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1975-04-15• Meridian City Hall April 14, 19?5 Meeting called to or er b the ayor Don M. Storey Members present: W. D. S aver; Kenneth Rasmussen; M in odine John Navarro ers reeen Y'3' Owe Fro ; t; Ri e c a ; o er Orton; Bruce Stuart; ss; Gary ymon Green oss; eer icense app ica read by the Mayor. ion rom ys one izza, n i , was p esen a an is s o e oca e at Fairview and East a 1st e o treet curve oca a in e o ars ers proper y The Motion was made y M in B dine and seconded by ohn avarr that the application for a be Keystone Pizza to be r li oper erase ted b or consumption on the Don G. Hill be appr prem ed. sex f r a _ Motion passed: Skiv r, ye ; Rasmussen, yea; Bo ne, ea; N varro, yea. ! John Navarro, repres phone for the fire s ntin atio the from olunteer Firemen, re the City Hall. este an a tension It was decided that make the necessary a his rang xtens meats on should be allowed. This hone would a Mr. ble Navar ireme o is to to be contacted while on purpose. ills and c ls. The Fire phone anno be u ed for this The development of t e Ro Wood property as a propose dev lopme t by Dowdle and Marcum known as Mr. Dowdle was prase he G t. m Est tes Development was p esen ed. Mr. Skiver presented revious to this mee the in exult The of a Planning and 7o exults of this meeti ing was eetin to re held ommend to the Council that A co of these minu his es rea b a on allowed Multiple dwe ile ling conce tration. The Motion was made y W. D. Ski ver and seconded by J hn N varro that the City approve the dev and West Pine in the lopm vici rat of ity o Gem Estates, located West 7th Street for d~oi he p ing pose st roadway of multiple • family development a April 14, 1975 as a rec tali mmend finery d by the Planning and proposal. Zoni g Com fission on Motion passed: Skiv r, ye ;Rasmussen, yea; Bod 'ne, ea; N varro, yea. $1,500.00 from Roy W od w s rec ived in payment to co tact an er or of land sa a •o oy oo' som ye sago _ e o ion was ma e the lands formerly a y part v n of th fine an secon e y Old Sewer Plant on erne d al as rag We ussen a t Broadway -- a accep a an a be accepted as payme e t fo , the presen a as payme ands as described. y Motion passed: Skiv r, ye ; Rasmussen, yea; Bo 'ne, ea; N varro, yea. The proposal for Jan 'tori 1 se ices by Duskin Janit ial ervic s was presented. air agreemen was initial clean-up. T o c e pr ge a sent mon y ra e o anitor is paid $100. p but s is no or an keeping the u ing c ean. The Cit Clerk was i tru tad t take the necessar e s o sec re adequate Janitorial services. • s Mer idian City H~z7.l .Z. es prit 1'+, ty~/~ The Mayor mentioned he E aas L ber Company desired lari icati n concerning where a lumber yard "C" Commercial at th ould las be pl Coun ced. This was the p it meeting. One pla rcel a in flan he or zoned finance 'lumber yards are in The felt that the r ndus tail rial busin etail. Businesses a ss was the sco of e in heir 'C' Co 'ntent ercial. The City will interp et t is bu iness as a retail