pursuant to Weld County Ordinance No. 6, Section II, C., said applicant has paid the sum of $98.75 to the County of Weld for the renewal of the existing license, and WHEREAS, said applicant has exhibited a State Liquor License for the sale of malt, vinous and spirituous liquors for consumption by the drink on the premises only, outside the corporate limits of any town or city in the County of Weld at the location described as follows: 3101 State Highway 119, Longmont, Colorado 80501-9543 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 88-6 to said applicant to sell malt, vinous and spirituous liquors for consumption by the drink on the premises only, only at retail at said location and does hereby authorize and direct the issuance of said license by the Chairman of the Board of County Commissioners, attested to by the County Clerk and Recorder, of Weld County, Colorado, which license shall be in effect until June 26, 1989, providing that said place where the licensee is authorized to sell malt, vinous, and spirituous liquors for consumption by the drink on the premises only, 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. 880338 Page 2 RE: TAVERN LIQUOR LICENSE - VALLEY HAYLOFT, INC. BE IT FURTHER RESOLVED by the Board that the Change of Corporate Structure, removing the name Clara Moore and adding Shirley J. Boyd as Secretary, be, and hereby is, approved. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 2nd day of May, A.D., 1988. ATTEST: Weld County C'erk and Recorder and Clerk to the Board Deputy County filerk BOARD OF COUNTY COMMISSIONERS WEL OUNTY, COLORADO Ineir. Gene R. Brantner; Chairman C.W. Kirby; Pro -T EXCUSED DATE OF SIGNING - AYE APPROVED AS TO FORM: Jacquel'ne hnson County Attorney Frank Vamaquchi 880338 ira �(�J gt f @ �/��offlflr�C o lc) e S 11) O e m:ft Off UV@ V \JC.Y.]L.1@ Liquor Enforcement Division 1375 Sherman Street Denver, Colorado 80261 VALLEY HAYLOFT INC 31 11 H4( 119 LJNLHLJJJT CO d0501-9)43 Alcoholic Beverage License Account Number County City Ind n.— Type Liability Date UCENSE EXPIRES AT W DNGNT 14-15754 03 206 5813 3 062777 JUN 26. 1989 Type Name and Description d License Fes T TAVERN LIQUOR LICENSE - MALT. VINOUS. AND SPIRITUOUS $ 25.30 d5 PERCENT OAP FEE b 270.25 ___O_UUNTY TOTAL FEE(S) b 301.25 This license is issued subject to the laws of the State of Colorado and especially under the provisions of Title 12, Articles 46 or 47, CRS 1973, as amended. This license is non- transferable 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 should be addressed to the Department of Revenue, Liquor Enforcement Divison, 1375 Sherman Street, Denver, CO 80261. In testimony whereof, I have hereunto set my hand. // vim% Division Director DR 8402 (11/87) NEW '1988 Executive Director 880338 an col op THIS LICENSE EXPIRES z H O �I Retail Liquor Store, Liquor Licensed Drug Store, Hotel and Restaurant. Club, Tavern, Etc. a. U w En 0 p d D SPIRITUOUS LT, VINOUS TO SELL AT RETAIL SPECIFY KINDS OF LIQUOR YLOFT, INC T, VINOUS AND SPIRITUOUS Is 75/100 DOLLARS NINETY-EIGHT a 0 0 U ry m ci -t 4-a a) O 6q p rn H o z m1-4 °c O' z O H BY THE DRINK FOR a �o •- ci a reco o C)p11) _ b • y d .� a3 .d a) N 0 m coop `a o 0o c. Ci. >, a) m F 8 F O CO cd a) I.4 m z q a. al mz 0a0 m) ro ti O a c),, cpd ad q apG ca b O ea I El 0 3 N c• d m W Fm Q1 O z°Z.▪ ' _U.4o ca cd N 4-4 v. U 'O m F V O co h ▪ n y N O b a ai 0 "", ate, cd q v M �,rac0 c al 'O3" w Cl yro w 0 O tO C x q O cp ccd H �m7?