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Business Licenses RESOLUTION NO. 43-05 Whereas, applications for Beer Permits have been submitted and filed to this Council for approval and the same have been examined and approved: and Whereas, the premises to be occupied by such applicants were inspected and found to comply with the Ordinances of the City and have filed proper bonds. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: That the Manager be authorized to cause to be issued the following named applicants a Beer Permit. CLASS "C" BEER PERMIT Dubuque Discount Gas, Inc Hill Street Plaza, Inc Dubuque Discount Gas, Inc Inocente Rubio Nash Finch Company Hartig Drug Company Dubuque Discount Gas+(Sunday Sale) Oky Doky +(Sunday Sale) Dubuque Discount Gas+(Sunday Sale) EI Paisano Econo Foods #471+(Sunday Sale) Hartig Drug+(Sunday Sale) 2175 Central 535 Hill St 4110 Dodge 1543 Central 3355 JFK 2225 Central Passed, approved and adopted this 7th day of February, 2005. Terrance M. Duggan Mayor Attest: Jeanne F. Schneider, CMC City Clerk () ." i'l c.:; li , , ) ,-I , , - r' t6 '~I;;~ I j !-j '-' r',) '..::) RESOLUTION NO. 44-05 Whereas, applications for Liquor Licenses have been submitted to this Council for approval and the same have been examined and approved; and Whereas, the premises to be occupied by such applicants were inspected and found to comply with the State Laws and all City Ordinances relevant thereto and they have filed proper bonds. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: That the Manager be authorized to cause to be issued the following named applicants a Liquor License. CLASS "B" LIQUOR Dubuque Inn Corp. Best Western Dubuque Inn+(Sunday Sale) 3434 Dodge CLASS "C" BEER/LIQUOR LICENSE Melvin Spiegelhalter Pusateri Entrp Hammerheads Inc. Charles Steffen Town Clock Inn Inc James Goetzinger The Apartment, Ltd The Club House Pusateri's+(Sunday Sale) Hammerheads Bar/Billiards+(Sunday Sale)' Tony's Place+(Sunday Sale) Town Clock Inn Goetz's+(Sunday Sale) Dubuque Mining Co.+(Sunday&Outdoor Sale) 2364 Washington 2400 Central 2095 Kerper Blv 1701 Central 799 Town Clock 2776 Jackson 555 JFK Rd. CLASS "B" WINE Hartig Drug Company Nash Finch Company Carroll's Wine Company Hartig Drug Econo Foods # 471 Grape Harbor 2225 Central 3355 JFK Rd 123 Main St SPECIAL CLASS"C" LIQUOR Carroll's Wine Company Grape Harbor+(Sunday Sale) 123 Main St Passed, approved and adopted this 7th day of February, 2005. Terrance M. Duggan, Mayor Attest: Jeanne F. Schneider, City Clerk DUBUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION DPD#- Establishment: Address: Licensee: Address: License #: Issue Date: Expiration Date: Bartender: DaB: Address: Check Individual 123.46 5-7.2-a 5-7.2-a 123.47 123.49-3 723.4 Business 123.49-1 123.47-a 5-7.2-c 123.49-2-d 5-9 p(I/ '?.5 3 (/5 , '')-) 'J -OLj CASE #: TIME: DATE: PURPOSE OF INSPECTION Routine / Yearly Disturbance Report of Underage Persons Full Inspection Assist Other Agency Other (explain in narrative) FIRE CODE Exit Signs Visible? Obstructions in Exits? Within Occupancy Load? CHECK VIOLA TIONS THA T APPL Y Public Intoxication Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) Person