en eavor ~ -- 'Surface # located t t and tate is not in o er tion. Bruce Stuart, Work's Ma or instructed him Sup' to ., is t thi getting bids for a p in o eration and to mp an kee moto 't in The eration. The Mayor instructed that the s gns that have been p rchas d for two hour parking pu up y possible. he o ice epar men an or ep men as soon as 'Ric Orton presented he W 11 bi s. These bids were vari adding those items t ble at d ne d bee ded to be placed on omitted as a total corn ost a e ter i axis y tallation. Gem State Pump and I riga ion o 820 Blackfoot Road, Meri 'an w the apparent low bidder. Gem State Pump and I he riga Engin ion f era recommendation w r a bid of $12,520. s the , t propo the al of ity request in writing, Gem Stat equipment. Pum ~ to p oceed with the order ng o the cessary ~` This order contingen Contractor steal on fur hese 'sh d terns: tail sketches of all equi ent i eluded in the proposal showin both materials and p dime rfor lion, ce sizes and provide det fall the equipment; it s ec is ons or That the ontra orderly and workmanl for 'ke m hall nner nstall the above men 'thin two (2) workin ione day equ p from en in an he time t ey are notified by The Contractor the hall ity coord r their representati pate with a contract e t r (t o s be s ; _ ected by he i y to provide '.contractor shall be a wo expo king ible nstallation. It is for only those matte nder s pe tood t taini a e to delivery _ an nstalla ion of Meridian of April ~, he a 19?5 uipme t included in the r mi o e i y o ' An anal sis of um ro o als i included with these minu es. The Motion was made Ke eth smussen and seconde b D. fiver that the installation of and Irrigation in t he p e amo pan nt of motor for Well #8 b $12 20.00 with the gr n in ted t er rec Gem Pump ommendations as listed above be • lfil ed. a 'Ric Orton a lained the o am of W 11 8 fines to is a se th water from _ 'the new well artd di Lines need to extent tribu to M a int ridi the system. Street and to the ea E st of ast First St. .The Pump House will The buildin is to be ap ontai roxim louv tely 12' x 20' and o red o enin s for coo met in bak ircul d enamel finish. tion. The matter of a fan for cooli g is o be considered if n eded The Mayor asked Mr. .the Cit . Orton conce ning the type of wat r to er to be used by Mr. Orton stated th t tow rs co a in many shapes and spec ficat' ons. The is 11 Meridian Gity Hall .3 . ti prit lam, ~y-i~ like the one in Namp wit supp rting pipes that ale hold water increasing e eo ume. e se ec ion o a sign s o e en up a a e me e Engineers have press ted boo et containing design , sha es an patterns a w e e p in s ma er. Mr. Orton explained he nner n which lines to be aid f om th new well co a programs w e n s o e ai or w er -in pprox ma 30 days. The Motion was made y W. D. S ver seconded by Marv n Bod 'ne th t the lines for water diet ibut on fr m Well ~8. Motion passed: Skiv r, ye ; Rasmussen, yea; Bo ins, ea; Navarro, yea. It was dec ded to pr sent the p opo s or openning an c nsi e a