Refund Liq. Lic Arby's Q MartDate: 9-30-02
To The Honorable Mayor
and City Council
Dubuque, Ia. 52001
Dear Council Members:
I am hereby requesting a refund on BEER & LIQUOR COMBINATION LICENSE.
License No. BC25413, issued on 4-17-02 and
expiring 4 - 16-03 I discontinued business on
9-30-02 and respectfully request you Honorable Body to
grant me a refund of 37.50
Respectfully Submitted,
Name: Terry M Larvy
D/B/A: Arcon, Inc- Arby's Q-Mart
Address of Business: 10 Main Street, Dubuque, IA 52001
Federal Tax # or Social Security# 42-1445665
MAIL CHECK TO:
ALCOHOLIC
B EVE RAG ES Thomas J. VilSacK Governor ~f Iowa
DIVISION Sally J. Pederson Lieutenant Governor
State of Iowa
Lynn M. Walding Administrator
October 29, 2002
mrcou~ IBc.
10 Main Street,
Dubuque, IA 520010000
Dear Licensee/PermitteR:
RE: License/Permit No. BC0025413
Enclosed is state warrant in the amount of $7.50 which was issued in paymem of a refund
on your Beer Permit Class C permit.
Please apply to the CITY/COUNTY for their portion of the refund in the amount of
$37.50.
Very truly yours,
Karen Freund
Administrative Assistant
EriC.
cc: CITY CLERK/COU~'TY AUDITOR
A Division of the Department of Oommerce 19188EHulsizerRoad Ankeny, mwa 5002%$941
PH 515.281.7400 FAX 515.281.7375 TOLL FREE 866JowaABD WWWJowaABD.com
DIRECT PAYMENT VOUCHER REQUEST
DATE 11/19/03
Vendor#: T
By:SUSANW1NTER
Vendor Name ARCON, INC
& Address: 645 32ND ST S.W.
CEDAR RAPIDS, IA
52404
REFI ACTIVITYI OBJECT } AMOUNT [ INVOICE NUMBER
I 73100 42105 37.50 BEER REFUND
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
TOTAL $37.513
Description Of Good/Service Ordered:
REFUND ON BEER LICENSE # BC 25413 DISCONTINUED BUSINESS
ON 9-30-02
Good/Service Received By:
SUSAN WINTER
Department Authorization Payment Approved - Finance Director
Revised 4/2000