Under Age 21 in Bar After 9 P.M. (under age 18) Underage Possession of Aicohol Misrepresent Age When Purchasing Alcohol Disorderly Conduct Individual Total: Serving Intoxicated Person Serving Persons Under Age 21 Allow Person Under Age 21 in Bar After 9 P.M. Liquor in Container Other Than Original Violation of Buffet Drinking Ordinance NO VIOLATIONS OBSERVED NARRATIVE: ( Explain reason(s) for inspection, Violations observed, List all expired permits) I Business Total: A/I) 11M ill TltJN5 ItJI77T!J License Renewal Recommendation: ( If NO, explain) DYES 0 NO Officer: &ORPEI' Chief of Police: Bdg#: 70/1 Dale: ..il. Referral Filed Y N Y N Y N # OF VIOLA TIONS CJ v- o Supervisor: Date: (... rDDaUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION DPD#- CASE #: TIME: DATE: Establishmentd t ~~ ~ PURPOSE OF INSPECTION Address: / +53 ("'''.-.1 kif' /... ) Licensee: J!J~Eljl:% J{~;B Routine / Yearly - Disturbance - Address: /:53 'I/?.-,1 U Report of Underage Persons _ Full Inspection - License #: A (1/ 7 5?2_ )J Assist Other Agency - Issue Date: Other (explain in narrative) - Expiration Dale: :J. -/ 1-tJ :;, FIRE CODE Referral Filed Bartender: Exit Signs Visible? Y N DOB: Obstructions in Exits? Y N Address: . . Within Occupancy Load? Y N Check Individual CHECK VIOLA T/ONS THA T APPL Y # OF VIOLA T/ONS - 123.46 Public Intoxication () - 5-7.2-a Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) 0 - 5-7.2-a Person Under Age 21 in Bar After 9 P.M. (under age 18) 0 - 123.47 Underage Possession of Alcohol 0 - 123.49-3 Misrepresent Age When Purchasing Alcohol 0 - 723.4 Disorderly Conduct 0 Business Individual Total: - 123.49-1 Serving Intoxicated Person - 123.47-a Serving Persons Under Age 21 - 5-7.2-c Allow Person Under Age 21 in Bar After 9 P,M. 0 - 123.49-2-d Liquor in Container Other Than Original 0 - 5-9 Violation of Buffet Drinking Ordinance 0 ..x.. NO VIOLATIONS OBSERVED NARRATIVE: I Business Total: D ( Explain reason(s) for inspection, Violations observed, List all expired permits) /Vo VjOLP)TIOAl,~ Nn f-h License Renewal Recommendation: ~ES 0 NO ( If NO, explain) Officer: r;'cI~REU_ Bdg#: 70(3 Date: laiN/a"; Supervisor: / J.J)/J ~/<( Chief of Police: f~j\('\ ~ Date: I I "-.J DUBUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION DPD#- CASE #: TIME: DATE: Establishment: ---JflIUJ''s PfJ/f" ~ . Address: /70/ (jJ ~1J;~ Licensee:~f;:f& 1Jt,A) Address: 'vi PURPOSE OF INSPECTION Routine / Yearly 0 Disturbance 1- Report of Underage Persons ~ Full Inspection ~ Assist Other Agency (!> Other (explain in narrative) ----0- License #: j~:;< 'JOe:, U Issue Date: Expiration Date: NARRATIVE: ( Explain reason(s) for inspection, Violations observed, List all expired permits) f.'i3<-<tc z^"oX ~~.f ~j,.l.1 ~"!;, ""~OcJ ;; P<.i5i.<1:L i..'-',~I<. M~r i . Or~', Fit.LV (l.{2.fE'<-,r Bartender: DOB: Address: Check Individual 123.46 5-7.2-a 5-7.2-a 123.47 123.49-3 723.4 Business 123.49-1 123.47-a 5-7.2-c 123.49-2-d 5-9 FIRE CODE Exit Signs Visible? Obstructions in Exits? Within Occupancy Load? Referral Filed Y N Y N Y N CHECK VIOLA TlONS THA T APPL Y Public Intoxication Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) Person Under Age 21 in Bar After 9 P.M, (under age 18) Underage Possession of Alcohol Misrepresent Age When Purchasing Alcohol Disorderly Conduct # OF VIOLATIONS 3- o f<.) 