ion a 3:00 p.m. on April 2 , lg 5 at he City Hall with po sibl accep ante of bidder at a later da e. he Park recreation rogr was explained by Marvin odine whoa ounced .that the applicatio for atchi g funds in the amoun of $ 0,000 .00 had been requested from the B eau of Ou door Recreation. The drawing is sketc ed b Vern n Schoen designating pose' le r dway an parking with playgro d a d rec eation areas designa ed d was resented. .,, 'f he Motion made duri g th Apri 7th meeting concern ng t e orate hook-up ~.~ fee was discussed cl ified in relation to spec' fic bdivi ion and ~ annexations. '~ ,~ It was noted to the ity ounci that Elm Grove Trai er C t is using their ~ ~ ~ own water thus avoi 'ng t e par icipation in the cos s o a er ain enance -~ ~ ~` N ~ „ ~ for the City. ~. ~ o m ~ • ~ Mountain View Equip nt d req ested a Mobile Home or a offic adjoining ~ e presen ui i . was n e a s sewer oo -up ee o s o ~ ~ be paid for the sewe r use and t at water could be de fiver d fr the main .,, , o ~ ~ uz c ing. ~ ,•. q as The next item of bu iness had b en discussed by the ity ounci and the ri o ~ Chief of Police at rev ous C until meetin concer in he tehance of ~ ~ W m the radios for the ity. Ana eement is to be ente ed i to by he City for ~ ~ t!he City of Boise tc main ain t e radio at a contrac ri a as own b the ~ m agreement resolutio made a par of these minutes. 0?1~• v i•1 ~ ' p,~j ~ ~ ,o There being no othe busi ess t come before the Cou cil he me ting stood ~ z a adjourned. ~ ' es ,~+:~~ ity erk RESOLUTION NO. BY THE COUNCIL: BODINE , NAVARRO, RASMUSSEN AND SKIVER A RESOLUTION APPROVING AN AGREEMENT BETWEEN BOISE CITY AND CITY OF MERIDIAN FOR MAINTENANCE AND OPERATION OF A COMMUNICATIONS SYSTEM; AUTHORIZING THE MAYOR AND CITY CLERK TO EXECUTE AND ATTEST SAID AGREEMENT; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, BOISE and MERIDIAN pursuant to the pertinent pro- visions of Chapter 23, Title 67, Idaho Code, may enter into agreements enabling each to cooperate with the other for providing services and facilities to their mutual socio-political economic advantage; WHEREAS , upon recommendation of the Chief of Police, the Council of the City of Meridian at its regular meeting of /7 i~ ~~ 1975, found and deemed it in the best public interest to enter into an Agreement with Boise City for the maintenance and operation of a communications system for MERIDIAN'S use and purpose . NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND COUNCIL OF THE CITY OF MERIDIAN , IDAHO: Section 1. That the Agreement between Boise City and City of Meridian for the maintenance and operation of a communications system, a copy of said Agreement marked Exhibit "A" being attached hereto and incorpo- rated herein by attachment, be, and the same hereby is, approved as to form and substance . Section 2. That the Mayor and City Clerk be, and they hereby are, authorized to respectively execute and attest said Agreement for and on behalf of the City of Meridian . Section 3. That this Resolution shall be in full force and effect immediately upon its adoption. and approval. a __ L__. _..... ~....