Casey's Beer Permit RefundTHOMASJ. VILSACK
GOVERNOR
SALLYJ. PEDERSON
LT. GOVERNOR
STATE OF IOWA
IOWA DEPARTMENT OF COMMERCE
ALCOHOLIC BEVERAGES DIVISION
LYNN M. WALDING, ADMINISTRATOR
September 4, 2001
Monday Company, The
4003 Pera Rd,
Dubuque, IA 520010000
RE: License/Permit No. BC0019355
Dear Licensee/Permittee:
Enclosed is state warrant in the mount of $5.00 which was issued in payment of a refund
on your Beer Permit Class C permit.
Please apply to the CITY/COUNTY for their portion of the refund in the mount of
$25.00.
Very truly yours,
Karen Freund
Administrative Assistant
BBC.
cc: CITY CLERK/COUNTY AUDITOR
1918 S. E. HULSIZER RD./ANKENY, iOWA 50021-3941 / PHONE 515.281.7400 /TOLL FREE 866.469.2223 / FAX 515.281.7385
www. lowaABD.com
To The Honorable Mayor
and City Council
Dubuque, Ia. 52001
Dear Council Members:
I am hereby requesting a refund on CLASS ~ BEER PERMIT
License No. ~Ct~l ff3~3~ , issued on F~a~ ~ ~o o o and
expiring ~)~'~ ~1oo t I discontinued business on
6 ]~q 1,~oo~ and respectfully request you Honorable Body to
grant me a refund of ~
Respectfully Submitted,
Name
D/B/A
Address of Business
Federal Tax # or Social Security #
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