0> o '2. Individual Total: Serving Intoxicated Person Serving Persons Under Age 21 Allow Person Under Age 21 in Bar After 9 P.M. Liquor in Container Other Than Original Violation of Buffet Drinking Ordinance NO VIOLATIONS OBSERVED f) o (') o r, I Business Total: I=:J ,<:/7/0<! Z,5'f' License Renewal Recommendation: ( If NO, explain) g-yES 0 NO Officer: Chief of Police: Bdg#: Date: Supervisor: Date: ~ DUBUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION DPD#- CASE #: TIME: DATE: Establishment: ~ bW~ Address: ?-,~ PURPOSE OF INSPECTION Routine / Yearly () Disturbance ~ Report of Underage Persons --1l!....- Full Inspection ~ Assist Other Agency t> Other (explain in narrative) 6 Licensee: Address: License #: U Issue Date: Expiration Date: Bartender: DOB: Address: Check Individual 123.46 5-7.2-a 5-7.2-a 123.47 123.49-3 723.4 Business 123.49-1 123.47-a 5-7.2-c 123.49-2-d 5-9 FIRE CODE Exit Signs Visible? Obstructions in Exits? Within Occupancy Load? CHECK VIOLA TIONS THA T APPL Y Public Intoxication Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) Person Under Age 21 in Bar After 9 P.M. (under age 18) Underage Possession of Alcohol Misrepresent Age When Purchasing Aicohol Disorderly Conduct Individual Total: Serving Intoxicated Person Serving Persons Under Age 21 Allow Person Under Age 21 in Bar After 9 P.M. Liquor in Container Other Than Original Violation of Buffet Drinking Ordinance NO VIOLATIONS OBSERVED I Business Total: NARRATIVE: ( Explain reason(s) for inspection, Vioiations observed, List all expired permits) S ,hI' lfJ:7TN6 I -ZiFI'"I c) /I() /c4 . License Renewal Recommendation : ( If NO, explain) D"YES 0 NO Officer: Chief of Police: Date: Supervisor: Date: I P~~/6i ( (J \. Referral Filed Y N Y N Y N # OF VIOLATIONS o C D t) (!) o 1') c o ill C- O DUBUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION f}A44 ~j&..tuvAiv f p.Mi;;U~ .:J, 'i ()b {};:;;::t;A---b U {).j &77/ DPD#- Establishment: Address: Licensee: Address: License #: Issue Date: Expiration Date: Bartender: DOB: Address: Check Individual 123.46 5-7.2-a 5-7.2-a 123.47 123.49-3 723.4 Business 123.49-1 123.47-a 5-7.2-c 123.49-2-d 5-9 CASE #: TIME: DATE: PURPOSE OF INSPECTION c Routine / Yearly Disturbance .2.- Report of Underage Persons ~ Full Inspection ~ Assist Other Agency ~ Other (explain in narrative) 0 FIRE CODE Exit Signs Visible? Obstructions in Exits? Within Occupancy Load? CHECK VIOLA T10NS THA T APPL Y Public Intoxication Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) Person Under Age 21 in Bar After 9 P.M. (under age 18) Underage Possession of Alcohol Misrepresent Age When Purchasing Alcohol Disorderly Conduct Individual Total: Serving I ntoxicated Person Serving Persons Under Age 21 Allow Person Under Age 21 in Bar After 9 P.M. Liquor in Container Other Than Original Violation of Buffet Drinking Ordinance NO VIOLATIONS OBSERVED I Business Total: NARRATIVE: ( Explain reason(s) for inspection, Violations observed, List all expired permits) JJC C p.iL S License Renewal Recommendation: ( If NO, explain) [:;YVES 0 NO Officer: Chief of Police: Date: Supervisor: Date :1 ph9~V ( I Referral Filed Y N Y N Y N # OF VIOLA T10NS C () (') l!l o ,(l) o (') (") o o D DUBUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION DPD#- CASE #: TIME: DATE: Establishment:~. ~..Jr ~ 1. fi~ _. PURPOSE OF INSPECTION Address: 7 ~/tJ::;, ~ I~ ~ Routine / Yearly " Licensee: ~f)'\ f!t-clt- Disturbance -.tl.