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1972-01-05 Council Packet
Kenai City Council Meeting Packet January 5, 1972 AGENDA REGb£AR MEETING, KENAI CITY COUNCIL JANUARY 5, .!972~ 8'00 P.M. A, B, D. E· Fo Go H, PLEDGE OF ALLEGIANCE ROLL CALL PERSONS PRESENT SCHEDULED TO BE HEARD' 1. 2. MINUTES 1. Regular M'eeting of December 15, 1971. CORRESPONDENCE 1. 2. 3. 4. REPORTS 1. City Manager's Report a. Things to do list - 12/15/71 b. Meeting Local Boundary Commission c. Meeting with Kenaitze Indians d. Mommsen & Bush Lanes S/D's e. Wildwood Air Force Station f. Lobby Juneau 2. City Attorney's Report 3. Mayor's Report 4. City Clerk's Report ~ 5. Finance Director's Report 6. Planning & Zoning's Report 7. Bo.rough Assemblymen's Report OLD BUSINESS 1. 2. 3. 4. 5. 6. NEW 1. , . .5, 10, il, BUSINESS Liquor License Renewal Retail and Dispensary Liquor License Renewal Retail and Dispensary Liquor License Renewal Liquor License Renewal Oaken Keg #54 and #58 Permit for Games of Chance and Skill Kenai Elks No. 2425 Kenai Community Center Kenai Recreation Department Permit for Games of Chance and Skill Permit for Games of Chance and Skill Permanent position of Police Chief Kenai Community Water System - Eadies Frontier - Larry's Club - - Casino Bar - GFB Enterprises - Catholic Church - Beta Sigma Phi 12. Ordinance on meeting time for City Council PERSONS PRESENT NOT SCHEDULED TO BE HEARD' CITIZEN'S GRI. EVANCES AND REQUESTS' 1. Don Hines 2. 3. PAGE None 2 2 2 None None None None 3 .MINUTES, KENAI CITY COUNCIL REGULAR MEETING JANUARY S, 1972 8'0'0 P.M. - KENAI LIBRARY ROLL CALL' B· C· D· E· E - 1 Ca) The Council gave the Pledge of Allegiance to the flag. Members Present - James Hornaday, Hugh Malone, Tru McGrady~ Robert Norene and Mayor John Steinbeck. *In late. Members Absent Doyle. Robert Bielefeld (excused) and James With consent of Council, to the Agenda' the following items were added G - 10' G - 11' G - 12' Permanent position of Police Chief Kenai Community Water System Ordinance on meeting time for City Council PERSONS PRESENT SCHEDULED TO BE HEARD MINUTES The minutes of Regular meeting of December 15, approved as distributed. CORRESPONDENCE REPORTS 19 71 were City Manager's Report Things To Do List - 12/15/71 The City Manager reported all things accomplished except' Items E-1 and G-6, which are in progress. Me..e..ting with the Local Boundary COmmission Members of the Local Boundary Commission will be in tomorrow for a meeting with Council and representatives from the North Road area. MINUTES, KENAI CITY COUNCIL MEETING OF--JANUARY S, E-- 1, City' Manager's Report (continued) 1972 Page Two F, -. Cc) Cf) E. - 2 E -. 3 E -- 4 B - 5 E - 2 Meeting with the Kenaitze Indians The meeting with the Kenaitze Indians will be held at the earliest possible date. The Kenaitz.e Indians have been very busy but hope to meet soon. Mommsen and Bush Lane Subdivisions Will be heard under New Business. Wi'ldw'ood Air Force Station Captain Matza met with Mr. Glotfelty and Mr. Glotfelty briefed him on the City's proposal' for Wildwood Air Force Station. Captain Matza will meet with Colonel Cunningham the week of February 7, 1972. The week of February 7, 1972 Mr. Smalling and others from the Office of Economic Adjust- ment will be in Kenai meeting with City officials. L'o'bb y JUneau The City Manager would like to have an indication from Council as to how often the City should have a lobbyis't in Juneau. After some discussion, it was recommended the Administration come back wi th a positive approach. City Attorney's Report Came in late - will be heard after E-.7, report. MayOr's Report Bo rough Assemblyman's No report. Ci,ty,Clerk's Report No r'eport. Finance Director's Report No re po rt. City Attorney's Report . , , Fisher reported the rate increase hearing is scheduled for January 17, 1972. The City's request for dismissal was denied. Fisher spoke with Mr. Rhodes of H.£.A. and their Attorney is asking for dismissal. ~,MINUTES, KENAI CITY COUNCIL MEETING OF JANUARY 5, Reports (continued) 1972 Page ,.T. hre e E - 6 E - 7 G· G - 1 Planning & Zoning's Report No. report. Borough As'sembly. men's Report Hugh Malone reported on the Borough Assembly meeting of January 4, 1972. This was the first night for Assemblymen Steinbeck and Norene. The Ordinance pertaining to vote abstention by Assemblymen failed. A supplemental appropriation of 63,455 - Emergency Employment passed. A supplemental appr~.riation for Local Service Roads and Trails Program p_ass, The Assembly will m~et with the Local Affairs Agency at 8'00 p.m., .January ¢~'~, 1972. · ^ change order was approved for the Kena-i Junior High School. The Assembly tabled :'.'~ request to move portables to Port Graham. · · There will be a hear i. ng in Soldotna tonight on State Burn-i ng Permits. .. No.rene reported 89 tracts across the Inlet, at 3 Mile Creek, were auctioned, 35 were sold, 40+ were sold over the counter and 10 tracts are left to sell. NEW BUSINESS Liquor License Renewal - Eadies Frontier - Retail and Dispensary. The Administration recommends approval of these licenses. Malone moved and McGrady seconded to accept the recommenda- tion and approve the renewal of liquor license - Eadies Frontier - Retail and Dispensary. The motion carried with Hornaday dissenting., .~IlNUT~ES, KENAI CITY COUNCIL MEETING OF JANUARY Ne~ Business (continued) 5, 1972 Page Four G- 2 Liquor License Renewal - Lar.ry's Club - Retail and G - 3 G - 4 G - 5 G - 7 C - '8 Dispensary. The Administration recommends approval of these licenses. Norene moved and Mal'one seconded to accept the Administrations recommendations and approve the renewal of liquor license - Larry's Club - Retail and Dispensary. The..motion carried with Hornaday dissenting. ~ Liquor_. License Renewal - Casino Bar The Administration recommends approval of this license. Norene moved and McGrady seconded to accept the Administrations recommendation and approve the renewal of liquor license for the Casino Bar. The motion carried with Hornaday dissenting. · Liquor License Renewal - GFB Enterprise -Oaken Keg , #'54 an'd #58. The Administrati°n recommends approval of these licenses. McGrady moved and Norene seconded to accept the Administrations recommendations and approve the renewal of the liquor license for GFB Enterprises - Oaken Keg #54 and #58. The motion carried with Hornaday dissenting. Permit for Games of Chance and Skill - Kenai Elks No. 2425 The Administration recommends approval of this permit. · McGrady moved and Malone seconded to accept the Administrations recommendations and approve the permit for Games of Chance and Skill for Kenai Elks No. 2425. The motion 'carried unanimously. Kenai Recreation Department Heard in executive session immediately following the meeting. Permit for Games of Chance and Skill, Catholic Church The Administration recommends approval of this Permit. MINUTES', KENAI CITY~ COUNCIL MEETING OF"JANUARY G - New Business (continued) 5, 19 72 Page Five G - 8 G - 9 G - 6 G - 11 Permit for' Games of. Chance and Skill, Catholic Church continued. Norene moved and Malone seconded to accept the Administrations recommendations and approve the permit for Games of chance and Skill for Catholic 'Church. The · motion carried unanimously. Permit for Games of Chance and.Skill - Beta Sigma Phi The. Administration recommends approval of this permit. Hornaday moved and Norene seconded to accept, the Administrations recommendations and approve the permit for Games of Chance and Skill - Beta Sigma Phi. Kenai Community Center The Administration has had a request from Crossover to donate the Recreation Center for the Drug Abuse program to be manned seven days a week, twenty four hours a day. Betty Ames is moving out of Fort Kenay and the Committee on Aging is moving in and' the Recreation Center will be free. The Administration recommends approval of this request. This organization consists, of various churches and an adult will be the re full time. They will have the responsibility of care and maintenance of the facility. Norene moved and McGrady seconded to move 'ahead and accept the Administrations recommendation and donate the Recreation Center to this church group for drug abuse. The motion carried unanimously. Kenai Community Water System The Council discussed the acquisition of Mommsen Sub- division's water and sewer system. Mr. Massey and Mr. Norene spoke with Mr. Ashwill of S.B.A. on this. The CitY. can wait until after foreclosure or purchase it before from Mrs. Killen. The price she is asking is a high figure. Mrs. Killen's lawyer, Mr. Henderickson will meet with the City Manager Friday, January 7, 1972 and report back to Council on January 19, 1972. "MINUTES, KENAI CITY COUNCIL MEETING OF JANUARY 5, G - New Business (continued) 1972 Page 'Six G - 12 G - 10 H~ H - 1 Ordinance on Meeting Time for City' Council Mr. Norene spoke of changing the code to standardize the time of me'etings. Others spoke in' favor of 8'00. He may bring this up when there, is a full Council. Permanent Position of Police Chief Mr. Glotfelty .related Cecil Johnson's 90 day probation period is up January 15, 1972 and recommends he be appointed permanent Police Chief. Malone moved and McGrady seconded to accept the recommendation of the .Administration and appoint Cecil Johnson permanent Police Chief. The motion carried unanimous ly. PERSONS PRESENT NOT ~CHEDULED TO BE HEARD' Citizen's Grievances and Requests Don Hines Mr. Hines and Mr. Bo~g. en discussed with Council and members of the Polic-- Department some neighborhood problems concerning ?olicing. Meeting .Adjourned 10'-10 P.M. Respectfully .Submitted, Sharon Sterling City C1 erk E THINGS TO DO LIST 1/5/72 Positive approach to Lobbying G~ 11 Report back to Council on progress of acquisition of Mommsen S/D Water and Sewer System. THINGS TO DO LIST 12/15/71 (c) E - 1 F - 1 G - 1 G ~ 6 G - 9 G ': 10' Distribute the budget Preliminary time schedule Done Gather data on por~ authority In Progress Take Resolution 71-46 & .71-47 into consid- erati'on at meeting with Kenaitze Indians. Amend Resolution 71-48 "an officer of tile City is to be one of' the signatures." Urban Renewal - Old Kenai to Planning and Zoning.. Done P & Z Commission Pay Preston, Thorgrimson, Starin, Ellis & Hollman - $10,100.31 and back bill H.E.A. · . · $7,548.84. Done Letter to Grahd Jury regardin~ communication system in new Public Safety Building. Do~e Letter to Borough Assembly regarding appoint-Done ment of Robert Norene as .Borough Assemblyman. APPLICATION FOR LIQUOR LICENSE IN THE STATE OF ALASKA ,~,~,~L,C^,O~ ~o ........... ALASKA STATE ALCOPIOLIC BEVERAGE CONTROL BOARD i. FOR"~EW LICENSES AND RENEWALS: .... THE"'U"~DERSIGNE',)~*HEREB~ APPLIES FOR A DISPENSARY TYPE LICENSE FOR THE PERIOD ]]]/72" TO 1__2._/_3_1_/~,.2jD TENDERS HEREWITH THE SUM OF $ 1000, O0 PLUS A FILING FEE OF $25.00. APPLICANT'S NAME AND MAILING ADDRESS E. D. K~~ Henderson . . · Box 85 KENAI , ALASKA 99611 3. CITY ....... ~KENAI BOROUGH .. (NAME) · 4. IF RENEWAL, GIVE PRESENI' LICENSE NUMBER 71-0992 _ ,, BUSINESS NAME AND LOCATION Eadies Frontier Club }~LE 3 __~,]AI, ALASKA 99611 KENAI PENINSLTLA ..... OTHER ........................................ (COMPLETE ONLY ONE) (NAME) .5. THE LOCATION OF THE PREMISES 6. FOR TRANSFERS ONLY: (~JcSHECK ONE O IS NOTWITHIN 50MILES OF AN INCORPORATED CITY, BOROUGH, OR . . · k:.Zw 27 THE UNDERSIGNED HEREBY APPLIES FOR TRANSFER OF · ...................................... T';~'P"t~"C~F' [i~'i~[ LICENSE NUMBER ' FROM .......................................................................................................................................................................................................................... DOING BUSINESS AS .......... AT THE FOLLOWING LOCATION: STREET ADDRESS... · 7. CITY ............................................. iN.~.,V,.E.) ............................................................. BOROUGH .................................................................................. OTHER.. (COMPLETE oNLy ONE) (lq AYE ) ........................................... A..Pp. LICANT'S .NA_M..E A.N. D MAi LING ADDRESS: ' ": 'BUSINESs NAME AND LOCATIO-I:xl ' ' -HDWLO.,':-~G- ............. ' ............................... :':' ~ STATE R E SIO~Z h..~T .... ,. ..... -.9. I/WE HEREBY CONSENT TO THE ABOVE TRANSFER SIGNATUJ~ :: i ' - ~ ' SIGNATURE 2 · J0. DISTANCE BY SHORTEST DIRECT LINE FROM ANY SCHOOL GROUNDS, CHUR: H, COLLEGE OR UNIVERSITY ............... 3...Jl~e,S .................................................................................................................... il. HAVE YOU ANY OTHER KIND OF LIQUOR LICENSE? ~) YES O NO IF YES, GIVE TYPE AND LICENSE NO..71-06010 .............. CD © 12. HAVE YOU EVER BEEN CONVICTED OF A FELONY? ¥..[.:_S NO IF YES, COMPLEIE IHE FOLLOWING: '"i::"'--" .... :'"' " PLACE OF CONVICTION (CITY OR TOWN AND STATE) : DAlE OF CONVICTION · ,3.-IF CORPORATION, ARE YOU QUALIFIED TO DO BUSINESS WITHIN THE:_ STATE? O YES C) NO 14. APPLICANT HEREBY DECLARES. IF APPLICATION IS FOR RETAIL OR DISPENSARY LICENSE, IF AN INDIVIDUAL OR ASSOCIATION, THAT HE HAS RESIDED IN ALASKA FOR AT LEAST ONE YEAR PRIOR TO THE DATE OF THIS APPLICATION; IF CORPORATION, THAT IT IS QUALIFIED TO DO BUSINESS IN ALASKA. 15. NON-INFRACTION OF LAWS OR REGULATIONS PERTAINING TO THE SALE OF INTOXICATING LIQUORS: _~ I WAS WAS NOT CONVICTED OF AN INFRACTION OF ANY FEDERAL, STATE LAW OR REGULATION OR CITY ORDINANCE COVERING THE SALE OF INTOXICATING LIQUORS DURING THE TERM OF THE LICENSE. IF CONVICTED, GIVE DETAILS: 16. I ~"~E)FURTHER STATE THAT THE ABOVE LICENSE (~ HAS O HAS NOT BEEN EXERCISED OR ACTIVE AT LEAST THIRTY (30) DAYS DURING THE PAST YEAR. IF LICENSE HAS NOT BEEN ACTIVE AT LEAST THIRTY (30) DAYS,EXPLAIN: ~' APPROVED THIS ...... :'~'~"' UNFOLD FORM TO COMPLETE."IF · DAY OF / · i 19 .,~~ ,~....~~' TYPED, TEAR ALONG PERFORATION AND! f . - , ------ INSERT EACH SECTION SEPARATELY. I._ ,. />,/,~¢,~,¢~~ ~~ COMPLETE PAGE 2 ALSO-- ' ........ DIRECTOR j~_ ,//.~.,~--/ ~ I LICENSE NO. j~ /~' ,,/5"' ? / BUROUOH OR CITY-COUNCIL .i' PAGE I · o j- THE FOLLOWING INFORMATION IS NEEDED TO PROCESS YOUR APPLICATION. PLEASE ANSWER ALL QUESTIONS SO YOUR LICENSE RENEWAL OR TRANSFER CAN BE COMPLETED V~ITHOUT FURTHER CORRESPONDENCE. CHECK ONE 17. TYP.E O?LICENSE Be~rage Dispensary O NEW O TRANSFER Q RENEWAL 18: Jif: APPLICANT 15 AN INDIVIE~UAL OR INDIVIDUALS: NAME ADDRESS ................. I'--BIRTHD~,T~ ...... PHONE' J~O.-- J SOCIAL SECURIIY E D H~~ HendersOn J Box 85 · · . , K~ai, Alaska 4/18/27 283 9834 280 20 2818 19. IF APPLICANT IS A CORPORATION: 20. FEDERAL EMPLOYER IDENTIFICATION NUMBER 92-0022372 CORPORATE NAME OFFICE PHONE DOING BUSINESS AS LOCATION ............................................................................................ MAILING ADDRESS ............................................................................................................................................................................................................. CITY CORPORATE OFFICERS: TITLE NAME HOME ADDRESS BtRTHDATE PHONE NO. SOCIAL SECURITY NO. PREStDENI vICE PRES. SECRETARY TRE'ASURER 21. DIRECTORS AND/OR- STOCKHOLDERS: . .i '.-..'/'-" HOME ADDRESS " ~ HOME PHONE SHARES OR % J NAME 22. UNDER WHAT NAME WAS YOUR PAST YEAR'S ALASKA STATE INCOME TAX FILED? '' NAME .' .': . J 'YEAR i.' J .. - . .:.~.'iii:' ;~'.i i;:~iii"~. :~ .': .'~...i.~ S po US E,S NAME . . I 23. WHAT NAME WILL BE USED ON YOUR PUBLIC SIGN OR IN YOUR ADVERTISING PROGRAM TO IDENTIFY YOUR LICENSED PREMISES? i. '1 .............................................................................................. EAD~ES FRONTIER CL~ .............................................................................................................................................................................................................................................................................................................................................................................................. I 24. Section 04.10.180, regulations 4110 and 4111, and interpretations of Section 04.10.190, require a full disclosure of any financial inter.est in a liquor J~' license. The Board requests that you list all purchase agreements, loans from banks or individuals, silent partners, or anyothe~ cOntracts, including I lessee agreements, lhal affect the financial interest of this license. Failure 1o make a complete disclosure of all financial inlerest is a false statement ~' and the penalty warrants revocation of the license. Please study the above sections in your rules and regulation booklet. Declare all other finan- I- cial interests below. (2) (4) oFSUBSCRIBETNDD~.~n~r~SWORN TO ME THIS 14th _~ I i I I t I ! I ! I ! t 'DAY -, DI~-ASC-! ®,, PAGE 2 MY COMMISSION EXPIRES . 6/3/72 ....... :;.~ I. FOR NEW LICENSES AND RENEWALS: · ,," THE UNDERSIGh~E.D HEREBY APPLIES FOR A ~/1/72 :~iTO k.2~_~/, ~D TENDERS HEREWITH THE SUM OF $ ? -----'----'i~"~l~['i~~;'~' NAME AND MAILING ADDRESS E. D. ~H~~ Henderson Box 85 LIQUOR LICENSE IN THE STATE OF ALASKA APPLICATION NO. ALASKA STATE ALCOHOLIC BEVERAGE CONTROL BOARD RETAIL TYPE LICENSE FOR THE PERIOD ~Q_O,_O_C , PLUS A FILING FEE OF ~25.00. BUSINESS NAME AND LOCATION EADIES FRONTIER LIQUOR STORE - · HOW tON© r-'ES:Z. E NT Mile 3 ~3~N~, ~S~A 99611 IC~AI, ~~d~ 99611 Ke~ai · ~ 3. CITY .......................... BOROUGHKe~ai Pe~insula ............. OTHER (NAME) ............................................ " (COMPLETE ONLY ONE) (NAME) ............................................. · 4. IF RENEWAL, GIVE PRESENT LICENSE NUMBER... 7].-06010 ® C) 5. THE LOCATION OF THE PREMISES IS ~s NO1 WITHIN 50 MILES OF AN INCORPORATED CITY, BOROUGH, OR 6. FOR TRANSFERS ONLY: CHECK ONE THE-UNDERSIGNED HEREBY APPLIES FOR TRANSFER OF FROM .................................. f,,;i~"E~"E)'iE ~i'C~'i~'~SE .................................................................................................. LICENSE NUMBER ................... DOING BUSINESS AS ......................................................................................................... AT THE FOLLOWING LOCATION: STREET ADDRESS ........................................................ : .............................. 7. CITY ........................................................................................................................................................................................................................ , - ....................................... (N~TE.~ ............................................................. BOROUGH ............................... iiq'~M'Ei ................................................... OTHER ............................................... (COMPLETE ONLY ONE) J 8. J APPLICANT'S NAME AND MAILING ADDRESS ' BUSINESS NAMEAND LOCATION ~.~. " ' ' . ...... 9. I/WE HEREBY CONSENT TO THE ABOVE TRANSFER SIGNAT. RE ! · SIGNATURE 2 _ JO'. DISTANCE BY SHORTEST DIRECT LINE FROM ANY SCHOOL GROUNDS, CHUiiCH, COLLEGE OR UNIVERSITY ........ ~..I['l,i.l,e~. ............................................................... ~! .......................................................... I1. HAVE YOU ANY OTHER KIND OF LIQUOR LICENSE? (~ YES O NO IF YES, GIVE TYPE AND LICENSE NO. 71-0992 .......................................... 12. HAVE YOU EVER BEEN CONVICTED OFAFELONY? O /ES t~NO IF YES, COMPLETE THE FOLLOWING:_ L.i.i._....,. . PLACE OF CONVICTION (CITY OR TOWN ~D STATE) - DATE OF CONVIC?ION ;, ' ........................................................................................................................................................................................................................................ ................................. . .................................................................. . 