-0 ✓ rn^ dC 4'D a) O5 ..t," O . �: the drink for consumption on the p F O La N . OF O 'd co m 5 d" -••.s �jO y .., Z t . o ,,C- i> H .�-c O H mq "O rCD i H H G7 2r co U J_ m a 20 0 L m wgir - a a) Q� - F� z IT) Cr 6> r -R w a- U't cc z ar 1g. . - • az Cl U tL cc S861 aunt 009E Sd « 3 c Pg 6t 6 Q_ a I. > . .Ea L 0z « O 1: $ 8 i2 8 y .9u • ! 3 b E • CI g M �N . C g O ULI C1 M U"1 cr Z Lt -1 co o 0 d ! H Z a • Wx0 CD E a O O • J M rl ri I m L X C Q v 2 fn X DOMESTIC RETURN RECEIPT r U_S.G.P.O. 1987-178-268 880338 R 8176 (10/87) Colorado Department of Revenue Liquor Enforcement Division 1375 Sherman Street Denver, CO 80261 303-866-3741 DO NOT USE THIS FORM TO REFLECT A CHANGE IN PARTNERSHIP. IF THERE IS A CHANGE IN PARTNERSHIP, USE THE DR 8404 OR DRL 403 AND FILE A CHANGE OF OWNERSHIP WITH YOUR LOCAL LICENSING AUTHORITY. REPORT OF CHANGES LIQUOR AND 3.2 BEER LICENSE iii4LtitteENaESS Si APPLICANT NAME: TRADE NAME: V,ALL.ZY L.:o -1OFT ADDRESS OF LICENSED PREMISES: Street Address 310 1 $i.., MAILING ADDRESS Street Address 31111 i /V 1 City Ira riglIRID CHANGE OF CORPORATE STRUCTURE (Applies to corporate licensees only) Attach acertif cate of Good Corporate stand and, for each neurofficer. direcID4 'and stockhclder;:attach a DRL4D4 1, Individual History Recordtand Copy nt Minutes .. _..,....+REPLACES (Name): `ACKNOW LEDG !.!- 3 19B DATE City • Use to report change of corporate structure, change of trade name or change of manager only. • Submit to Local Authority (Local Authority will submit to State) SALES TAX ACCOUNT NO.: LICENSE NUMBER: faX TELEPHONE NUMBER: 716,r7 46 State Co Zip NAME of new wrporate,efflcera$,Q)teyto.[4F President So;lre. Vice President .+'.ia"=Y£,: f.""IJOre Secretary °y3-:"" ,S fi3y WOK ARRRESS 119 , Lonq;T, State CO zip 90.50i OM 3141 iiwv 119 NEW STOCKHOLDERS/TRANSFERS OF CAPITOL STOCK HOME ADDRESS D.O.B. Clara Moon, %OF STOCK NOW OWNED DIRECTORS: HOME ADDRESS D.O.B. REPLACES (Name): CHANGE OF'TRADE1NA OLD TRADE NAME: INEW TRADE NAME: CHANGE OF≥NIANAGER FORMER MANAGER: Name For Beer & Wine, aSt.#11.1kiiCAMAtiOaliatei-- :%HoteltffitiotatitatitiLicensees must submit a DR 8387, ManaaetfO l:Ienistration Date of Birth NEW MANAGER: Name tTH OF /A.PPLUI Date of Birth I declare under penalty of perjury in the second degree that f have read thie report and all attachments thereto and that I know the contents hereof, and that all matters and information set forth therein are true, correct and complete to the best of my knowledge and information; and I agree to conform to all applicable statutes and all rules and regulations promulgated by the Colorado Department of Revenue in connection therewith. I DATE: AUTHORIZED SIGNATURE: dN, TITLE OF SIGNER (if corporation) The foregoing changes have been received and examined by the Local Licensing Authority. LOCAL LICENSING AUTHORITY ID. NUMBER. I LOCAL LICENSING AUTHORITY FOR: nr WELD COUNTY, COLORADO ATTE TITLE: CHAIRMAN BOARD OF COUNTY COMMISSIONERS -))EPUTY COUNTY TOWN/CITY DATE: 5/2/88 DATE: 5/2/88 88U33d Note: Local Authority, please submit all cries to the Liquor Enforcement Division. One copy will be returned to the applicant and one to the Local Authority upon acknowledgment. DR 8400 (4/87) Colorado Department of Revenue Liquor Enforcement Division 1375 Sherman Street Denver, Colorado 80261 866-3741 LIQUOR OR 3.2 BEER LICENSE RENEWAL APPLICATION License Number: License Type: Liability Information: Business Location: Current License Expires: ...,. ....Jai `i ©1111Y/COURFY CO RV YOUR PROMPT ATTENTION IS REQUIRED. FAILURE