Refund Oky Doky 15, Meloy, RDate
To The Honorable Mayor
and City Council
Dubuque. Ia 52001
Dear Mayor and Council Members:
I am attaching hereto Cigarette License No.~)~ ~
June 30, ~-(])O~-I discontinued business on ilJl-d
respectfully request your Honorable Body to grant me a refund of
expiring on
and
Na-~e ~/
/s/ Ronald J. Meloy
Oky Doky #15
1101 Rhomberg
420-1508143
Mail Check to:
Ronald J. Meloy
595 Almond
Dubuque, IA 52001
Address of Business-_ ~
Federal Ta~-# or' Sdciat Security #
Mail Check To:
iowa Retail Cigarette
Permit Renewal
/~Explr~ a
STATE OF IOWA
RETAIL
{5i ;arctt¢ ¢rmit
CityNumber
004536
In accordance with laws of the State of Iowa, and the action of
the City Council of DUBUQUE Iowa
(or Board of Supervisors) (City or County)
Business Location Name: OKY DOKY # 15
110t RHOMBERG AVE
Business Location Address:
DUBUQUE IA 52001
OVER THE COUNTER
Type of Sales: Ownership Type:
Legal Owner Name: RONALD J. MELOY
INDIVIDUAL
Legal Owner MailingAddress:
595 ALMOND ST
DUBUQUE IA 52001
is hereby authorized to sell cigarettes at the business location address
above in the City~tlUQUk;v,~ DUBUQUE
County of , Iowa.
This permit is nontransferable, is effective from and after NOVEMBER 7,20 OaOnd
automatically expires on June 30th, 20 01 , unless previously revoked
In Testimony Whereof, I have caused the seal of the said
County DUBUQUE
City to be hereunto affixed Done at
in the State of Iowa, t~is 7TH day of NOVE~ f2~9
CLERK
JEANNE F. SCHNEIDER
00
04536
White Copy - Permit Holder
Yellow Copy - City/County
704)01 (4/00)