13. IF CORPORATION, ARE YOU QUALIFIED TO DO BUSINESs WITHIN THE STATE? YES NO ;.,' · J 4. APPLICANT HEREBY DECLARES. IF APPLICATION IS FOR RETAIL OR DISPENSARY LICENSE, IF AN INDIVIDUAL OR ASSOCIATION, THAT HE HAS RESIDED IN ALASKA FOR AT LEAST ONE YEAR PRIOR TO THE DATE OF THIS APPLICATION; IF CORPORATION, THAT IT IS QUALIFIED TO DO BUSINESS IN ALAS~. 15: NON-INFRACTION OF LAWS OR REGULATIONS PERTAINING TO THE SALE OF INTOXICATING LIQUORS: I OWAS O WAS NOT CONVICTED OF AN INFRACTION OF ANY FEDERAL, STATE LAW OR REGULATION OR CITY ORDINANCE COVERING THE SALE OF INTOXICATING LIQUORS DURING THE TERM OF THE LICENSE. IF CONVICTED, GIVE DETAILS: ............................................................................................................................................................................................................. .................................................................................................................................................................................... .......................................................................................................................................................................................................................... ~ ,6. i ~) FURTHER STATE THAT THE ABOVE LiCENSE ~ HAS O HAS NOT BEEN EXERCISED OR ACTIVE AT LEAST THIR~ ~ DURING THE PAST YEAR. IF LICENSE HAS NOT BEEN ACTIVE AT LEAST THIRTY (30) DAYS,EXPLAIN: ...................................... APPROVED TH'IS DAY OF ,19~. DIRECTOR UNFOLD FORM TO COMPLETE. IF TYPED, TEAR ALONG PERFORATION AND INSERT EACH SECTION SEPARATELY. COMPLETE PAGE 2 ALSO , .. LICENSE NO. PAGE I BUROUGH OR CITY COUNCIL · .~ THE FOLLOWING INFORMATION IS NEEDED TO PROCESS YOUR APPLICATION. PLEASE ANSWER ALL QUESTIONS SO YOUR LICENSE RENEWA OR TRANSFER CAN BE COMPLETED WITHOUT FURTHER CORRESPONDENCE. CHECK ONE 17. TYPE OF LICENSE Retail ..... . O NEW O TRANSFER 18 IF APPLICANT IS ~N INDI~/IDUAL OR INDIVIDUALS: " NA/~ A .c, ......................... "~ . 'E ] DDRE. S ' IBIRTHDATE L PHONE NO. SOC,^LSECURi,¥NO. -~. D. H-e-n-d~-~son 'PX)x'"~5-, Ken~-~~ ~laska '" ~i8/27 "-283~S~4 ' 2~0..20..2'81 ,. 19. IF APPLICANT IS A CORPORATION: FEDERAL EMPLOYER IDENTIFICATION NUMBER ..... 9270.022372 t CORPORATE NAME ....................... ~ ........................................................................................................................................................................... OFFICE PHONE ............ DOING BUSINESS AS ................................................................... .......................................................................................................................................................................................... LOCATION .................................................................................................. MAI'LING ADDRESS CORPORATE OFFICERS: ....................................................................................................................... CITY 20 [ TITLE L TREASURER 21 DIRECTORS AND/OR STOCKHOLDERS: NAME .- : 'i ..:" :'.::"..'-' ,: HOME ADDRE. s~'- -' .... ' : i'. HOME PHONE SHARES OR % I22. UNDER WHAT NAME WAS YOUR PAST YEAR'S ALASKA STATE L._~. NAME . ~'__;.' .' ".-'.- ~-'- INCOME TAX FILED? ..... ..... J' YEAR ' J :':':'" : "' - SPOUSE'S NAME :.'~i:':.-..'-:~ 'J............-...-....~.° .D., .H.....en..d~s 23. WHAT NAME WILL BE USED ON YOUR PUBLIC SIGN OR IN YOUR ADVERTISING PROGRAM TO IDENTIFY YOUR LICENSED PREMISES') EADI~S PRONTIER_..LIQUOR STORE ' · 24. Section 04.]0. J80, regulations 4J JO and 4J J J, and interpretations of Section 04.J0. J90, require a fuJJ disclosure of any financial interest in a liquor license. The Board requests lhaf you list all purchase agreements, loans from banks or individuals, silent partners, or'any other contracts, including lessee agreements that affect the financial interest of this license. Failure lo make a complete disclosure of all financial interest is a false statement and the penalty warrants revocation of the license. Please study the above sections in your rules and regulation booklet. Declare all other finan- cial interests below. ' ' · " None i25. SIGNATUR E(~ O.F~AP~PLICANT($) ! (~)--~'::", , ~'~"e'-~'~'~' '"~~'''t---~ _(3) i I (2) ..... ' i . , DR-ABC. I ®,, (4) PAGE 2 SUBSCRIBED AND SWoRN To ME THiS !4th _DAY OF= .~.~m~ . li~?! , _ MY COMMISSION EXPIRES__ 6/3/72 APPLICATION FOR LIQUOR LICENSE IN THE STATE OF ALASKA ~p~,c^~o~ ~o. ALASKA STATE ALCOHOLIC BEVERAGE CONTROL BOARD -~ FOR NEW UeENSES AND RENEWAi-S: ' ~. ~ THE UNDERSIGNED HEREBY APPLIES FOR A ,~t. '~ ~ ~'~ ' f:? :;' . ~._.. ~ .~ ~j . ,~ TYPE LICENSE FOR THE PERIOD HEREWITF~ SUM ~' P~US ~ F~~ F~E OF ~.00.' /"i'7> ~[ ~I" ~ ~DE~S ~HE OF ~ 7/~'"z'~ 2. APPLICANT'S NAME AND MAILING ADDRESS BUSINESS NAME. AND LOCATION . - ~'ES~DENT .................... . . ......................................... .................................. ................... /Z ......................................... BOROUGH ............................. . ................................................................................ (COMPLETE ONLY ONE) . '~. (NAME) .,~Z__ (NAME) 5. THE LOCATION OF THE PREMISES ~ IS O IS NO~ WIIHIN 50 MILES OF AN INCORPORAIED CIIY, BOROUGH, OR ' ~. CHECK ONE 6. FOR TRANSFERS ONLY: IHE UNDERSIGNED HEREBY APPLIES FOR TRANSFER OF LICENSE NUMBER ................................................................................ TYPE OF LICENSE " FROM ................... DOING BUSINESS AS ..................................................................................................................................................................................................... AT THE FOLLOWING LOCATION: STREET. ADDRESS 7. CITY ................................................................................................................................................... BOROUGH O~HER ...................................................... (COMPLETE ONLY ONE) (NAME) (NAME) 8.[ .... -~ ~..-- A'P~-LiCANT'S NA'M~ AND MAILING ADDRESS BUSINESS NAMEAND LOCATION -~ i-HOWt. ONO' ......... ' ..................... i.'STATE -: 9. I/WE HEREBY CONSENT TO THE ABOVE TRANSFER SIGNAIURE ! SIGNAIURE ~ . - 10, DISTANCE BY SHORTEST DIRECT LINE FROM ANY SCHOOL GROUNDS, CHURCH, COLLEGE OR UNIVERSITY ................ ~~,. .......... ~.~ .~ .............................. .~ ................................ ~ ............................................ 12 HAVE YOU EVER BEEN CONVICTEO OF A FELONY? YES ~NO IF YES, COMPLETE THE FOLLOWINO: .. i- ..- . .- PLACE OF CONVICTION (CITY OR TOWN AND SLATE) "-': .....'i.:':~'.:_.. ' DATE:.OF CONVICIION ,,,. .. .. -. ,,,,. . ......... · ....... . -- ..... - ................................................................................................................................................................................................. ~ ...................................................................... : ............................................................................... ......................................................................... ~ ......................................... ~ ........................................................... .-; ~3. ~F CORPORATION, ARE YOU QUALiFiED TO DO BUS~NESS W~TH~N THE STA~E? O YES O NO 14. ~PPUC&NT HEREBY DEC~E$, IF APPLICAIION IS FOR REI~IL OR OISPENSARY LICENSE, I'F AN INDIVIDUAL OR ASSOCIATION, IHAI HE HAS RESIDED IN ALASKA FOR AT LEAST ONE YEAR PRIOR TO THE DATE OF IHIS APPLICATION; IF CORPORAIION, IHAI Il IS QUALIFIEO ID OD BUSINESS IN ALASKA. 15. NON-INF~CTION OF LAWS O~ ~EGU~TION$ PERTAINING TO ~HE SALB OF INTOXiC~TING LIQUORS: ~WAS ~ WAS NOT CONVICTED OF AN INFRACTION OF ANY FEDERAL, STATE LAW OR REGULATION OR CITY ORDINANCE , COVERING THE SALE OF INTOXICATING LIQUORS DURING THE TERM OF THE LICENSE. IF CONVICTED, GIVE DETAILS: DURING THE PAST YEAR. IF LICENSE HAS NOT BEEN ACTIVE AT LEAST THIRTY (30) DAYS,EXPLAIN: UNFOLD FORM TO COMPLETE. IF APPROVED THIS DAY OF TYPED, TEAR ALONG PERFORATION ANE: ,19__ INSERT EACH SECTION SEPARATELY. COMPLETE PAGE 2 ALSO ..... ~ DIRECTOR LICENSE NO .................. PAGE I BUROUGH OR CITY COUNCIL 20. ' NAME PRESIDENT · VICE PRES. SECRETARY TREASURER :21. DIRECTORS AND/OR STOCKHOLDERS: I~ THE FOLLOWING INFORMATION IS NEEDED TO PROCESS YOUR APPLICATION. PLEASE ANSWER ALL QUESTIONS SO YO.UR LICENSE RENEWAL _1[' ~ TRANSFER CAN BE COMPLETED WITHOUT FURTHER CORRESPONDENCE. CHECK ONE 18 IF APPLICANT tS AN~INDIV 19. IF APPLICANT !'~ A CORPORATION: FEDERAL EMPLOYER IDENTIFICATION NUMBER CORPORATE NAME OFFICE PHONE ........................................................................................ DOING BUSINESS AS LOCATION ............................................................................................ MAILING ADDRESS CITY ........................................................................................ CORPORATE OFFICERS: TITLE HOME ADDRESS ........ BIRTHD~-TE "' ~HoNE'~5. s°~,'A~' SE~-UmT~-"~~ I':' i"~ NAME ' . :.:.'-: . .' HOME ADDRESS .' - HOME PHONE SHARES OR % 22. UNDER WHAT NAME WAS YOUR PAST YEAR'S ALASKA STATE INCOME TAX FILED? t."-; ' ..-.i NAME .' ' : '" I '. YEAR ' ! ' -..- SPO~USE'S NAME " ',. I....,~,,....,..~:..t..:.Z.,.:~.,:,,..,.,:..,.,vsl,.'.'..i.:.~'. ........ ' ........ : ............... ;.L'_ii;/. .............. ].i._/...?..~i.'.,,.:~.'..'. ............. : ........... ' ....... ~.'.'/..6:.::...~..c..: ............ .;,:;.../.-,.:..xx...,,~.,....,.'~.,:/; ,,,? := :23. WHAT NA~E WILL BE USED-ON YOU~R PUBLIC SIGN OR, IN YOUR ADVERTISING PROGRAM TO IDENTIFY YOUR LICENSED PREMISES? ....................... Zr~.....~..~:,-: ' ~~ t...