Filing Letter to Board in Response to M Bennett Email with Exhibits 12 02 2024

Page 3 PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER !zed.33- g1 -@J The following questions identify information about the licensed premises. This describes the area or place which is to be licensed for the sale, servic€, consumption, delivery, rec€ipt or storage of alcoholic beverages. ll the license is inac{ive and NOT SITED AT A PLACE OF BUSINESS, answer question 3.1 only, entering N/A for "not applicable.' !f you use N/A as a response to question 3.1 , question 2.2 on Page 2 should also be ansu€red N/A.I 3,1 HOW MANY SEPARATE BUIL {l"vk BE INCLUDED UNDERTHIS LICENSE? ! lf more than one building is to be included under this license, a separate Page 3 is to be submitted covering each building An up-to{ate sketch ofthe entire licensed premises should be submitted for inclusion in the State ABC license file. or .{ ro BE LrcENs 3,2 BUILDING NO Yes _ 3,3 IS THE ENTIRE BUILDING TO BE LICENSED? No lfthe anslver to question 3.3 is'No,' specify which floors are to be under license and which ones are nol by answering the following questions: 3.4 Basement Allof it 1"tfloor 2nd noor 3"floor Allof it -YesYes -No No -Yes -No Specify each additional floor number to be included under this license: -Yes -No -YesYes -No No -Yes -No All of it -Yes -No All of it lf only part of any floor is to be licensed, attach a more detailed explanation with sketches to clearly delineate licensed areas from unlicensed areas. 3,5 ARE ANY GROUNDS ADJACENT TO THE BUILDINGUNDER LICENSETO BE INCLUOEDAS PARTOFTHE LICENSED PREMISEST l/ ves 3.6 IS THERE ANY UNLICENSEO AREA LOCATED BETVVEEN BUILDINGS UNDER THIS LICENSE OR BETWEEN LICENSED ADJACENT GROUNDS? -No\-/ --..........- Yes -/ uo IF THEANSVVER IS'YES,'ATTACH ASKETCH OF THE LICENSEDAND UNLICENSEDAREAS SHOWNG OIMENSIONS IN FEET, 3.7 DoES THE AppLrcANT o$N THE BUTLDING? BUILDING? DOES THE APPLICANT LEASE THE BUILDING? y'v"" YES IF "YES,' IS THERE A MORTGAGE ON THE -TES tto ---E,NO /NO lf there is a mortqage on the property, answer question 3.8. lf the licensed premise is leased, answer question 3.9. 3,8 MORTGAGEE (HOLDER OF MORTGAGE) (Last Name, First Name, Middle lnitial or Corporate Name) Street Address Slreet Name Number P.O. Box # _ State Municipality zip 3,9 LANDLORD (HOLDER OF LEASE) (Last Name, Firsl Name, Middle lnitial or Corporate Name) -- Street Address -

porate Name) Street Address Slreet Name Number P.O. Box # _ State Municipality zip 3,9 LANDLORD (HOLDER OF LEASE) (Last Name, Firsl Name, Middle lnitial or Corporate Name) -- Street Address - Number Municjpality P.O. Box # zip - Street Name State