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Bus. Lic. Cigarette Ref Asbury Amoco . Date 3 - 30 -C)D~ To The Honorable Mayor and City Council Dubuque, Ia 52001 Dear Mayor and Council Members: I am attachi ng hereto Ci garette Li cense No. f){3@ - 017 expi ri ng on June 30, ~OtJ"'. I discontinued business on "3 -/c../ -()Co and respectfully request your Honorable Body to grant me a refund of $ ~5CD 4.L__y ~UJ h:M/, Name ~7~ &/ ~. JJCJU -4cS~~ Address of Business 1-(('- 0'10. }'i30 Federal Tax # or Social Security # Mail Check To: ~~qMu/ &/ Pc ~ J'9~ ~;)du"'jcU ~/ ?J Sc:#OJP . . STATE OF IOWA RETAIL Clq)l~PPE (]XE~Irr City Number DBQ-077 In accordance with laws of the state of Iowa, an'd the action of the City Council of DUBUQUE Iowa (City) Business Location Name: ASBURY BP FOODS HOP . Business Location Address: < 3300 ASBURY RD DUBUQUE IA 52001 Type of Sales: OVER THE COUNTER Ownership Type: CORPORATION Legal Owner Name: MULGREW Oil COMPANY Legal Owner Mailing Address: 85 TERMINAL ST P,O, BOX 894 DUBUQUE IA 52004 Is hereby authorized to sell cigarettes at the business location address above in the City of DUBUQUE County of DUBUQUE , Iowa, This permit is nontransferable, is effective from JULY 1, ,20 05 and automatically expires on JtJne 30, 2006 , unless suspended or revoked. In Testimony Whereof, I have caused the seal of the said City to be hereunto affixed. Done at DUBUQUE in the State of Iowa, this 1 ST day of JULY ,2005 Issued By: " /.' '/ // /' .->J>/:</./// .r ,~../,-/</-__/. _ , , C / City Mayor or Clerk This copy to be posted by the retailer where the sale is to be made in plain view of the public.