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Home My WebLink About06-244 R E V I S E D JULY 25, 2006 06-244 RESOLUTION (CARRIED__7-0__ LOST _______ LAID OVER _______ WITHDRAWN _______) PURPOSE:APPROVE MISCELLANEOUS CITY LICENSES INITIATED BY:CITY CLERK WHEREAS, an application for a license has been made, fees deposited, and all legal procedures have been taken as per Ordinance of the City of Oshkosh, NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that the following licenses be granted: SPECIAL CLASS “B” LICENSES ORGANIZATION & PERSON IN CHARGE: DATE, TIME & LOCATION ? VFW FLORIAN LAMPORT POST 1908…………………………July 25 thru 29, 2002006 th Person in Charge: Gregory Postl 25 / 7:00 pm – 12:00 am th th 26 thru 29 / 5:00 pm – 12:00 am th 525 W 20 Avenue / Orion Hangar 442 Monroe Street Event Name: Orion Hangar Dance th th OSHKOSH NORTH BOOSTER CLUB……….………………………….August 5 & 6, 2006 Person in Charge: George Zinth 1:00 pm – 5:00 pm Menominee Park / Gazebo Area Event Name: Fleet Farm Midwest Fishing Tournament WINNEBAGO COUNTY FAIR ASSOCIATION……………………… August 7thru 14, 2006 Person in Charge: Thomas Egan 9:00 am – 1:00 am 500 E County Road Y / Winnebago County Fair Grounds Event Name: Winnebago County Fair th th th ST. RAPHAEL CHURCH………………………………………. .August 11, 12 & 13, 2006 th Person in Charge: Amy LaCosse 11 / 4:00 pm – 10:00 pm th 12 / 4:00 pm – 11:00 pm th 13 / 11:00 am – 5:00 pm 830 S. Westhaven Drive Event Name: St. Raphael Church Picnic th th ST. JOSAPHAT CHURCH……….………………………….August 19 & 20, 2006 th Person in Charge: Steve Patri 19 / 5:00 pm – 10:30 pm th 20 / 10:00 am – 6:30 pm 1333 Walnut Street Event Name: St. Josaphat Parish Picnic ? Indicates Revision JULY 25, 2006 06-244 RESOLUTION CONT’D th WINNEBAGO COUNTY FAIR ASSOCIATION……………………………. August 20, 2006 Person in Charge: Thomas Egan 1:00 pm – 11:00 pm 500 E County Road Y / Winnebago County Fair Grounds Event Name: Winnebago County Fair OPERATOR (BARTENDER) LICENSES (EXPIRES: JUNE 30, 2008) Anderson, Michael J., 1002 Waugoo Avenue Clark, Perry R., 1848 Ashland Street Cleveland, Matthew D., 1830 Lake Breeze Road th Chantelois, Kris M., 217 W. 15 Avenue Davies, Laura A., 1016 Oregon Street, B th Demler, Terrence, 857 W. 11 Avenue th Felker, Sean A., 242 W. 14 Avenue th Foresta, Christopher, R., 1625 S. 18 Street, Manitowoc Fredrick, Daniel C., 3823 Summerset Way Hayes, Ryan AJ., 817 Wisconsin Street Hazen, Heather L., 1744 Ohio Street Lofgren, Melissa A., 319 Baldwin Avenue, A Kasuboski, Lisa M., 1533 Jefferson Street Kohlman, Matthew P., 3734 Summerset Way, #10 Page, Julia L., 1020 Vine Street, #204 Porath, Tera L., 123 Keaton Court, Omro Ruechel, Adam M., 1633 Swan Road, #4 Ryfinski, Chad D., 2600 Shorehaven Lane Schutte, Denise A., 3048 Jackson Street Sonnleitner, Donna M., 1334 