~ b . . · ' 24. Section 04:10.180, regulations 41 l0 and 4111, and interpretations of Section 04.10.190, require a full disclosure of any financial interest in a liquor license. The Board requests that you list all purchase agreements, loans from banks or individuals, silent parlners, or any other contracts, including lessee agreements, lhal affect the financial interest of this license. Failure to make a complete disclosure of all financial interest is a false slalement and the penally warrants revocation of the license.' Please study the above sections in your rules and regulation booklet. Declare all other finan- cial interests below. . I (~) (3) DAY t I J~ DR--ABC- t (. SUBSCRIBED AND SWORN TO ME THIS / ., OF , "-~'~J,-~' 19 ., ,.',/ .. I ., ~t -"~, t :,: ./ /'~,"'"' /' 4/z..-~: 1""/ i! ~,). / PAGE 2 MY COMMISSION EXPIRES ......... ,~,,. ':...~?,., APPLICATION FOR LIQUOR LICENSE IN THE STATE OF ALASKA AppLi'C_ATiObj NO` " ALASKA STATCALCOHOLiC BEVERAGE CONTROL BOARD "' I-.'""F~R'NEW LIcENsEs AND RENEWALS: '" ' ~ 7)- TO ,~:'/' f~*ND TENDERS HEREWITH THE SUM OF $ ~::?:, ~,"c~ ..... , PLUS A FILING FEE OF ~25.00. APPLICANT S NAME AND MAILING ADDRESS BUSINESS NAME AND LOCATION ...... " S t ~.',? ' ,. ..... .... T. · ..... ................. .~ .................... . .................. ................ .................................................................................................................................. 3. CITY .............. ~~J ..... ~ ........... BOROUGH ............... /~~ Z~ ~ j ................ O~HER. (COMPLETE ONLY ONE) ' ' ~.~ (NAME) ,..,'~ ....................... ........................................... 5. THE LOCATION OF THE PREMISES ~ IS O IS NOT WITHIN 50 MILES OF AN INCORPORATED CITY, BORObGH, OR. ,. 6. FOR TRANSFER~ ONLY: CHECK ONE THE UNDERSIGNED HEREBY APPLIES FOR TRANSFER OF LICENSE NUMBER ............................................................................... FROM.' .................................................................................. TYPE OF LICENSE DOING BUSINESS AS ............................... ...................................................................................................... AT THE FOLLOWING LOCATION: STREET ADDRESS ............................................................... ~7. CITY ................................................................................... BOROUGH. 'OTHER ..................................................... (COMPLETE ONLY ONE) (NAt.~E) ....................................... . ....... ?tq-~-~ ................ : .............................. .. ~ ~}~- :. APPLICANT'S NAME AND MAILING ADDRESS J ' BUSINESS NAME AND LOCATION I-HOW~C~-~ .... , ........... , ............. , ,, , . ....... ' ..................... ' ...... 9. I/WE HEREBY CONSENT TO THE ABOVE TRANSFER. . SIGNATURE I S~ONA)U~E ~ ~0..~,S,~c~ ~ ~.o~,~T ~,~CT ~,~ ~O.~ ~ ~C.OOL ~~ C.~C.. COLL~O~ O~ U.,~,.~ ~~;' ~ (' % ii. HAVE YOU ANY O~HE~-K.~ND OF L~QUOR L~CENSE~ ~.. Y~S NO ~F YES, G~VE TYPE AND L~CENsE NO :~ 12. HAVE YOU EVER BEEN CONVICTED OF A FELONY? YES NO IF YES COMPLETE THE FOLLOWING: . ::]' ::'." .. 'PLACE OF CONVICTION (CITY OR TOWN AND STATE) ' :.:'::' :: - :']]:]:...DATE OF coNvI.CTION ..................................... . ........................................................................................................................................ .......................................... . ............................................................................................................................... ~ 13. IF CORPORATION, ARE YOU QUALIFIED TO DO BUSINESS WITHIN THE STATE? O YES O NO I '14.APPUCANT HE. REBY DECLARES. IF APPLICATION IS FOR RETAIL OR DISPENSARY LICENSE, IF AN INDIVIDUAL OR ASSOCIATION, THAT HE HAS · RESIDED IN ALASKA FOR AT LEAST ONE YEAR PRIOR TO THE DATE OF THIS APPLICATION; IF CORPORATION, THAT IT IS QUALIFIED TO DO BUSINESS IN ALASKA. ~ 15. NON-INFRACTION OF LAWS OR REGULATIONS PERTAINING TO THE SALE OF INTOXICATING LIQUORS: I .: I OWAS ~. WAS NOT CONVICTED OF AN INFRACTION OF ANY'FEDERAL, STATE LAW OR REGULATION OR CITY ORDINANCE .. COVERING THE SALE OF INTOXICATING LIQUORS DURING THE TERM OF THE LICENSE. IF CONVICTED, GIVE DETAILS: 16. ,I (WE) FURTHER STATE THAT THE ABOVE LICENSE 'HAS O HAS NOT BEEN EXERCISED OR ACTIVE AT LEAST THIRTY (30) DAYS DURING THE PAST YEAR. IF LICENSE HAS NOT BEEN ACTIVE AT LEAST THIRTY (30) DAYS,EXPLAIN: APPROVED THIS DAY OF - 019 _ DIRECTOR LICENSE NO.. PAGE ! UNFOLD FORM TO COMPLETE. IF TYPED, TEAR ALONG PERFORATION AND INSERT EACH SECTION SEPARATELY. COMPLETE PAGE 2 ALSO-- ,.,, ....... ~ · .. BUROUGH OR CITY COUNCIL I I' f I t THE- FOLLOWING INFORMATION IS NEEDED TO PROCESS YOUR APPLICATION. PLEASE ANSWER ALL QUESTIONS SO yoUR'LICENSE DI:NEWA OR TRANSFER CAN BE COMPLETED WITHOUT FURTHER CORRESPONDENCE. ' o 17. T~'I5E OF LICENSE ~ '~' ':~ / { ' '~' .,, ' - ' NEW TRANSFER RENEWAL 18. IF APPLICANT !S AN INDIVIDUAL OR INDIVIDUALS: ~--' ', NAME ADDRESS 'j "~i~'f~HDATE .... . ..~ -~~-., .. .,. F ~: /~: e : ~:' r,~ ' : ........................ . - ' . ................................ ,-,~ . J .... ~ ........ 1~ ~"'~ ~' ~=~ ~ ~"~'~ '~ ................. : ....... .... ~ ................................. '.. ..................................................................................... ................................................... : ........................................ '.. 19. IF APPLICANT IS A CORPORATION: FEDERAL EMPLOYER IDENTIFICATION NUMBER CORPORATE NAME OFFICE PHONE· DOING BUSINESS AS LOCATION t MAILING ADDRESS I CORPORATE OFFICERS' .................... : CiTY . s~c~T~'~ 'j ~ ........ i.~.~,.:SS:.~ ........... J J .......................................................................................................................... · 21. DIRECTORS AND/OR STOCKHOLDERS: · ' NAME " ' ::' : :::HOME ADDRESS : : . ' ·"" HOMEPflONE.(:.: ' SHARESOR% . . . ........... ' ".. ' .. 22. UNDER WHAT NAME WAS YOUR PAST YEAR'S ALASKA STATE INCOME TAX FILED? ~' . / NAME : " ' · YEAR · - - l~] .... ,'/] / : ' --~- ' ' "-: ' ~':- '. ...... ,.- :_ SPOUSE'S NAME : 1 /_ ~ ~ . . . ~ ~ : .. . ................................................................. · ~....z ................................................................................ : ......6, ~:./~ ~ .-::.:: ........................................................................................... : ......................................................................................................... : :.:.::: :. :::~: ::. :~: :::::: .L ::::: ~:: ::~..'~...:...:.:.:...: :'::::: :::..~. :::~ ::.:'~ ~::..:.:: :::: :::~....: .'.-.: ::.:':.~:.. ............ · ..~ ........................................................................................................................................ ...................................... ~ ........................... . ............................................... 1.23. WHAT NAME WILL BE USED ONYOUR PUBLIC SIGN ~R IN YOUR ADVERTISING PROGRAM TO I ' I - ' ~ ~ ~ ~ - ~,, DENTIFY YOUR LICENSED PREMISES~ ~ ....................... ~ ................... ~ .............. ....t ................ ..................................... :.~ ...... : ........ :: ....... : ........... ~ ~::...,~...~,~ ......................................................................................................... : ............................... ! 124. Section 04.10.180, regulations 4110 and 4111, and interpretations of Section 04.10.190, require a full disclosure of any financial interest in a liquor I license. The Board requests that you list all purchase agreements, loans from banks or individuals, silent partners, or any other contracts, including lessee agreements, that affect the financial interest of this license. Failure to make a complete disclosure of all financial interest is a false statement and the penalty Warrants revocation of the license. Please study the above sections in your rules and regulation booklet. Declare all other finan- cial inlerests below. I I -I J DRrABC-'I ® ,, PAGE 2 SUBSCRIBED AND SWORN TO ME THIS// ; _DAY - . MY COMMISSION EXPIRES . .... / APPLICATION FOR LIQUOR LICENSE IN THE STATE OF ALASKA APPLICATION NO. ALASKA STATE..ALCOHOLIC BEVERAGE CONTROL BOARD ' : . I. "~OR,_, NEW LIC .... ~SES AND RENEWALS.~/--', ;~ ~.~ ~,,~ : IHE UNDERSIGNED HEREBY APPLIES FOR A.~~,~,~~':~//,..'~....,._~.~,....;~..:.-.- ...... "~,~':;':--.'Tf:?~'~,/~YPE LICENSE FOR THE PER. LOD,.___., TO , AND TENDERS HEREWITH THE SUM OF,/$ - · ...... ~-~ ~ -~-~'/:4C:'?f"??-~; ~.----; PLUS A FILING FEE ©~"~;~5.00 2. APPLICANT'S NAME AND MAILING ADDRESS~~' ..... -- BUSINESS N~ME AND LOCATION ,,,,,x ~'/ /~~.~ .~ ' '";" "5" '-' :'"" ............... ' "" .o,, ,,-, ......................................................... ' ..... T..'~ ............... ~ ............................................................... ........... .,. .,. ,, , /. ~,. :._. :.,,~ ..... . .............................................................. · ~ _/~~,- ~ ,,~ - . . ................................................................................................................................................ '. .... "~:..-;qL . 7~-:..¥. :.' -' ...... ~ ~' ~- , a. c~¥,_ .(./~, ~r<~-~,..? ~., ~/~x? _~ ./i",~ ..... BOROUeH OTHER ~..~ (NAMEI~.~.~;: .... .............................................................. (NAME) ~ ~. (COMPLETE ONLY ONE) .......z- $. THE LOCATION OF THE PREMISES .