TO COMPLETE THIS FORM ACCURATELY AND PROMPTLY MAY RESULT IN YOUR LICENSE NOT BEING RENEWED. • F EL OUT THIS FORM COMPLETELY, AND CHECK APPROPRIATE BOX BELOW. This renewal reflects no changes from last application. • SIGN THE FORM There are changes from last application. (Report changes on • SUBMIT FORM TOTAL MOON (CITY/COUNTY) LICENSING AUTHORITY FOR APPROVAL DUE TOrenewal annliratinn ) CHECK WfIH (• in the second degree that this application and all attachments are true, correct, and complete to the best of my knowledge. 10eciare unoen penmay 0 pelp,' .... Authorized Signature: ,y_ , ... ; ., l , Business Phone: Title of Signer (if corporation): Sales Tax No. ;anal _ w - 7,r;2' SUBMIT THE STATE COPY AND LOCAL (CITY/COUNTY) AUTHORITY NO LATER THAN 45 DAYS BEFORE YOUR EXCEPTION: Wholesaler, manufacturer, importer, and approval and must be returned directly to the Colorado The foregoing application has been examined and and we do hereby report that such license, if granted, THEREFORE THIS APPLICATION IS APPROVED. AUTHORITY. COPY TO YOUR LOCAL (CITY/COUNTY) LICENSE EXPIRES. public transportation system license renewals do not need Department of Revenue no later than 30 days prior to license :O, L . _ G S OGRlTn� _ , lei ,...a.. e. the premises, business conducted and character of the will comply with the provisions of Title 12, Articles LICENSING Local Licensing Authority expiration. applicant is satisfactory, 46 and 47, C.R.S. Local Lic. Audi. I.D. No.: { Local Licensing Authority for: Weld County. Colorado ■ TOWN/CITY XX COUNTY Signal N X e /L Title: Chairman Board of County C mmissioners Date: 5/2/88 A%tAtActFC,n� Deputy Date 5/2/88 — ..,, ,.,.,,.r, rv, rant datarh Do not detach Do not detA/h Do not detach Do not detach D . BusiaesS A.Ocatieti ,,, U _ .. 1 Name/Trade Name: Use License Number for All Reference LIABILITY INFORMATION RENEWED EXPIRES AFTER LICENSE County City Indust Type Liab. Date aIz 'J4 1, 4.) 3 ...._1( O8 / AP TYPE OF LICENSE ISSUED SIAIE hbE CITY 85% OAP 41-9 (9) 45-9 (9) -1 (9) ( Make checkpayable to : COLORADO DEPARTMENT OF REVENUE TOTAL AMOUNT DUE w EXTENDED HOURS - Applies only to Hotel and Restaurant, Beer and Wine, Club, l avern, and Arts licenses. If desired, check yes' and enclose Total Amount Due PLUS $170.00. NOT WRITE BELOW THIS LINE Extended hours? YES Ill NO DO R $401(6/8'7 Attschm,nt to .iq..orr3,2 1. Uo you have legal posession of the premises for which this application for license is made? YES NO❑ Are the premises: OWNED O RENTED If rented, effective and expiration date of lease: Ucerisa Ranowaf Appttcstion' 2. (a) Has the applicant, or any of the partners, or offi- cers, stockholders or directors of said applicant (if a corporation) ever been convicted of a crime? If an- swer is "yes,' explain in detail and attach. (b) Have persons lending assistance or financial support to the applicant, or manager, or employees, ever been convicted of a crime? If answer is "yes,' explain in detail and attach. YES O NOD YES ❑ NO 7. If the applicant is a corporation, answer the following: (a) Corporation is organized under the laws of the State af: Date Incorporated: (b) Principal place of business is: (c) Date of filing last annual corporate report to the Colo. Secretary of State' (d) Name of each officer listed below: President: ' Date of Binh Home Address: Vice-Pres.: Date of Birth Home Address: 3. Has the applicant, or any of the partners, or officers, directors or stockholders of said applicant (if a