~~~ ,^ •~ ~ • ADOPTED by the Council of the City of Meridian, Idaho, this day of ~'pr%'~ 1975. APPROVED by the Mayor of the City of Meridian, Idaho, this day of ~pYj ~ 1975. Mayor ATTEST: City Cler 2 .~ ~ ~_ .m ~..~. • • 'r e ['~1L3dy~C1iSC4~'dLV' b • . ~V ~ A 1~ ~ 1.y 03 iCS d ld: ~VH AS, ~®~~ aid l~T;II3T pu~r~taa~at to t1aa_ pent px~otri- t~T~~, R' ~~ ® i~ ~~ai~~ra~®n ®P tie pgoanisaa, it ia~ agreed: ~• P. ~~Y~~ a~°ca~ ~ pr®vfd® ~ai~t~na~ca for th® op~rati®ra ~ ~ . '~ ffi~~ ~ r~~~red -eoa~nmtaaaication~ sgrste~~ at th® f®11®g ~: . t ~e~ paid ~y Y to ~~Y~E: 8a~ &~® ~ ~ainte~anoa per zaontB~ £o~° ®ao~: ., i a ®iDii~ wit ~t $~ , ~~ ~. ~a~o atatio~ gat ~I~a00 3. ~l~estr®nie air. ~mm a8 ~2 . afl _ • i ~~ ~, t,, ~.. S~~e~®~ ~. ~~~ tga~m ~rf tt~ A®~eaant ~ o~ ~p7'~~ f~ ._._._.• 1g?~® gal t~ ~a~~~ ~sa~ ~~ ova D~c~~~ber ~1~ 1ga^5; t~r~ldc~dD ~w~v`er. that""' t~ ~aa~at mad ~~ ~~gend~ ®~ ~ ~®~.r®t®~~~a~° brie for ~acc~~dt~~ boa~~~t y~~a 4J~,y .1 tc- s~ami iaael~aaag D~co~rab~r 91 of ~~ca~ ~®~z°) b~ eat~x~~t ka~~~ by t~~ p~rt3e~ ~~~a ~® ~~~ tray ~mmd oonditie~~~ ~~ h®r~in pr~vl~c~, or i~ tia~ ~v~~t tit ~ ®~ alb caf tla~ ~~~ ~ ~~aditlesn® ~~ ch~re~r~d. ~ru , ch~~~~ 8ia~ be noted #~i tie ~n~doa~a:a~~aa4 by tl~e p~~°t9~~ h~r~~ . - 2 ,o, ~. . ~. RI~I~.F~i, at i sole e~cpenae, ~+ 1 con-ply wi~h'all 1~~~, 4. $IDIAI~T shall indn and save and hold ha~l~a ~I3E irca~ ~d Per stay aid all loss®~a, clelBna, actic~n~ and jud~~nent® Par el~ag~ o~° iffiju~°iea to persona oa° Pr®perty~ end loasc~a ar~d e~pezaaea in the inaint®nance and opc~xr~tion of its coan~,~icatiana system by ~~JISE . ~. ~d1~~N r~greea to Purx~i~h, deliver ~ar~d ireatall its awa com- m cn~omma ayat®affi i$acludin~ all coYnpoffi®nt p~arta a,nd made all xaeceaaary and pr®~~° ffie~t~ to place its Bald ~atenn in full opea~r~ti®a~ and completely funetioxaal, d apc~ic~slly t~in~ obLi~ated to p~°ovide at all times such ma~Ine®rfiDn~ con~e~t~stio~ by w~lah ~ correct and reffi~dq any defects appearing in said ~yct~m ao tbat tlne ~~ame will op~rat~ and ~unotion ,~ contemmaplated rind int®nded by fit. 6. ~4I~~ shall be responsible fos~ the care and aai.'c~B~eepin~ off ~ ~-g~a-~~"' ~, II®ISE ~h~.tl root. .tho~at ~e pxior w~itt~ con~mL~ ®$ Iii. ~~ y eh~~e~ 3n ®~° ~tt~~hffia~nt~ ~ th® eo~~ni~ti®n~ a~y~te~ o~ o~ r~®ve ~ o~ the e~uip~e~t o~ P®on of the ooffia~u~le~~on~ r~+ot~r o4 I~il®i P~o~ the p1~e whew -lt waa i~-~l~d e . ~ . `~hia A~ee~e~t ~ 1 be birediu~ e~iso~ tlac~ ~~ horeto ~sd Ohl ~aat ~® ~~i~able o~ tx~~sa~er'~hle irn ~h,ole o~ i~ past ~ritl~®ut thc~ ett~ c~aneent of the other . Ii~1 t~I'1"PdE~~ ~1tEREC~F', the p~°tiee hereto have c~u~+ed thi€~ .~~°c~e~aerst to be executed Fay tkaeis duly e~utiiorized off~'ioer~ the day eaad ~ ~®t abo~re ~rrittera n 330IS~ CI"CY ~y Tvlayaa° ~'P'TIES~'o Char Cleprk ~y ~ . ,; n ~ IVi~y®~ AT"T'1~~~': i~ i City Cle ~ ~-110-?