~ IS O IS NOT WITHIN $0 MILES OF AN INCORPORATED CITY, BOROUGH. OR_ 6. FOR TRANSFERS ONLY: CHECK ONE THE UNDERSIGNED HEREBY APPLIES FOR TRANSFER OF FROM ............... ' ................................. fYP'E"0F"tiCE'~i~ ...................................................................................................... LICENSE NUMBER ....................................................................... .............................................................................................................................................................................. DOING BUSINESS AS ................................................................................................................................................................................... AT THE FOLLOWING LOCATION: STREET ADDRESS .......................................................................................................................................................................................................... ................................................................................................ CITY ('Ri~'E') .... i ................................ BOROUGH ........................... IN'X;~E) ........................................... OTHER ......................................................... (COMPLETE ONLY ONE) 8. PPLICANT'S NAME AND MAILING ADDRESS " BUSINESS NAME AND LOCATION ~. .............. · ' ]RESiDE.N? 9. I/WE HEREBY CONSENT TO THE ABOVE TRANSFER · . SIGNATURE I SIGNATURE 2 10. DISTANCE BY SHORTEST DIRECT LINE FROM ANY SCHOOL -GROUNDS. CHURCH,COLLEGE OR UNIVERSITY .................................................................................................................................................................................... '~11. HAVE YOU ANY OTHER KIND OF LIQUOR LICENSE? O YES O NO IFYES, GIVE TYPE AND LiCENSE NO. 12. HAVE YOU EVER BEEN CONVICTED OF A FELONY? YES NO IF YES, COMPLETE THE FOLLOWING: :~.:.%;..:. .... .. PLACE OF CONVICTION (CITY OR TOWN AND STATE) -..-. ' DATE OF CONVICTION . .................................................................................................................................... ................................................................................................................. ................................................... ...................................................................................................................................................... ........................ , !,~13' APPLICANTIF CORPORATION,,,,.,..._..,ARE YOU QUALIFIED TO DO BUSINESS WITHIN THE STATE? O YES O NO ,--,.HEREBY ul::~l~l,l:l:::~. IF APPLICATION IS FOR RETAIL OR DISPENSARY LICENSE, IF AN INDIVIDUAL OR ASSOCIATION, THATHEHAS RESIDEDINALASKAFOR AT LEAST ONEYEARPRIORTO1'HE DATEOF THISAPPLICATION;IF CORPORATION, THAT IT IS QUALIFIED TO DO BUSINESS IN ALASKA. 15. NON-INFRACTION O...~LAWS OR REGULATIONS PERTAINING TO'THE SALE OF INTOXICATING LIQUORS: I OWAS WASNOI CONVICTED OFAN INFRACTION OF ANY FEDERAL, STATE LAW OR REGULATION OR CITY ORDINANCE COVERING IHE'SALE OF INIOXICAIING LIQUORS DURING THE IERM OF IHE LICENSE. IF CONVICIEDo GIVE DETAILS: '6. ;I.(WE)FURTHER STATE THAT THE .ABOVE LICENSE ~ HAS O HAS NOT BEEN EXERCISED OR ACTIVE AT LEAST THIRTY (30) DAYS DURING THE PAST YEAR. IF LICENSE HAS NOT' BEEN ACTIVE AT LEAST THIRTY (30) DAYS EXPLAIN: UNFOLD FORM 10 COMPLETE. IF APPROVED THIS DAY OF TYPED TEAR ALONG PERFORATION AND; I 19. ' ' INSERT EACH SECTION SEPARATELY. DIRECTOR LICENSE NO. PAGE I COMPLETE PAGE 2 ALSO BUROUGH OR CiTY COUNCIL I THE FOLLOWING INFORMATION'S NEEDED TO PROCESS YOUR APPLICATION. PLEASE ANSWER ALL QUESTIONS SO YOUR LICENSE RENEWAL OR TRANSFER CAN BE CQMPLETED WiI'HOUT FURTHER CORI~ESPONDENCE. CHECK ONE I .,:/7' ,~,...,,/~...,~iS:c~t," """ '~""' '"--"? O NEW O TRANSFER ~ENEW/ .-'t~117. T~PE OF LICENSE ~,~_._, . :.. 18. IF APPLICANT IS AN INDIVIDUAL OR IND~g'IDUALS:' J.' NAME J .................. XDDREss' ' I' ' ~;;:'~i ,./., ,./ '2- .... ',~. ~ ~-.~': ~ i /'-~-.': ,~- /->-'.: '~-"./' ..... / ---n.;_, -× f -' >~ --:',~',. .... . _:,-.'"'-.'i ",' .:' / ! 19. IF APPLICANT IS A CORPORATION: FEDERAL EMPLOYER IDENTIFICATION NUMBER ................ : ...................... CORPORATE NAME .................................................................................................................................................................................... OFFICE PHONE ..................................................................................... DOING BUSINESS AS ........................................................................................................................................................................................................ LOCATION ................................................................................................ MAILING ADDRESS ....................................................................................................................................................................................................................... CITY ...................................................................................... CORPORATE OFFICERS: TITLE .... ~ 'NAME . HOME ADDRESS · . BIRTHDATE PHONE'NO. SOCIAL SECURITY NO. PRESIDENT · VICE PRES. SECRETARY TREASURER 20. 21. DIRECTORS AND/OR STOCKHOLDERS: NAME .. I''L " "'" HOME ADDRESS .' HOME PHONE SHARES OR I 22. UNDER WHAT NAME WAS YOUR PAST YEAR'S ALASKA STATE INCOME TAX FILED? t:..'.: ......... .--.-,. ~: ....-:...~.- ...: I- ~:. ~.~ ' ' I '-'-..-..,: .,.::::.:'.'::..':.S~O:~'!~'~'~E '.':'.. ~. :.-.::.,.... ~ " .. i ~,, ' ~.--/ . ~ .... ' ' ' ' . :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::.:::.::':: :::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::: :::.:::::::: ::::::::::i:' ::::::.:. .. 23. WHAT NAME WILL BE USE~N YOUR PUBLIC SIGN OR IN YOUR ADVERTISING PROGRAM TO IDENTIFY YOUR LICENSED PREMISES? 24. Section 04.10.180, regulations 4110 and 4111, and interpretations of Section 04.10.190, require a full disclosure of any financial interest in a liquor I.. license. The Board requests that you list all purchase agreements, loans from banks or individuals, silent partners, or any other contracts, including J .. lessee agreements, that affect the financial interest of this license.. Failure to make a complele disclosure of all financial interest is a false statement and the penalty warrants revocation of the license. Please study the above sections in your rules and regulation booklet. Declare all other finan- cial interests below. · J: I 25. $1'GNA~T.URE(S) OF APPLICANT(S) " 'l (I)_. I I .. (2) I [. I DR-ABC-I ®,, · PAGE 2 I , · APPLICATION FOR LIQUOR LICENSE IN THE STATE OF ALASKA ^~u~,~o~ r~o. ~ , A'LASKA STATE ALCOHOLIC BEVERAGE CONTROL BOARD ; i. F(~NEW LICENSES AND RENEWALS: THE UNDERSIg~jNE/D HEREBY APPLIES FOR A //~ ~ 7'".'~. / Z ,'4i "~b ,.x. ~ /,"' I'YPE LICENSE FOR THE PERIOD /z)O, ~ d PLUS A FILING FEE OF $25.00. /,//_./) ~. TO/~.~7~ AND TENDERS HEREWITH THE SUM OF $ --' 2. APPLICANT'S NAME ANDMAILING ADDRESS ¢ lc z-:-,, c.:.. ............ ................................... .......... ./.....Z ..... ............ .... // ...... :'.: 3. CITY /~' (' t'/0 .f, ........................................................... BOROUGH ...................................................................... OTHER ................................................. (COMPLETE ONLY ONE) ........................ (NAME) .................... (NAME) . 4. IF RENEWAl, OlV[ P~ESE~I LOCATION OF ~s NOJ WITHIN 50 MILES OF AN INCORPORATED CITY, BOROUGH, OR - 5. THE 6. FOR TRANSFERS ONLY: CHECK ONE LICENSE NUMBER THE ~NDERSIGNED HEREBY APPLIES FOR TRANSFER OF ............................................................................................................................................................................................. IYPE OF LICENSE DOING BUSINESS AS FROM AT THE FOLLOWING LOCATION: STREET ADDRESS BOROUGH ...................................................................................................... OTHER ................................................................. (COMPLETE ONLY ONE) 7. CITY ................................................ (NA~'E') ..................................................................................... (NAME/ ...... HOW LONC: 8 .: APPLICANt"S NAME AND MAILING ADDRESS BUSINESS NAME AND LOCATION STATE REStDENT ....... : ....... - ...... ~ ........ . ........ ........................................................................................................................................................................................................................... 9. I/WE HEREBY CONSENT TO THE ABOVE TRANSFER SIGNATURE 1 SIGNATURE 2 J0. DISTANCE BY SHORIEST DIRECT LINE FROM ANY SCHOOL GROUNDS' CHURCH' COLLEGE OR UNIVERSITY ................................................................................................................................................................................................... 0 0 ........ vnJ~ i irENSE kin ' giVE L I 'k,.., I .v ................................................................................... ,--. ii. HAVE YOU ANY OTHER KIND OF LIQUOR LICENSE? YES NO ~rYES, ,,~-~_AND 12. HAVE YOU EVER BEEN CONVICTED OFAFELONY? O YES (~NO IF YES, COMPLETE THE FOLLOWING: PLACE OF CONVICTION (CITY OR TOWN AND STATE)- . ! 'DATE OF CO~ 13. IF CORPORATION, ARE YOU QUALIFIED TO DO BUSINESS WITHIN THE STATE? YES NO 14. APPLICANT HEREBY DECLARES. IF APPLICATION IS FOR RETAIl OR DISPENSARY LICENSE, IF AN INDIVIDUAL OR ASSOCIATION, THAT HE HAS RESIDED IN ALASKA FOR AT LEA~T' ONE YEAR PRIOR TO THE DATE OF THIS APPLICATION; IF CORPORATION, THAT IT IS QUALIFIED TO DO BUSINESS IN ALASKA. 15. NON-INFRACTION OF LAWS OR REGULATIONS PERTAINING TO THE SALE OF INTOXICATING LIQUORS: I ~ WAS "~_'~"~AS NOT CONVICTED OF AN INFRACTION OF ANY FEDERAL, STATE LAW OR REGULATION OR CITY ORDINANCE COVERING THE SALE OF INTOXICATING LIQUORS DURING THE TERM OF THE LICENSE. IF CONVICTED, GIVE DETAILS: ' .oy'ee ...... selt-ing ...... liqnor .... t.o .......... a ........ minor ....... un. der .... AS ........ 0.~.-.~ ........ ~'0-.'~ ............ 1.8.0 ............................ ' .............................' DURING THE PAST YEAR. IF LICENSE HAS NOT BEEN ACTIVE AT LEAST THI.RTY (30) DAYS,EXPLAIN: UNFOLD FORM TO COMPLETE. IF APPROVED THIS DAY OF TYPED, TEAR ALONG PERFORATION AN[ 19.