cor- poration) or manager, ever: (a) been denied an alcoholic beverage license? YES O NOQ' (b) had an alcoholic beverage license suspended or revoked? YES O NOR' (c) had interest in any entity that had an alcoholic beverage license suspended or revoked? _...._ YES.O,NO If answer is 'yes" to any of the above questions, explain in detail and attach. Treasurer; . Date of Binh Home Address: Secretary. I Is Home Address: 4. Does or did applicant, or any of the partners, or officers, directors or stockholders of said applicant (ii a corporation), have a direct or indirect interest in any other Colorado liquor license (include loans to or from any licensee, or interest in a loan to any licensee)? If answer is "yes," explain in detail and attach. Operatng Manager: • - YES ❑ NOE]' 5. Identify the persons, firms or corporations who now or will have a financial interest, evidenced either by a loan to, or equity ownership in, the business for which this license is requested. State the names and addresses and the amount and source of such financial interest (i.e., bank, relatives, friends, previous owners, etc.), expressed in dollars or other items of value, such as inventory, furniture or equipment. Use separate sheet if necessary. Name !Interest Home Address: 7/1? :='i. JJj'rw s.:.;'•.in;:.,.% i_ '•'._. ,(e) List all stockholders,5% or over, (if a public corporation} including actual owner or pledgee. (Use separate sheet if necessary) Name: l Date of &ah Address Name: Address: % of Stock Date of Bath %of Stock (f) Name of all Directors/Trustees of Corporation Name. r'. rr Name,. Date of Birth Date of Birth Address Describe type and amount al interest: Name Name .. 8. If applicant's partnership list all general partners. Use separate sheet if necessary" • Date of Birth. Name Date of Birth 6. List on a separate sheet the names and addresses of all liquor businesses in which any of the persons in question No. 5 are materially interested. Name Dale of Birth Name Date of Birth THIS PAGE MUST BE COMPLETED AND ATTACHED TO YOUR SIGNED RENEWAL APPLICATION FORM. FAILURE TO INCLUDE THIS PAGE WITH SAID APPLICATION MAY RESULT IN YOUR LICENSE NOT BEING RENEWED. 880338 R 84041 (2/85) 14. Name of Present Em lover: .•r Y.r r ' ft'et,i a itS4i t pare. gt 4 c40, , . 2113 16. Address of Business Where Employed: (street £d number/city/state/zip) / 3/c 1 Hu/ / 119 Lis yh1Ont(-) C./O, ffo5cl 17. Present Position: ve-•-,4,-o. -t Yob 5 19. Marital Status: 54Pera je- 21,Spouss Date of Birth: STATE OF COLORADO DEPARTMENT OF REVENUE/LIQUOR ENFORCEMENT 1375 Sherman Street Denver, Colorado 80261 INDIVIDUAL HISTORY RECORD To be completed by each individual applicant, each general and over 5% limited partner of a partnership, each officer, director, and over 5% stockholder of a public corporation, and the manager -of the applicant. NOTICE This Individual History Record provides basic information which is necessary for the licensing authorities' investigation. ALL questions must be answered in their entirety. EVERY answer you give will be checked for its truthfulness. A deliberate falsehood will jeopardize the application as such falsehood within itself constitutes evidence regarding the character and reputation of the applicant. Name of Business: Vc 11 eyr t 0.ynloo* 2. Your Full Name last/ lt/middle) 6o1d SAirle ' :r 4. Date o Birth: 5. U.S. Citizen?: YES ONO Place of Birth: Gre"e,1e" t CO/O, If naturalized, state where: Naturalization Certificate No.: Date of Certificate: Date: H -a5 -f 3. Also Known As: (maiden name/nickname/etc.) 5h,'tie y T Hoof is when: Social Security Number. Say- 1/ U S. District Court: If en alien, give Alien's Registration Card No.: Permanent Residence Card No.. 5, Height: 5-•i it 8. Your Relationship to Applicant: (sole owner/partner/corporate officer/director/stockholder or manager) Weight: 745 - Hair Color: trowh Eve Color: Greek Sex: F Race: w.' 7. Do you have a Colorado Drivers License? If' YES", give number: 54,1 . .. t' Sp .. Stockholder, Number of Shares Ow ed Beneficially or of Record: Percent of Outstanding Stock Owned: 10)f Partner State Whether: ❑GENERAL ALIMITED c. A9 ?O 11. Residence Address: (street and number/city/at to/zip) ---. '316/ 11- fl/Q .Lon rn°bt etc 12.Is your residence. If rented, f m whom?' •,. rase.' er: albs 7 z ria to sp^ DOWNED ❑RENTE D -^�""'.M.-..... «......._ 13_Mailing Address, If Different From Residence: Percent of Partnership Beneficially Owned: ,.�T c 9101 1-1-w� fly _ LoItj ofOh17 c'o/o, to So/ 15.Type of Business of Employment: Pest- oovf d 18.Home Telephone: 774-7X142_ 20. Name of Spouse (include maiden name if applicable): Pot D, goy el. Place of Birth: Ba I^ (Ad , Co /-F, a-rch spouse's residence address is different than yours, list here.: (street and number/city/state/zip) fa'6o.l' Ait old 7owh f/• 126'sa ,3. It spouse works, state name of present employer: 4'ei1 rr,r,r re, .t — Re// -c/. 32 6sr0 Address of present employer: 6e.11 rr, or ecc!- 1341 -Pie 9 2-6 g d 1, Lest the namel s) of all relatives working in the liquor industry, giving their. Occupation: -reefc-k dr; ve% Business Telephone: 776-'2y G2 Name of Relative. Relationship to you: Position held: Name of employer: Location of employer: a -me of Relative: Relationship to you: Position held: Name of employer: Location of employer: 15.--o You now or have you ever held a direct or indirect interest in a State of Colorado Liquor or Beer License? If YES answer in detail. YES ENO 9 f 9eeP 1/' r,e n5 e cld 77hie 1-5 L«rl'vrirr Cam,ght,/ lv76 - J2,7 3.2 82 r Wes/cke 5ervfce ,965r -/22c Do you now, or have you ever had a direct or Ind interest in a liquor or beer license, or been employe a liquor or beer related business outsioe ottr State of Colorado? If "YES", describe in detail. DYES IIINO 27, Have you ever been convicted of a crime, fined, imprisoned, placed on probation, received a suspended sentence or forfeited bail for any offense in cnm,nas O' military court? (Do not Include traffic violations, unless they resulted in suspension or revocation of your driver's license, or you were convicted of driving under the influence of alcoholic beverages.) If "YES", explain in detail. DYES [$J NO 28. Have you ever received a violation notice, suspension or revocation for a liquor law violation, or been denied a liquor or beer license anywhere in the U.S If "YES", explain in detail. YES 51NO 29. Have you ever held a gambling or gaming license or owned a Federal Gambling Stamp? If "YES", exp ein in detail. DYES CiINO State/Federal: Year: City: State: State/Federal: Year: City: State: 30. Military Service: branch: From: To: Serial No.: Type of Discharge: 31. List all ad where you have lived for the last five years.(Attach separate sheet If necessary) Street and Number: te, Box s Street and Number: 3 to 7f 117 32. List all former amPloYersiOr bust City/Stets/Zip: qed .ceA,fi%ttj- •o-ke5 co /a $.