- Address: 797 ffl.uT1 ,.,. f}~{1'-" Report of Underage Persons ---0..- Full Inspection ~ Assist Other Agency ~ Other (explain in narrative) i) License #: Issue Date: Expiration Date: Bartender: DOB: Address: Check Individual 123.46 5-7.2-a 5-7.2-a 123.47 123.49-3 723.4 Business 123.49-1 123.47-a 5-7.2-c 123.49-2-d 5-9 L1'-. I r:7 J c:;- FIRE CODE Exit Signs Visible? Obstructions in Exits? Within Occupancy Load? CHECK VIOLA T10NS THA T APPL Y Public Intoxication Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) Person Under Age 21 in Bar After 9 P.M. (under age 18) Underage Possession of Alcohol Misrepresent Age When Purchasing Alcohol Disorderly Conduct Individual Total: Serving Intoxicated Person Serving Persons Under Age 21 Allow Person Under Age 21 in Bar After 9 P.M. Liquor in Container Other Than Original Violation of Buffet Drinking Ordinance NO VIOLATIONS OBSERVED I Business Total: NARRATIVE: ( Explain reason(s) for inspection, Violations observed, List all expired permits) NO (' ALL <; . License Renewal Recommendation: ( If NO, explain) ~ES 0 NO Officer: Chief of Police: Date: Supervisor: Date: Referral Filed Y N Y N Y N # OF VIOLA TIONS ([) (") () ~ C> I/') .0 () {j (') o D D~BUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION DPD#- CASE #: TIME: DATE: EstablishmentC061 ~ Address: c9J7~-h'Vt ./ Licensee: :.Jif.fi'I1 i1~ .JJ~~~ IV Address: 22).'. ~ License #: / ~~ /&5 ?,o Issue Date: Expiration Date: Bartender: DOB: Address: Check Individual 123.46 5-7.2-a 5-7.2-a 123.47 123.49-3 723.4 Business 123.49-1 123.47-a 5-7.2-c 123.49-2-d 5-9 PURPOSE OF INSPECTION Routine / Yearly 6 Disturbance ~ Report of Underage Persons 6 Full Inspection ---0- Assist Other Agency 0 Other (explain in narrative) -0 FIRE CODE Exit Signs Visible? Obstructions in Exits? Within Occupancy Load? CHECK VIOLA T/ONS THA T APPL Y Public Intoxication Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) Person Under Age 21 in Bar After 9 P.M. (under age 18) Underage Possession of Alcohol Misrepresent Age When Purchasing Alcohol Disorderly Conduct Individual Total: Serving Intoxicated Person Serving Persons Under Age 21 Allow Person Under Age 21 in Bar After 9 P.M. Liquor in Container Other Than Original Violation of Buffet Drinking Ordinance NO VIOLATIONS OBSERVED I Business Total: NARRATIVE: ( Explain reason(s) for inspection, Violations observed, List all expired permits) tJc) ria iL 5 License Renewal Recommendation: ( If NO, explain) ~ES 0 NO Officer: Chief of Police: Date: Supervisor: / I /"</~?/oY ( , Date: I ~ Referral Filed Y N Y N Y N # OF VIOLA TIONS eJ C> o o o o D o o o ~ {'J DUBUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION DPD # - ,.7 te L;.-1/0/l. L&'L;.;~E. #<1TE.L if- I3R.IJ S5 !