Liquor License Refund_Rick Worcester, The Lift BarDate:
To The Honorable Mayor
and City Council
Dubuque, IA. 52001
Dear Council Members:
S-1,3 ---((
I am hereby requesting jefund on BEER & LIQUOR COMBINATION LICENSE,
License No. /-(: QJ375/ d , issued on and
expiring JL7UJ f/ . I discontinued business on
7-3)-1 / and respectfully request your Honorable
Body to grant me a refund of A t'33.7.5 .
Respectfully Submitted,
iC,e GOo k Crsrl8'1Q --
Name
D /B /A
/ 3° nitht)
Address of Business
MAIL CHECK TO:
6-ck Ctl okr. f s —
ALCOHOLIC
BEVERAGES
DIVISION
State of Iowa
August 26, 2011
rick worcester
180 main St.
Dubuque, IA 52001
RECEIVED
11SEP -2 9:07
City Clerk's
OubuLle, IA
office
RE: LICENSE / PERMIT No. LC0037590
Dear Licensee / Permittee:
Terry E. Branstad Governor of Iowa
Kim Reynolds Lieutenant Governor
Stephen Larson Administrator
Enclosed is a state warrant in the amount of $887.25 which was issued in payment of a
refund on your Class C Liquor License (LC) (Commercial).
Please apply to the CITY / COUNTY for their portion of the refund in the amount of $633.75
Licensing Section
Iowa Alcoholic Beverages Division
1918 SE Hulsizer
Ankeny, Iowa 50021
515.281.7400 (option 1)
Toll Free 866.469.2223 (option 1)
Enc.
cc: CITY CLERK / COUNTY AUDITOR
A Division of the Department of Commerce 1918 SE Hulsizer Road Ankeny, Iowa 50021 -3941
PH 515.281.7400 FAX 515,281.7385 TOLL FREE 866.IowaABD WWW.IowaABD.com