__ INSERT EACH SECTION SEPARATELY. '' COMPLETE PAGE 2 ALSO. ' ..... DIRECIOR LICENSE NO. -- PAGE I BUROUGH OR CITY COUNCIL I THE FOLLOWING INFORMATION IS NEEDED TO PROCESS YOUR APPLICATION. PLEASE ANSWER ALL QUESTIONS SO YOUR LICENSE RENEWAl OR TRANSFER CAN BE COMPLETED WITHOUT FURTHER CORRESPONDENCE. Ct4ECK ONE (17. ~PE OF'LICENSE . .. /~) -~' t"'~t , Z Z,, ~ /..z ,: ~-' O NEW O TRANSFER (~ RENEW/' ~.18. ~'APPLtCANT IS AN INDIVIDUAL OR I'NDIvi'~j~LS:'' ........................................... NAME ADDRESS B1RTHDATE 'PHONE NO. SOCIAL SECURITY NO. ............... I 19. IF APPLICANT IS A CORPORATION: FEDERAL EMPLOYER IDENTIFICATION NUMBER ............ ~.'~.,~ - L'), ~ / '~ z-/,/.~"" J CORPORATE NAME ~/Z 1''> /~>:, .~':',~..,,,~.:.)~. 1 ,- ~ .- ~:~' ~ ........................................ OFFICE PHONE ..,,~L. ~ ~-' :'"~/~-'J iJ~. DOING BUSINESS AS ~.,~(z/¥'~.~ . ./~"...~. ....... '~.~.....~,.~ ........................................................................................................... LOCATION ~ ~ ~/ '~' / 'I MAILING ADDRESS / .... ,,..~ ~:~'~ d' ~'f->~ ~.~// ~ ~ C~T~ ~ .............................. .-i~- CORPORATE OFFICERS: ~ ~ -TIT~E ..... NAME HOME ADDRESS DATE ' .~i s~C~T~ I ~ ' " :, ' "~ ~'~" ...................................................................... 1' ~'~;:"~ ......... ~'~;"~'">:)"~;'~ ......................................... ,I ~:l. DIRECTORS AND/OR STOCKHOLDERS: ~//~/3 g ,: ~ ~'4-:t:'/ p tl - ~ ~- O:-~ W/ EL' l._ - ....... ]---- NAME J .... ' .- '. ~-'-'.':'.' ~ME ADDRESS' .' ' ! "HOME PHONE I SHARES OR % 'J .]."~. .~ , ~ '~ . ~. , ........... ~ ....... ... . ........... . · ....... .. . ~ ..................................................... ~ ............... ~ ................................................................................................... ~ .................. ~ .................................. ~ ..................... ~ ...... · ~,~, d~'~ ~'~ /~:' ~ ~. ~- J~~ .~x-,:,- i~.->~. .~..~.i I.:..= , ....... .............. .................... ......... ................................................................. I ............................................................................. ................................................................................................................. ,.,:..,..,....:..,:.-,...-.., 122. UNDER WHAT NAME WAS YOUR PAST YEAR'S ALASKA STATE INCOME TAX FILED? ~ J-~:'. . ,......~, ~~"' ~' ":": '~ 'I': : r~AR"..~' '. ..... SPOUS~'S~A~E .... .; ............. ........................... !.23. 'WHAT NAME WILL BE USED ON YOUR PUBLIC SIGN OR IN YOUR ADVERTISING PROGRAM TO IDENTIFY YOUR LICENSED PREMISES? 1.24r Se.ction 04.10.180, regulations 4110 and 4111, and interpretations of Section 04.10.190, require a full disclosure of any financial interest in a liquor J '" license. The Board'requests that you list ali purchase agreemenls, loans from banks or individuals, silent partners, or any other contracts, including j lessee agreements, that affect the financial inteFest of this license. Failure to make a complete disclosure of all financial interest is a false statement ~. and lhe penalty warrants revocation of the license.. Please study the above sections in your rules and regulation booklet. Declare all other finan- ~ '.{..~ cial interests below. :. ,' ~.'-,., .:_,:~ ....... L .............................................................................................................................................. ; ~" ............ e ~ ~ ........ ~ ~ ~' ........ '~ ~ ..... ~'~'~'~'~ .......... ~"~'~"~:~~ ........ ~'~.'" ....... ~"~'~'~'~"~ ........ ~"~"i'"Z'"Z"~"~ ...... ~"~'~'~":~"~; ~' ~' ~ ..................... ~ .... ~-' '~ ................................... : ........ : ...... : ...................... , ....... ~ ............................ .: .............................. ,.~.~ > ..,: ......... ~: ,..~ ~ ..... ~.s~ ~ ...~, ,~. ...................... ~... :"~ ........ . ....... : .............. :... ........... ~ ............................................. ~ .,~ ..................................... ................................................................................................................ : ................. - ......... (3)_ (4) '1. J . DR-ABC-i ®,, PAGE 2 APPLICATION FOR LIQUOR LICENSE IN THE STATE OF ALASKA APPLICATION . ALASKA STATE ALCOHOLIC BEVERAGE CONTROL BOARD !. FOR NEW LICENSES AND RENEWALS: '[HE UNDERSIGNED HEREBY APPLIES FOR A /~ ~ 7~/. , / J, ~ U r...;' ~ TYPE LICENSE FOR THE PERIOD "' . ,/,t7 ~q ...... TO/-~~, AND TENDERS HEREWITH THE SUM OF $ ,~ ('2~), c';.) (..) ..... PLUS A FILING FEE OF $2.5.00. 2. APPLICANT'S NAME AND MAIL. ING ADDRESS BUSINESS NAME AND LOCATION , ................ ........ :.. ....... ............................ ...... .................. ................ l.:~.. ~.o ........... ~-,.~. ,,~ ~r.-...// ......... :..,"-, ..................................................... /...~.1o.~ ./.~ "~.. z-'/~... ~ ..... .:--~ :.Z~ ............... 3. CITY .............. /~. ~r~)''! (£. t.' .......................................... BOROUGH OTHER ......... ' ............................ (COMPLETE ONLY (NAME) (NAME) , '4. IF RENEWAL, GIVE PRESENT LICENSE NUMBER ............ ~ ~'. ~...~:..?~. ................................ ® © 5. THE LOCATION OF THE PREMISES IS ~s NOT WIIHIN 50 MILES OF AN INCORPORATED CITY, BOROUGH, OR.. 6. FOR TRANSFERS ONLY: CHECK ONE THE UNDERSIGNED HEREBY APPLIES FOR TRANSFER OF LICENSE NUMBER ............................ TYPE OF LICENSE · FROM ......................................................................................... .: ............................................................................................................. DOING BUSINESS AS .......................................................................................................................................... ' AT THE FOLLOWING LOCATION: STREET ADDRESS ~ - 7. CITY. ................................................................................................................................................ BOROUGH ............................................................................ ' .................. OTHER ................................................... (COMPLETE ONL' (NAME) (NAME) APPLICANT'S NAME AND MAILING ADDRESS BUSINESS NAME AND LOCATION .. :9. I/WE HEREBY CONSENT 1'O THE ABOVE TRANSFER ,~ SIGNATURE I SIGNATURE 2 . JO.DISTANCE BY SHORIEST DIRECT LINE FROM ANY SCHOOL GROUNDS, CHURCH,COLLEGE OR UNIVERSITY ................................................................................................................. ~ ......................... . · !!' HAVE YOU ANY OTHER KIND OF LIQUOR LICENSE? O YES O NO IF YES, GIVE IYPE AND LICENSE NO ................................................ J 12 HAVE YOU EVER BEEN CONVICTED OFAFELONY? O YES (~NO IF YES, COMPLETE THE FOLLOWING: I.... . : :-"-::--..:. PLACE OF CONVICTION (CITY OR TOWN AND STATE) ... DATE OF' CONVtCTIC .. . · · 13. IF CORPGRATION, ARE YOU QUALIFIED 10 DO BUSINESS WIIHIN THE SIAIE? YES NO [14.APPLICANT HEREBY DECLARES. IF APPLICATIQN IS FOR RETAIL OR DISPENSARY LICENSE, IF AN INDIVIDUAL OR ASSOCIATION, THAT HE HAS : RESIDED IN ALASKA FOR AT LEAST ONE YEAR PRIOR TO THE DATE OF IHIS APPLICATION; IF CORPORATION, THAT IT IS QUALIFIED TO DO BUSINESS IN ALASKA. ~ 15. NON-INFRACTION OF I.~WS OR REGULATIONS PERTAINING TO THE SALE OF INTOXICATING LIQUORS: i I. OWAS ~ WAS NOT CONVICTED OF AN INFRACTION OF ANY FEDERAL, STATE LAW OR REGULATION OR CITYORDtb COVERING THE SALE OF INTOXICATING LIQUORS DURING THE TERM OF THE LICENSE. IF CONVICTED, GIVE DETAILS: · · .~ ..................................................................................................... i I~. I(WE) FURTHER STATE THAT THE ABOVE LICENsE (~ HAS O HA~NOTBEEN EXERCISED OR ACTIVE AT LEAST THIRTY (30)[ j DURING THE PAST YEAR. IF LICENSE HAS NOT BEEN ACTIVE AT LEAST THIRTY (30) DAYS,EXPLAIN: UNFOLD FORM TO COMPLETE. APPROVED THIS DAY OF TYPED, TEAR ALONG PERFORAi i ~9 INSERT EACH SECTION SEPAR~ COMPLEIE PAGE 2 ALSO.-'---'- DIRECTOR LI~ENS'E NO PAGE I BU·ROUGH OR CiTY COUNCJ ~ THE FOLLOWING INFORMATION tS NEEDED TO PROCESS YOUR APPL'ICATION. PLEASE ANSWER ALL QUESTIONS SO YOUR LICENSE RENEW/:, ~')~' OR TRANSFER CAN. BE COMPLETED WITHOUT FURTHER CORRESPONDENCE.' CHECK ONE ')7. TYPEiF OF LICENSE /4g ~ T~:-: , l .. Z, O O INDI'~UAL~v,u ~: ~ ~ ~ .................... NEW TRANSFER"" RENEWAL :~8. APPLICANT IS AN INDIVIDUAL OR 9. IF APPLICANT IS A CORPORATiON: · ' FEDERAL EMPLOYER IDENTIFICATION NUMBER C ~ ~ . ....... ~ ~. - ~.~.. ..~.~ / ........................ I[ DOING BUSINESS AS D ~./d~ - · ~-'~ ......................................................................... ... LOCATION ........ /('. ~, ~-x.~c.. 1.' .......... !~ CORPORATE OFFICERS: .~20. TIT~E J NAME ..J' HOME ADDRESS ! BtRTHDATE t p.o~[ ~o. ~oc,,.,,~c,~,~, ~o. ,., .... I ~ · ...... - ................................. ~ ............................. / .................................. /~.-~.. ~ ................................... !.~/~. ~:j;. y .... b.2.v.-~..~t; ~:.. 1~. z ~- ~,;, -~ ~ e ! ~.~' [REASURER I /'~ ] ~ ~ . ~' · I ~ -- . , ~ . -. ~ ~ r ~ ........ ~ · '--~ '- ~'"~ .~-21.[~ DIRECTORS AND/OR STOCKHOLDERS: - ~ _ '~ .~ . · ........ .,, . ~ J ...... ~ .... ~ , ...... ~._ zz:/..~.,.~, ................................................ , ~. ~ ~ ~, J, ~>,. ~ d I: ~'~ ~ _~) ,'~ '!~, -,: .... = --,, J ..... ~-.., ..... T, ......... :~'.~.~ ...................................................................... ~.~..~ ......... t.~>,.~- ............ >~....~'. ~.. 122. UNDER WHAT NAME WAS YOUR PAST YEAR'S ALASKA STATE IN~.i:OME TAX FILED? , I -" --' '~' ...... NAM.t: .... '-' '- t '--:?': ...... I "'~ ' | ....... .~'~'. .... .. · .... '.. !'"~i ':.' YEAR. il.:" '-.: '.-' S.POUSE'SNAME - !