<:INS. Establishment: ~/J!i L Aft ~A < ) Address: '5i~~.Jr Licensee:8(l~ I, l?~jJ^lI+' L/VI/ Address: ~3~ jf;'7~-z:;2 /6 /? 76 License #: Issue Date: Expiration Date: Bartender: DOB: Address: ChecK Individual 123.46 5-7.2-a 5-7.2-a 123.47 123.49-3 723.4 Business 123.49-1 123.47-a 5-7.2-c 123.49-2-d 5-9 C OdEll ~ CASE #: TIME: DATE: PURPOSE OF INSPECTION Routine / Yearly Disturbance i- Report of Underage Persons _ Fulllnspeclion Assist Other Agency Other (explain in narrative) FIRE CODE Exit Signs Visible? Obstructions in Exits? Within Occupancy Load? CHECK VIOLA TIONS THAT APPL Y Public Intoxication Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) Person Under Age 21 in Bar After 9 P.M. (under age 18) Underage Possession of Alcohol Misrepresent Age When Purchasing Alcohol Disorderly Conduct Individual Total: Serving Intoxicated Person Serving Persons Under Age 21 Allow Person Under Age 21 in Bar After 9 P.M. liquor in Container Other Than Original Violation of Buffet Drinking Ordinance NO VIOLATIONS OBSERVED I Business Total: NARRATIVE: ( Explain reason(s) for inspection, Violations observed, list all expired permits) p.....Ai:?C~ .r ..rrtli<Li:/I' r.n:..rJ A t7.Q C<:;j 8' / IS I tJq f.J0L1JI ;r.NTC~ "U.r,;( f!le"''! 05:>7 ~ "J!," <F: 7"0' . ,,"r J lo71o " u Ik~ 5SfNt., I( td<'~ :l.o&<> tf"a-s P.J8i&: 3:,./'lOY ~~ /,!?<../o'1 /(:1 'PI If,,=> '2 />aaz;;r..w/l-i OT"',.....;Zd/lML~ &rtl- t"'i~D License Renewal Recommendation: 0 YES 0 NO ( If NO, explain) Officer: Chief of Police: Bdg#: Date: Supervisor: Date: Referral Filed Y N Y N Y N # OF VIOLA TIONS if D .:) cJ 3 g- NfL:> tie <9 o (!) C, I'l if 0 e> (> {l . u DUBUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION DPD#- CASE #: TIME: DATE: Establishment: /1JJ. ~ 1kC-t1.w.r~ PURPOSE OF INSPECTION Address: .217<; ~ Licensee b~ ~~~~ Routine / Yearly 0 - Disturbance -2- Address: ,;:( 7 . _ Report of Underage Persons ....Q....... Full Inspection -L2- License #: Assist Other Agency C' Issue Date: Other (explain in narrative) ~ Expiration Date: FIRE CODE Referral Filed Bartender: Exit Signs Visible? Y N DOB: Obstructions in Exits? Y N Address: Within Occupancy Load? Y N Check Individual CHECK VIOLA T10NS THA T APPL Y # OF VIOLA T10NS - 123.46 Public Intoxication c;l 5-7.2-a Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) ! - ; - 5-7.2-a Person Under Age 21 in Bar After 9 P.M. (under age 18) r - 123.47 Underage Possession of Alcohol - 123.49-3 Misrepresent Age When Purchasing Alcohol +- - 723.4 Disorderly Conduct Business Individual Total: 123.49-1 Serving Intoxicated Person cj - i - 123.47-a Serving Persons Under Age 21 , - 5-7.2-c Ailow Person Under Age 21 in Bar After 9 P.M. 123.49-2-d Liquor in Container Other Than Original , - - 5-9 Violation of Buffet Drinking Ordinance - NO VIOLATIONS OBSERVED NARRATIVE: I Business Total: 0 ( Explain reason(s) for inspection, Violations observed, List ail expired permits) J f2€A.'f2.7C'O rttE.P15 - _-:.7' . , . --"-- - - - License Renewal Recommendation: DYES 0 NO ( If NO, explain) Officer: Bdg#: Date: Supervisor: / ! M 7 ') c""'- Date: I pJ~9/o1 I Chief of Police 1" -/ ~i'---. I ./ (~<::s DPD#- DUBUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION CASE #: TIME: DATE: E"'bl;'hmem/fa.;~!