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Liquor License Refund_Cafe Mana Java WestDate: % —1 (i c=20 /( • To The Honorable Mayor and City Council Dubuque, Ia. 52001 Dear Council Members: I am hereby requesting a refund on my SPECIAL CLASS "C" LIQUOR LICENSE, License No. _BW00093112 , issued on 02-02-2011 expiring 02 -01 -2012 . I discontinued business on _04 -04 -2011 and respectfully request your Honorable and Body to grant me a refund of 3 ) 3 Respectfully Submitted, 0 (1ft %ze h- 7..k-u 6.1.;:x LL,C Name D/B/A • /So ,mod Address of Business City `SState Sa.ao� Zip m 0 MAIL CHECK TO: ` C • O 0X 2-)(7 5a o041 ®33? ALCOHOLIC BEVERAGES DIVISION State of Iowa October 12, 2011 Cafe Manna Java West LLC 150 J.F.K. Rd Dubuque, IA 52002 Terry E. Branstad Governor o owa Kim Reynols E . VE vernor Stephen Larson Administrator 11 OCT 17 Phi 12: 04 RE: LICENSE / PERMIT No. BW0Q93112 Dear Licensee / Permittee: City Clerk's Office Dubusiue, IA Enclosed is a state warrant in the amount of $273.38 which was issued in payment of a refund on your Special Class C Liquor License (BW) (Beer /Wine). Please apply to the CITY / COUNTY for their portion of the refund in the amount of $253.13 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