~ ~; ~ $ ~ . • ETA 4~ ~~ . Cocr~ty off A ~ ®n t day ®f , ig7~, be~o~® a~~, ~ mm® ~ub1Sc in mad ~®~ ~r~d 3tat~, p~~on~ly ~Pp~a~~d ~CHA~D ~. E~DL~ ~,~ J®ffi~ ~ . Ib N~AC~ e mown to me to~ b~ tYa® li6i~~®g ~aa~ Cif Cl~rl~ of ~ CI°i"Y ® II2®, wYn® ~~~cut~d tb~s within ina3~u~~at, ~d ~®wled~~d ~ ffi~ tF~t ~oi~~ Cif ~x~c~~ tla~ ~a~~. ~7 ~JdT%~E~S V~I3E~~~', I b~~~ b~~°~ts~to ~t ~~ hid eared e~x~d ®c~nl ~~~# tb® day ~d year li~~2 ab®v~ w~t~n . N®tary Public f~~ Iclabo r~aiclin~ at 13~si~~, Tdaho ~~A~ ®~ Tt2~Il~ ~ ~ ara. Coa~ty ®ff Ads ~ ~~ tffii~ day o~ - -___~, . 1~~5, befo~~ rs~, n®t~~y pa~blic ius a.~ad ~®~ ~~,id Mate, p~r~on,~ly apP®d T?Cl~t t!~ . S'T®N,EY and ~~ J e C®~, ® ~ ara~ to b~ the 14~ayo~ and City Cl¢~rk c! t~a€~ City o£ dim, Id~ah~, who e~~cuted the witbira ix~at~°va~aae®t, mad ac~owl~~d t® ~a® tb~t 4~~ CiBy o~ k~~~ ~ ~~u8cd tho ~e . I~ 3~I~' ~~ AE®~, I have h~s~u~to ~~t gay 2aand aaad axed ®ff~ ~~ ~a~ day and year ~r~t ~.bav~ w~°itt~n . YET®ta~ Public ~o~ Ic~ho .___ ~e~idia~~ at ~e~3.di~an, Idals® 5 R-11®- 78 ° '-•""'~`~ :~~LQ l DEEP WELL PUMP I~ ~ A EIUf3BIDIARV OFT RORA PU P ,,~ ..y uNir oR o~ronwx~ OIONA ESTIMATE SHEET ESTIMATED F R ~° ~ ~~ TYPE OF SERVICE MODEL NO. I Diameter Well Depth Static Water Level Pumping Level Feet GPM Head °/D E f. BHP Laboratory Dsch. Pressure ( prig) Feet _ ~) i ` Losses Total Pumping Head Feet i ~~ ~ ,% Field Pump Capacity GPM A ~ vZ ~ DESCRIPTION PRICI List NG SCHE Mult. DULE Net Approx. Wgt. MOTOR: (Make) HP , (f RPM Volts ° Phase Cycle Type Frame No. _ Special Features: F~,A GEAR DRIVE: (Make) Size Ratio Special Features: ~ FLEXIBLE SHAFT: Size I'/ " With Flanges ~. ~ eei HEAD SIZE: Dschg. Flg. Size LB. ~ ~ COLUMN: p~~Q Ft. "Std. Pipe x "Tube x ~, BOWLS: Size Type ~ No. of Stages 3 °'" ~,S SUCTION PIPE: Ft. of "Std. Pipe STRAINER: Size ~' "Type ~'~a~ Matl. ~/~~d~• AIR LINE: Ft. of " (Gale.) (Brass) @ $ Ft. ALTITUDE GAUGE & FITTINGS: ~ ~-S SOLENOID OILER Volts PRELUBRICATION TANK & FITTINGS: SOLENOID PRELUBRICATION VALVE: Volts f'~-r' ~-f o~~ l~ tad r~ o® ~ ~ , ~~ . z ~ ~_. ,~ -~ TOTAL EACH TOTAL UNITS TOTAL PRICE ' LENGTH BASEPLATE TO BELL LOP ~ / LENGTH BASEPLATE TO BOTTOM OF STRAINER ~~ i, ~/l Quoted by A 8 N FUgF i IP RIGA tI°N nHa ~ 11 /I/ ff<iWEH STREET 8 ~ ~ ^ Z L9 I IAl HIf~l A.1. IGPHr~ bYA] Pron. IT081 8BB It18B 111 I~ Inches ~ Special Notes Feet Feet ~~"^+a~` A UNIT oR m6NHi7AL BIONAL vUHi HOAL~MAIMn~HOHn LLl wyh•N.6°P DATE QUOTE # ITEM ## ~-- - 4r ~y ~1-U-® ENGINEERS, INC. 212 10th Ave. So. - Nampa, Idaho 83651 '1 ANaLxs~s Ptunp Proposals fox Nell No. 8 { MAYNE PUMP Equipment (with new motor) $ 14,358.00 Installation 335.00 Equipment (with. used motor) $ 13,858.00 Installation 335.00 Delivery--Approximately 10 weeks LAYNE OF IDAHO Equipment $ 13,446.00 Installation 650.00 Delivery--May 14, 1975 MERIDIAN PLUMBING *Equipment (less column and wire) $ 10,710.40 **Column and Wire 2,155.00 **Installation 1,375.00 9 AGRI LINES, PARMA DIVISION Equipment (Johnston) Installation Delivery--4 weeks Equipment (Peerless) Installation Delivery-4 weeks $ 14,158.60 768.00 $ 15,021.92 768.00 • Base Costs $ 14,693.00 $ 14,193.00 $ 14,096.00 $ 14,240.40 $ 14,926.60 $ 15,798.92 i a .l 5.