/t,f:; .. fi~RPOSE OF INSPECTION Address. ..20 C S- ....e ,f:) v 't:i1:. I A' JJ.. l Routine I Yearly .d.. Licensee: 1(I(/J1(LJ..LI4VY /.){;i/ Disturbance Address: Report of Underage Persons _ Full Inspection Assist Other Agency Other (explain in narrative) License #: Issue Date: Expiration Date: Check Bartender: DOB: Address: Individual 123.46 5-7.2-a 5-7.2-a 123.47 123.49-3 723.4 Business 123.49-1 123.47-a 5-7.2-c 123.49-2-d 5-9 U 2837/5 3J.--o::;' FIRE CODE Exit Signs Visible? Obstructions in Exits? Within Occupancy Load? CHECK VIOLA T10NS THA T APPL Y Public Intoxication Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) Person Under Age 21 in Bar After 9 P.M. (under age 18) Underage Possession of Alcohol Misrepresent Age When Purchasing Alcohol Disorderly Conduct Individual Total: Serving Intoxicated Person Serving Persons Under Age 21 Allow Person Under Age 21 in Bar After 9 P.M. Liquor in Container Other Than Original Violation of Buffet Drinking Ordinance NO VIOLATIONS OBSERVED I Business Total: Referral Filed Y N Y N Y N # OF VIOLA TIONS ,..;< / 3 D NARRATIVE: ( Explain reason(s) for inspection, Violations observed, List all expired permits) lc]/nC;/64 - L P,)b\\( :r:",.t~)^\t'~.m()...\ A[{e~'h., \ \:)\c...{)'~..-\,~\" (Dn,\llr+ J \ PC)".$.t->"ic,'\ , I T r,(" r(.>,.'\-n--.",~\~~ ~0,")",:t-L1V1(P r),~~_nl"'C ty..,...n:S,A wi-\V\ ~\\C \1\+0)( ^~Tf::*{~ c)';~'ll"'(I."\t.) I"'l(!(it,..;",-\-r- \f:l'C:::~\I~ ~....-bi\nli5\..-aW1t:"'~-rt- License Renewal Recommendation: ( If NO, explain) ~ES D NO Officer: Bdg#: 70 d Date: OJ It 0 /~,-; Supervisor: Chief of Police: I 1 /),/~ , Date: I DUBUQUE POLICE DEPARTMENT LIQUOR ESTABLISHMENT INSPECTION DPD#- CASE #: TIME: DATE: Establishment: ~.0;; /J!-f)!:~ ~ v PURPOSE OF INSPECTION Address: . F - IAtftlJ fi'W ~ Routine / Yearly ---0- Licensee: --rfv ~!Iul Disturbance Address: Report of Underage Persons J..e Full Inspection License #: 2071 Assist Other Agency Issue Date: , Other (explain in narrative) \ 1/ Expiration Date: .rJ-7-o~ FIRE CODE Referral Filed Bartender: Exit Signs Visible? Y N DOB: Obstructions in Exits? y N Address: Within Occupancy Load? Y N Check Individual CHECK VIOLA TIONS THA T APPL Y # OF VIOLA TlONS - 123.46 Public Intoxication D - 5-7.2-a Person Under Age 21 in Bar After 9 P.M. (18-20 yrs old) :l - 5-7.2-a Person Under Age 21 in Bar After 9 P.M. (under age 18) - 123.47 Underage Possession of Alcohol - 123.49-3 Misrepresent Age When Purchasing Alcohol - 723.4 Disorderly Conduct Business Individual Total: - 123.49-1 Serving Intoxicated Person - 123.47-a Serving Persons Under Age 21 - 5-7.2-c Allow Person Under Age 21 in Bar After 9 P.M. - 123.49-2-d Liquor in Container Other Than Original - 5-9 Violation of Buffet Drinking Ordinance \T7 - NO VIOLATIONS OBSERVED NARRATIVE: I Business Total: D ( Explain reason(s) for inspection, Violations observed, List all expired permits) AJ:0 i./iOLiCl71D"J< " ~ a TEA License Renewal Recommendation: [B--fES D NO ( If NO, explain) Officer: c.)'''(>~' , Bdg#: (oiS Date: eJi J,{) /nr;' Supervisor: / I , ./ " l:') I AJJA.. Date: I I II~/o~ I Chief of Police :" ~