°5414- City/State/Zip: Lohq vcn, Ge/o teS.o/ engaged in within the last five Oise: (Attach additional sheets If necessary) From: /U 7 From: /y 5'7 To: /9k-, To 19 set Name of Employer:.. I I S{�• E. {<ou4 P Name of Employer:. ij.. IL,.. All /oft List thi (street and number) .j06 Lot(rm 1 Address: (strut and number) (city/state/zip) -Pt. G//rrn 5 (city/state/zip) co /b • Lop rnnh 1., G0/a Position/Held: Cook; it io n 5i eld: %t�ehdC r' From: '985 From: /9 r. - To: 19;7 To: Ic87 and 33. names e d attach letters of recommendation from three persons Who can vouch for your good character and fitness in connection with this application. Name of Reference: MerlOee MohJ4-h Name of Reference: 1306 s; n,o n Name of Reference: Leo Ttitrait Address: (street and number) 5-6 32 E cote h't v np, SO Address: (street and number) it, f75 S• Z e,hveh Address: (street and number) P70.5' S. Voudlr'ree (city/state/zip G0///952 co/d,90 "2 al Icity/estate/zip) �" .La e wood) cob. jfc2A4 (city/state/zip) •F • co/%•h5 co /a • k o 5-2 No.Years Known: LS No. Years Known No. Years Known: v OATH OF APPLICANT I declare under penalty of perjury in the second degree that l have read the foregoing application and al/ attachments thereto, and that all information therein is true, correct, and complete to the best of my knowledge, SIG TUBE: TITLE: DATE: _ 2 5-- 8"5-' 880338 STATE? '� v {RADO DEPARTMENT OF STATE CERTIFICATE I, NATALIE MEYER, Secretary of State of the State of Colorado hereby certify that According to the records of this office VALLEY HAYLOFT, INC. (COLORADO CORPORATION) has complied with the applicable provisions of the laws of the State of Colorado and on this date is in good standing and authorized and competent to transact business or to conduct its affairs within this state. Dated: APRIL 6, 1988 SECRETARY OF STATE ■ • )t 12 tt LIJ 2 m§\$ -n cc tu cra cn Z \\}g )z`/ \ Cal CZ 0 \}in)o en r74 Special Delivery Fee L Resticted Delivery Fee Return Recero`t showing to whom and Date Delivered Return Receipt showing to whom. Date. and Address of Delivery TOTAL Postage and Fees c Postmark or Date o Seel _r_,_,e We. Consult k • !o 18 DO 0 cn \mgr \ \( 0 f 114 0 Z• W A cla r4 a(\} CO X 7. Date of Delivery DOMESTIC RETURN RECEIPT CO Wine COLORADO May 13, 1988 Weld County Commissioners Clerk to the Board 915 - 10th Street Greeley, CO 80631 RE: Liquor License Renewal Dear Licensing Authority: DEPARTMENT OF HEALTH 1516 HOSPITAL RJAD GREELEY COLORADO 80631 ADMINISTRATION (303) 353-11586 HEALTH PROTECTION (303) 353- .1635 COMMUNITY HEALTH (303) 353. 1635 The following Food Service Establishment, Valley Hayloft, located at 3101 State Hwy 119, does have a valid 1988 Colorado State Food Service License and is in compliance with majority of the Rules and Regulations Governing the State of Colorado Food Service Establishments (July 1978). If any questions should arise in this matter, please contact this department at 353-0635, ext. 2236. Sincerely, Wes Potter, Director Health Protection Services 38 338 RECEIVED OF T "ASURER'S OFFICE, WELD C NTl N° 1529 Greeley, olorado..t�-L�"f/',{?}`y2,5 FOR CREDIT r..-ty Goneral Hind '101 0000 1 l,Q, r l L_Q_ gr_z.p ��? j Health Department 119 0000 r� Human Resources 121 0000 Social Services 112 0000 Housing Authority Road & Bridge Fund 111 0000 Airport 177 0000 County Clerk Cash Escrow 810 0803 Fee Fund 900 0912 School District Gen Fund School District C R F School District Bond Fu//q-�d(, ��yyqqqq{� 880338 FRANCIS M. LOUSTALET L J-' 4 I TOTAL AMOUNT (iV a surer County Treasurer clerk
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