~~' ~ ----'----- ~ -- ------- ----= - - --- o .~-U-® ENGINEERS, INC. 212 10th Ave. So. - Nampa, Idaho 83651 I ANALYSIS (Continued) Proposals for Nell No. 8 Base Costs GEM STATE Equipment (Layne and Bowler} Installation Delivery-- :~-. $ 12,145.00 375.00 $ 12,520.00 *Pump submittal does not strictly meet specification requirements. **Cost estimates by Engineer. ~~~ JI s ~ DUSKIN'S JANITORIAL SERVICE ~~._~ WHEEL INN MOBILE MANOR space 172 te'a' MERIDIAN, IDAHO 83642 PHONE 888-3974 April 8,1974 WORKING DAYS MONDAY THRU FRIDAY Clean as necessary to make the building look sharp. Wash windows inside and out probably once per month door windows every night inside and out, Sweep or dust floors daily, Clean and wax the floors as needed. Vacuum Rug floors daily. Empty trash cans into inside barrel daily, Empty trash cans in back room as necessary daily, Clean rest rooms (stools, sinks daily) floors as the rest. Clean hallway. Clean desk tops and counter tops as needed.(waxed once per week.) Dust all fixtures as needed® Clean and dust walls as needed. Clean tables, counters and chairs as needed, Maintain entrance ways. Dust m3chlne tables in main offa~ces as needed. Cleaning $160.00 Supplies 11.00 Windows 6,00 TOTAL $177.00 We feel after looking at your place of business that it is in poor shape and would take quite~a bit of work to get it in shape. We feel it' could look much better than it does now. We also feel that it needs an initial clean-up. We feel we could do the initial clean-up for $2.00 ~- A ~ ,~ • STATE QF IDAHO a ADA COUPdTY CITY OIL' MEP,IDIAN 7~~ Meridian Street rleridian9 Tdahoe 83642 ~f L}111 i;. :. if~IlC~k 3~ ~F~~~1ldtlllR llIl lj lh~'IC Ills ((ii .~(.1L,~' I:i ,. ~ ~'.' ~ l~~ '1 ~: ti(~I?a~ 'I'. ~n.,~.ll(nill III ifi:• .: ~'4~J.'JI?L, ~~~~il~rl~~l•.. i„I~`,' ~`I~~_ .11:1 f1 (~f C11C1: lUlll flY IfIC ICb CI>C ~.' I° .I ., ~ ~. ~ : .. 'l'.'I ~. ~`!i`Ill: ,, i~ ~',_~ h.` ., i'~~(~i ... (1) Application is hereby made for a license as a- _____ e ~ i l~ / _ _ ~ Da INSERT: a Retailer, or Package vendor only of beer and fee in the sum of $ ~~ ®d _~ _-___ is enclosed. ( Retailer- ~100s00 Package Vendor- $2500 ) tVame of Business-6~~~-~~ ~l~f~rrrlidr~Address- -- - --- -a- Name of Applicant .~ ~d.~ ~~1~t L(_ __ _..._____ ~`ype of Business -~/rra~iUi~vd ~ - - . INSERT: CORPORATION, INDI VIDUAL.PARTN ERSNIP. ETC. Address of Premises ~Pv~~~k. ~~d - STREET CITY COUNTY (IF NO STREET ADDRESS. GIVE ACCURATE DESCRIPTION) (2) Premises are (check one) : ^ Owned ^ Owned and Mortgaged Amount of loan secured by mortgJaged $ -.__-__; ~' Leased or ^ Rented Owner of building is (~~_r'-.1~Q2 ~~~ -~~-~~~~ ~~c~~.a~.~ NAME AND ADDRESS -- Person halci-ing mortgage on premises is__ ((,~ NAME ANO ADDRESS - - 3~'j Fixtures in the premises are of the value of $~,1~~.