~23. WHAT NAME Wj'LL BE USED ON YOUR PUBLIC SIGN OR _.IN YOUFiADVERTISING PROGRAM TO IDENTIFY YOUR LICENSED PREMISES? ......................................................... ~....t ....... e..~ l~ .......~, ~ , 24. Section 04.10.18~0, regulations 4110 and 4111 and interpretations of Section 04.10.190 require a full disclosure of any financial interest in a liquor · . license. t' I I'. J' .... . . (~) ._ (3).-:. I I' 125. SIGNATURE The Board requests that you list all purchase agreements, loans from banks or individuals, silent partners, or any other contracts, including lessee agreements, that affect the financial interest of this license. Failure to makea complete disclosure of all financial interest isa false statement and the penalty warrants revocation of the license. Please study the above sections in your rules and regulation booklet. Declare all other finan- cial interests below. ............................................................. : ............ /V.~... .>t..~ ....................................................................................................... ' ! I I I I ? I I DR-ABC-I ®, t' 1. PAGE 2 SUBSCRIB? AND SWORN TO ME THIS .:~ ~) . DAY OF_ .1; "~Y .r._.. , _ -'f -/< 19 -7 1 ',~-' ~t !,.I,~ · MYCOMMISSI~XPIRES_ '~ .... Z ~ 04-643'~ ~'" · ~,~r~g~r o~~.g~'w- sr~g o~ ~,s~ ~APP~CAIIO FOR PEI~HT FOR AUTHORIZED G,~MES OF CHANCE AND SKILL Calendar Year Ending 197_2. Address: Dept~ of Revenue Division-Games of Cha~.ce & Sldll ALASKA OFFICE I]UILOING, POI;CII SA. Juneau, Alaak~ 99801 THIS APPLICATION MUST BE FILED WITH THE COM~SSIONER OF REVENUE: PERMIT F~E: $10.00 Per Annum D 'NE~q ~[] RENE'~'AL · No games of chance and skill shall be conducted by any qualified organization unless a Permit, as herein provided, shall have been issued to the qualified organization conducting such Games of Chance and Skill. The Commissioner of Revenue shall, upon application therefor on such forms as shall be prescribed by the Commissioner of Revenue, and upon payment of an annual fee of $10.00, issue a Permit for the conducting of Games of Chance and Skill, to any Qualified Organization, Civic or Service ©rganization, Religious, Charitable, Fraternal, Educational, Veteran, Police or Fire Department and Company, Dog Mushers and Fishing Derby Associations in the state, which operate without profit to its mem- bers, and which has been in existence continually for a period of five (5) years immediately prior to the making of an applica- tion for a Permit, which shall expire at the ead of each calendar year in which it was issued. Minimum membership of twenty- five (25) members is also required. Such Games of Chance and Skill shall be m_lbject to the following restrictions': (1) The entire net proceeds of any games shall be exclusively devoted to the lawful purposes of qualified organi- zations permitted to conduct such games. (1) .... ~ ..... Bingo (2)___ X._ _Raffles and Lotteries Briefly describe activities checked (3) ............ Ice Classics (4) __Dog Mushers Contests (5) ............ Fish Derbies · (6) ............... Contests. qf Skill The nonprofit organization named below hereby makes application for a Permit as desCribed above, pursuant to the pro- visions of Chapter 15, Title 5, Alaska Statutes. ORGANIZATION: Name: Kenat ELKS Address:' Bo~... 666 Kenai, Ak. klyeska. ~ ~' . ' Operating Address of Activity' Kenai Elks. Lnc~ Alye slam St~ Ken-si, 'Alaska 9961,1~ QUALIFICATIONS FOR A PER. M/T: A. Type of organization (Check one) (1) ........ Civic or service (2) _ _,Religious (3) ....... Charitable (4) ..... X _Fraternal (5) ........ Educational (6) ......... Veterans (7) ...........Police or Fire Company (8) ......... Dog Mushers (9) ......... Fishing Derby (10) ......... Other (Describe below) B. State how long organization has been in existence ........ ~' 2~ Y eaz~ .............................................. --ALL ANSWERS MUST BE PRINTED IN INK OR TYPEWR~--- SCHEDULE I--0FFICERS Title C. Affiliation with National Organization: Name of National. . . ', . . _ ~" Head~tuarters .... .' ...... ~~~$'"~"'~q--~4~"~~'C~'~ "0:~'~"'~" ~;"~"-.~;~ .............. , .......... D. 0rgani~ as a Cor~ration; ........... Association; _. Partnership;-_ .......... Firm or .......... Other. ~. R~ognized as a ngnprofit or~nization under the Federal Income Tax Laws. Yes No ............ .................................................................................. ~ .......................................... z. Full Name (Print or type) Address .................................... ~.~.~ ~_~_.~:,~~~...~ ~~~ ~~.¢~ .... ~,~ ~ ~ ~ ~.z~ ~ ~.~:~ ...................................................... : ..................... ~. ....... '~/' "i~ ........ ~'"~ ............. " ............................................................... ~~.,--~ h~%~ ........................................... : ............ . .................... ' ................................ S-~., -o~: ....... ~, ............ ................................................. _~_?~._~ ~ ~ .................................. : ......................................... ~ ,.~- ................................ ............. ~ ................ ................. ~ ,~ ~,~.~,~ ..... · ~,~ .............................. . ~' ,~.~:~,i?':~ .._~~,~~~ ~;~'. . SCHEDULE II--PERSONS IN CHARGE OF GAMES (Must be a member of permitee organization) ' Full Name (Print or type) Address , Years of membership ....... D~c~. ~..~~ ........................................................... ~..~. ~. _,~.__ _. ~ ..... ~'~q~,~ ~..~ ~.~-, ..... ,~,~'~r~.~.$---~~ ............................................. ~ .............. ~ ....... : ......... , ~-~-~---~~ .......................................................... ~.~:~ i.~.: .................... ~:~ ..................................................... ~_._.. ........................... ................. ~ .......................... - ................................................................................................................................................. SCHEDULE III--DATES AND HOURS 'OF GAMES . Date Hqur -'-~,~~~ .......................... ~..~~ .... DEDICATION OF PROCEEDS: Date Hour A. Estimated gross _receipts (Yearly.) $ .................... - ' B. State t e. specffiC~PurPose!, ~::' ': :: :' ~ :~ for which the entire,, net proceeds are to be devoted and in what, gmnner. ......... ..... ~~~ .... --~--~Pl~._~.._ : '.-~i~"' ~,h~ly--!.~~ :Pat~~ ........ C. Name and address of organization foundation, trust or other civic, public' charitable~ ~oup to receive and use the proceeds of the pro~s~ activity ..... ~~.:~.. ~ ._ ..... ' .~~. ~~ ~~- --g~~---~~-- - . . We certify that all the officers and all the persons in charge of games are of good moral character and have never been convicted of a felony. We certify, under the Penalties of perjury, that all of the statements contained herein are true and correct to the best of our knowledge and belief. · CITY COUNCIL APPROVAL: SignatUre ..................................................................... Date Subscribed and sworn (Signature of:%wo officers required) 04-643 ji .._ > DEPARTMENT OF i¢'EVENUE -- STATE OF' ALASKA APPLICATION FOR PER,LIT FOR AUTI-IORIZED GAMES OF CtLANCE AND SKILL Adtlress: Dept. of Revenue .. Division-Games of Chance & S~ll A'LA~Ktt. OFFICE }{UILI)ING, PoIrcll SA Juneau, ~:~ 99801 Calendar Yea~r Ending 1.97ff_ THIS APPLICATION I~IUST BE FILED WITH'THE COSI5.~SSIONER OF REVENUE: PEIIMIT FEE: $10.00 Per Annum J~ RENE~'AL No games of chance and skill shall be conducted by any qualified organization unless a Permit, as herein provided, shall have been issued to the qualified organization conducting such Games of Chance and Skill. The Comzniasioner of Revenue shall, upon application therefor on such forms as shall be prescribed by the Commissioner of Revenue, and upon payment of an annual 'fee of $10.00, issue a Permit for the conducting of Games of Chance and Skill, to any Qualified Organization, Civic or Service Organization, Religious, Charitable, Fraternal Educational, Veteran, Police or Fire Department aa~d Company, Dog Mushers and Fishing Derby Associations in the state, which operate without profit to its mem- bers, and which has been in existence continually for a period of five (5) years inzmediately prior to the making of an applica- tion for a Permit, which shall expire at the end of each calendar year in which it was issued. Minimum membership of twenty- five (25) members is also required. Such Games of Chance and Skill shall be subject to the following restrictions' (1) The entire net proceeds of any games shall be exclusively devoted to the lawful purposes of qualified organi- zations permitted to conduct such games. (1) ~ _Bingo (3) ............... Ice Classics (5) _Fish Derbies (2) ..... ~ ....... Raffles and Lotteries (4) ............... Dog Mushers Contests (6) ..............Contests of Skill Briefly describe activities Z:,.,,:,. ................................................ ~_ i'~/. _ / The nonprofit organization named below hereby makes application for a Permit as described above, pursuant to the pro- visions of Chapter 15, Title 5, Alaska Statutes. ORG2~NIZATION' Address' ~(_ff~o ,A~ -? 3~'~ QUALIFICATION~ FOR A PEI:t~T' A. Type of organization (Check one) (1) .......... Civic or service (2)' ._ ..t~_._Religious (3) ......... Charitable (4) - . .... Fraternal (5) ......... Educational (6) ...........Veterans (7). _ .......... Police or Fire Company · · . (8) ........ -_ _.Dog Mushers (9) · _ .......... Fishing Derby (10) ............. Other (Describe below) B. State how long organization has been in existence ...... /~" --ALL ANSWERS MUST BE 'PRINTED IN INK OR TYPE~VIt~N-- · C. Affiliation witi~ NatiOnal Organiza:ion: ,. l~ame' oi~ National ................................................................................................................................................. Headquarters ......................................................................................................................................................................................... D. Organized as a Corporation; ............ Association; .. Partnership' . ........... Firm or ..... ._'~..._ Other. ( . . l.~. .~: . ~ !'~_ . /. : ~ : ,..~. .J .................... ) E. Recognized as a nonprofit organization under the Federal Income Tax Laws. Yes .............. No SCHEDULE ImOFFICERS Title Full Name {Print or type) Address · ' / . ..................... z2 ........' ..... h..~:~ ~. , :..4~. _b.. ~:.,.~.,._ z~ ...... Z-/.i~,.,.J:-.,_~.~: ................................................................................ .... ~4 .................. . ' ~' - ~.j~ ' -- ! / I ' ' .... ~:~ z ~:_. .... /:? :~,_~ .... U ~.c_~ .... >_ '._~,.. ..... ~,4.~_.~.z:,? ........... - ...................... ~- ................ : ............ .. ~:,_ ~. ~.. . _ . -/_ 5 :~:.~.~ ...................... 2_ ~-:,.o.~.., ~ .~::_d. i _,_ . .l! :~ .... :/>:. L ~:~".~ ............................................................ ~- - ~ - -~--:-'~- .......... /--"' ............. x .......... · SCHEDULE II--PERSONS IN CHARGE OF GAMES (Must be a member of permitee organization.) Full Name (Print or type) Address Years of membership ._.X.:_r.~:. ~. ~_,.: /i__x,_ ~.. ~,f' f ~. .......................................... Z-:-<~-x~:, -,~-5-'-~ ....... tt.~.~-,:,.: ....................................................... 7-y-:' ............... SCHEDULE III--DATES AND HOURS OF GAMES Date Hour "~ .......................... ~.:__~.c.,./; :~_./.,.~,x-~'. ..... ~:,~ ~.~-~ ..... ' ' --/-Z-,:,,--.~ ............ IJ:-'.:,-,-.-.f----~,'~.--.,-,x.- .... :': .... 2.:~-'_: .--_.:.,_~..~:~:. /~'"'U .................................... -~ ........ ..x - - .x, ,,'- . s__,._,,~, :_.-_../q,,.,,.,..,~../..L.,_~'____k_ ~._~-~ .... -/-(:?~ ~: .......................................................................................... Date Hour DEDICATION OF PROCEEDS: A. Estimated gross receipts (Yearly) $..~_.~..~/_._g: B. State the specific purposes for which the entire net proceeds are to be devoted and in what manner .__~_ :~.z-_/ ........... ......... ~ l . . .................. - ...................... ~ - ' -" - C. Name and address of organization, foundation, trust or oth~/civic, public, charitable, patriotic, religious or other , ' ' Z _ ~,~_ _~.~,.. ~o~p to r~~ ~ ~ ~ p~o~e~a~ or t~ p~o~a ~ti~tx ..-...'~-.--..--~------:---~:x,-,(Xl: ~ :~ .... ~-~--~ .......... ........ ......................... '/ a .......... 9.f. ZJ .................................... We certify that all the officers and all the persons in charge of games are of good moral character and have never been convicted of a felony. We certify, under the penalties of perjury, that all of the statements contained herein are true and corr~t to the best of our knowledge and bel~ef. {Signature of two. officers require) ...... : -:. ::.~:.::.: ..... ::~::.. ~:-~:: ~. ~ ::::.:::~:: ~: ~. ......... ............................................................................... . ' ~r,,~., x,m~ ..... . W ~ ..~2':::/ ../::~s~::~:~u-:: .................................. Dnte Subscribed and sworn Title, ~ ....................... Officer's Name /~,~I' ) "~" .r ['"' ......... ...... : ..................... : ................ Title 04-643 DEPARTMENT OF REVENUE -- STATE OF ,,IL/iSKA APPLICATION FOR PE~IIT FOR AU'DtO~ZED GAMES OF CitANCE AND SKILL Address: Dept. of Revenue Division-Games of Ch~ee & Sk~ Juneau, AI~ 99801 Calendar Year Ending 1~7 ~- THIS APPLICATION 5~tUST BE FILED WITH TI~IE C05[~ISSIONER OF REVENUE: Per Anaum --] NE~' ~ llEN E',V'A L No games of chance and skill shall be conducted by any qualified organization unIess a Permit, as herein provided, shall have been issued to the qualified organization conducting such Games of Chance and Skill. · Thc Commissioner of Revenue shall,, upon application therefor on such forms as shall be prescribed by the Commissioner of Revenue, and upon payment of an annual fee of $10.00, i~u-~ a Permit for the conducting of Games of Chance and Skill, to any Qualified Organization, Civic or Service Organization, l?..eii~ious, Charitable, Fraternal, Educational, Veteran, Police or Fire Department and Company, Dog Mushers.and Fishing'Derby Associations in the state, which operate without profit to its mem- bers, and which has been in-existence continually for a period of five (5) years irm,~,.ediately prior to the making, of an app!ica- tion for a Permit, which shall expire at the end of each calendar year in which it was issued. Minimum membership' of twe:hty- five (25) members is also reqtfired. Such Games of Ch. ance and Skill shall be subject to the following restrictions' (1) The cntire Bet proceeds of any games shall be exclusively devoted to the. lawful purposes of qualified organi- zations peFmittcd to conduct, such games. (1) _ _ ~' _Bingo (2)__ ....... " _Raffles and Lotteries Briefly describe activities checked .. (3) · - 'I~.4iassics (4) .............. Doc Mushers Contests (5) Fish Derbies (6) ....... _"k ..... Contests of Skill The nonprofit organization named below hereby makes application for a Permit as described above, pursuant to the pro- visions of Chapter 15, Title 5, Alaska Statutes. Operating Address o'f Activity' QUALIFICATIONS FO~Z A Ptgl~,~'I" A. Type of organization (Check one) (1) ........ Civic or service (6) ......... Veterans (2) .... Religious (7) .............. Police or Fire Company (3) ..... Charitable (8) ........ Dog Mushers (4) ...... Fraternal (9) .............. Fishing Derby (5) .......... Educational (10) ............. Other (Describe below) !~0 ." B. State how long organization has been in existence ............. "~t' ?_[~.'~__:_ --ALL ANSWERS MUST BE PRINTED IN INK Ol::t TX~PEV/I~ITTEN-- D. Organized as a Corporation; ............ Association' Partnership; ............ Firm or ........ Other. E. Recognized as a nonprofit organization under the. Federal Income Tax Laws. Yes ..... "~.__ No .......... SCHEDULE' I--.OFFICERS Title Full Name (Print or type) Address ju.::~/ ~.f'f i?.,~_~to~'~ Z,~,:c~ z~''~''~.,..,o ~,;'~ ' .-~.','"' o ................................... · = ................................................... ~- ............................................... :.....: _.< ................... ~__.: .~._. :. .......................................... : ............ . ;..: _<.-7: .-T__._.-~...-~ Ocr:=' ~ccr¢ t; crZ ................ ~ ............................................................................................ ~ ....................... t .... r::~_: ............................................................................ .... ~-"'~¥.. ........ ~-,:c.~ ~,~ r o ~ ~ E. c.,.,.> ,,,,. ~::,~ z,~, ~:,,..~ C'~_~., · . ............. _ . -~.--~ . . ............................................... ................................................................................................................................................... ............................................................................................................................................... -.._: ....................................................................... ~C[E~L~ II--PE~SO~S I~ ~t~ Of ~I~S (~ust E a member of permitee or~ani~tion) Full ~ame (Prim or ............................................................................................................................................ SCHEDULE III~DATES AND HOURS OF GAMES Date Hour ........................................................................... ......................................................................................... Date Hour · DEDICATION OF PROCEEDS' A. Estimated gross receipts (Yearly) $ .... .~!./_:?: ....... B. State the specific purposes for which the entire net proceeds are to be devoted and in what manner ....................................... '-:'~ ' ' ' " c ] r? ~ ' .............. ::'....~.-' - > .~ . ...... T. .................................... : ................................................................. C. Name and address .of organization, foundation, trust or other civic, public, charitable, patriotic, r~li~ous or other ~oup to receive and use the proceeds of the pro~s~ activity .................................................................................................... CITY COUNCIL APPROVAL: Signature We certify that. all the officers and all the persons in charge of games are of good moral character and have never been convicted of a felony. We certify, under the penalties of'perjury, that all of the statements contained herein are true and correct to the best of our knowledge, and belief. (Signature of two officers required) . ~./~..~ ............ ~..: :.5~._.~<:._.,: ................... · c.J.!A ~, ' /I ~, z~ ........ /..~-(..._.~.. :~_~.C,:::.~.. :ct,_. .............................. ': .............. '- Date Subscribed and sworn Title / Officer's Name · .,~,. · Title· KENAI COMMUNITY CENTER Project Cost Estimate Pool Building Library Building Auditor ium Bldg. Clinic Building Mechanical 9,381 @ $60.00 s.f. 2,000 @ $50.00 s.f. 9,156 @ $60.00 s.f. I,.904 @ $50.00 s.f. 1,000 @ $50.00 s.f. 11% Fees & Contingencies Total Building Cost Furnishi'ng &.. Equipment Library Clinic Auditorium Pool Landscapi_qg & Parking_ Community Center 166,000 @ $~2.00 s.f. Public Safety Building 72,000 @ $2.00 s.f. Landscape Architect's Fee 6% Total Lanscaping-Cost Building Cost Furnishing & Equipment Landscaping Cos t Total Project Cost $556,860.00 $100,000.00 $549,360.00 $ 90,000.00 $ 50,000.00 $1,441,240.00 158,536.00 $1,599,776.00 $ 40,000.00 $ 10,000.00 $ 80,000.00 $ 20,000.00 $ 150, 000.00 $ 332,000.00 $ 144,000.00 $ 28,600.00 $ 504,600.00 $1,599,776.00 $' 150,000.00 $ 504,600.00 $2,254,3.76.00