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BEER 1 WINE AUTHORITY I TYPE 119 <br />Sia;e! i'aW � a!LIiW jl<e l l b l!i) <br />'.. Apprmtlxl UV S!ele l3oanl ulAttouN :, 2015 <br />IB7.5'TRU(MONS: 1. Appliclminim-li...... -lw al/requneUm'1 inlnrmelion <br />2. Plesan type rr;u'%nl cL)vty % <br />r \\�(\1IHJJRI <br />3. Sb(In]ll onpficatkm riNi pnymonl l07kMD17ax'ngH <br />�/ /�J <br />dislrid otlira. D 1p_ `�./ v <br />SUN 2 5 1Ui� <br />nl appliranl ap19pnU W'pcnml ja <br />a tl .. LitU;E <br />:: ]f pV atd (unnbn! and Ver§1. <br />III person/nuINill) a1011.ation 1 <br />111,11. it conte I parsim"ll 'milt <br />Time o(ovent <br />start tinn_l/ '30 <br />Tyne ur devc+fplien of even <br />U1 <br />�3 <br />Send, deliver, or mail to <br />DIs'rRIcT i <br />DISTRICT4 <br />52422 G.nly Road 17 <br />651 S. C raimmco Or. <br />Distill, IN. Wll <br />Suymunr. IN 47214 <br />14,1>1,nnn(5141264-9480 <br />Tnlepilm a (612) 523.8314 <br />DISTRICT 2 <br />DISTRICT 5 <br />135:1 South Giwomor5 Iklve <br />3551):;rndh US Nvy At <br />Dojumhi:++City. IM 46125 <br />Vincennes. IN 47691 <br />T0.1illonn ('2Ct24'r42Rf <br />Teleptmna:(812) 882-129.2 <br />DISTRICT 3 <br />DISTRICT 6 <br />279 I'MA 300 Willi <br />MOO Elsl 3011, Stem <br />CravAordsv6W. IN 47983 <br />Indlanepolis. IN 45219 <br />Tr:N:nhone (765)362-8815 <br />Te1¢phone:(MI) S 1-4100 <br />L_GENERAI INFORMATION <br />rc3nruznlim clues. n�rpur ani irlwhlur:I)-----_-_-� �_ <br />J�20M0t)Cfv j <br />Y. h7fe, an421Fcr]tfa) <br />—y F,x m.ndrtr <br />STEP 2. <br />R Onlc (month, daY, yang <br />X1,202 �_ <br />CRAM [J PCA__ <br />3drlr <br />ll !+� <br />En�er4inry mnincl lNeplmn. nwnber <br />date (mmah, day. yang <br />v -1G2,) <br />Emillima ' AM PM__ <br />'._3._. ��_- <br />5A fx1 PI C ii t <br />Bet -u <br />w� Fewct-o1 t� <br />The&-�'2 G�acVr�� ISiznKc;v r" y <br />�el2rrn��E2 1`5 �enC,ec� � �" <br />'x'1A-1 a'Ny5 <br />1,10 13ARAQEA <br />ALL �3 C6� �C32V%Q Q% LiLr-r._a<k:A SC�;?UC'125 <br />flu. ACIP Iff"" i <br />gega 4�epvc0 FRcm KEGS to �tASTIc c res <br />K<Z? Arte SLI"ZG0 1'-' BEER.- GA2AEnN <br />11%ge 1 of <br />Gam; TK <br />