~ 'J- and are (check one): ^ Owned ©Held on Conditional Sales Contract ~( Leased or rented %f fixtures are held on Conditional Sales Contract or are leased or rented, the owner is: NAME AND ADDRESS If applicant is a partnership, the names and addresses of the other partners are: Corporate applicant must furnish the following: Date and place of incorporation___ --__._-_- Registered office _ ___-__ Name of Manager of corporation ___-_ _ ____ _ _____ Manager of corporation became a resident of Idaho on Names of all officers and board of directors of corporation If wholesaler, address where records are kept Recommendations ( 6 or more residents of Meric ~ ~s`lv /..~' ~~,~. `l3 ~ ~" ~~si 0,~~~`¢,~ ~©3~ ~ y c .~~~~~,, . ~~~ - - ,dam DAre ~ired)• ~ ~~/~ ~i~~f7/1I ~~ ~T'~l'Y'IaR~d~l~lY° ~ai~1® ®e~-TFa ®[~ ~ERSOi~IAL QUALI~'ICA~101~1~ ®F 6~PPLICAIV~' STATE OF IDAI-i0 l ~S. County of Ada O a, ~//~~~~ ` ~ ~--~ L l ( ,being first duly sworn on my oath depose and say: That I reside at ~~~ C-dl~pLA~Qac~ l~Y 3D /S ~ ~~,~ ;that I Street City County became a bona fide resident of Idaho on /-~T r~`/ ~ v , 19 ~~; that I am connected with the above-named applicant as: ~ owner ^ Partner ^ Manager of Corporrtio~~ That I now hold United States Internal Revenue Retail Liquor or Wine Dealer's Stamp No~.~Y~ or Malt Dealer's Stamp No.-~ (if none, write "none"). 'That the following is a statement of the occasions within the past three years, upon which I have been convicted of any violation of the lau s of the United States, the State of Idaho, or any other state of the United States, regulating, governing or prohibiting the sale of alcoholic beverages or intoxicating liquor, or have within the past three years forfeited, or suffered the forfeiture of, a bond for my appearance to answer charges of any such violation: (If none, write "none"). Date of Arrest Place of Arrest Charge Disposition That the following is a statement of the occasions, upon which I have been convicted of any felony with- in the past five years or have paid any fine or completed any sentence of confinement therefor within the past five years: (If none, write "none") . Date 7o~f Arrest Place of Arrest Charge Disposition ~-~-u-'~ -P - - - -- ------ - ----- That the following is a statement of the occasions within the past three years when my application for, or my license to deal in beer or liquor have been refused, suspended, or revoked. (If none, write "none"). DATE OF REFUSAL, SUSPENSION OR REVOCATION REASON FOR REFUSAL, SUSPENSION OR REVOCATION That I am a citizen of the United States; (if naturalized, give number and place)~~~ (If wholesaler cross out the following line.) That I am not an official, agent, or employee of any distillery, winery, brewery, or wholesaler or jobber of liquor or malt beverages. Signature of Applicant. Subscribed and sworn to before me this ~y of _,19 ~s~ 1~Totary Public, State o daho. r (SEAL) Residing at ~~ ~e~l~~ ~.~~~~~leBA~°e i1~E $~i€i t~9Fl~e4~3'"a•;~.ea;.i t~,S"77~P .« ??~L'r:~ ~'Pf+~1 a`?3c: t::yF„3Ssdd~:~~? ~7''{~T iSSAjJTiSO%181~~3r3'~ ~®S ~C.y~ f;R1~Y~ $1`dQRl ~QSd2.~tF'~'~t (lri~q "~~ ::i",. r'`i,a r ~, ~6=~i;S,r4a3'1?U, ~n~„ ,~a'~G'~-. ~_: ~i:,•~ do `~