Cedar Street Villars, Douglas C., 817 Wisconsin Street Waterhouse, Rhiannon R., 217 High Avenue TAXICAB DRIVERS LICENSES (EXPIRES: JUNE 30, 2008) Doyle, Patrick A., 9430 N. Oakwood Road, Neenah Schultz, Gary R., W6661 Firelane 6, Menasha TAXICAB LICENSE (EXPIRES: JUNE 30, 2007) SPECIAL DELIVERY PEDI-CABS th 347 W 17 Avenue (Two Pedi-Cabs) NOTE: RETURN TO CITY CLERK WITH LICENSE APPLICATION AND ATTACH MAP REQUEST .FOR S ~,~:~~~~~~~tMh&ft~~~~~~~;;~:~~~;~%~~:::~..~NSE ..::::::~:~~:::;::.:...,. ....:.::::::~:~:~::::::... . ..::~:m::::::'" \).. ":':::1'::~'::-" 'tJ ~ ..:::::::::~,:,:" r ~..,:........:.::::::::::;::.::...,.:,\." '. : :":" NO":':':':':" ifW"':':':':':':':':':':~:i:'J~f:"'" . '.'.' L:::I:O:G:Z,~~ ~~l pv_ .... "," . ..::::::~~~~~~~~~~~t~~~~~~~~~~~~~~~~~~~~~~~::- '::~~~l DATE(S) OF EVEl """{l,.~"", 7--..... ~, .. ,. . ,.". -. ,. ,....,.".. ,.. ..,... .... , Jjll:[:![1:illl11:ij:ll111!!11:i[i:l!I:~:f:::::::::::::jlilli:l1;1;~ DESCRIBE AREA{HE~.lll~D At CONSUMED 1..1-(.. .oR 0'\<:1'-" I' ".:-:.:.:.. ..:~:~t:::.. 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DATE SUBMITTED: 7- 6 "06 ? / --"J BYL~-:. . ..~~-..-'._ ~7- /f/' ;~~"/'_''''._- RE: B: OFFICE FORMS\SPECB.FRM ;; / en a; ::: ~ ~ ~ I~ II ) ~ w n f-----iJ Ul J i ~I ~ I ( ~r ~I r-- 1\ =r -------' W 5th Ave I (/) Bismarc~ Ave ~ ta 81 ~ \ W 8th Ave 'W 9th Ave -- --:-o-:---}J--.J W 4th fove ".. \ I Osh~osh Hilton and CoIlIl8~on I ~_____ ~ ~~~ '~e r.; v~ ~Icolle ~ '" ~ I Osbdm Ave I I laaaer In Harmel Ave ~ _ '0, (/) W 19th Ave (; ~ Eckardt C a 111 u.w 20th Ave) wI J /---\:'.> /r\'1 r Indi~!J r--- .1 W Waukau Ave I ) Howard Ave ! ',-_ Riley In _/ ,~\ B:J..... iV'-:' ~ :x:: I lond~bY-ef---/ij 'tJ 0:: Qj ~ W ~ c :..:: r---,...._ I I l, ~ 'IV 1 EJh jA.ve w I -I III U5 ~~' ~ S ~11525 W 20th Ave I' .!::! ~IIOShkosh. VV1549011 ~ ~7~ Q5 I 1)"'1 \ ~ _! \-E1 j \ 0 ',~ / \:2:1 Orion Hangar- -' \\ I \ 1- \ '. '. ...- Streets98 W 10th Ave w ~ 111 '!; ~ v. Gi .... '+ E 9th Ave I i ~' <11' !Pi' .@ Oji I / H Ie; V 11thAe W12thAe r ~ 1/1 14th A e en - CiS ] u: 15 ~ Iii c o 'g 0:: c 111 ~I I Ci. W16hAve i o W 17 hAve fi. I / // // "-- \ \ \ \ i / / ,. I I ql hi W ~. ./ " ,,' /~---- / I ! I i I \ \ \- \ W 21 ~AvJ ~.\ ( ..:; !8 \ ~ W 23rd A1 \,(1. /W 24th Ave \ i I 'I x( liW~hA~ ,~\ \, \" ~-4::- ~ ~I co1 I L .... Q 12 Iii all :2:L I -- Om 0.2 0.4 Copynght C 1986-1997, MICrosoft CorporaliOO and/or ds suppliers All nghls reSlllVed Please VIS~ Oll' web site at hllp:/Imaps expedlS com ~ t--l\Ve / ~-~../ I CI)! '------if trj,1 "-"--l ---------- Cove In ~~ ~i~\ "" ____v (l ~ ......., 0,6 0,8 Page 1 NOTE: RETURN TO Crrv CLERK WITH LICENSE APPLICATION AND ATTACH MAP REQUEST FOR L ~~~;,;I~~~!~'iiej~t~~~~,GAHU~N . FOR ',',',.,',',', . .:;::~~{Wi ~~::;: :;-" :.: .~-::;:: :~::::::::: :~~\i~j ~~~~ i ~~}~~~ i~~~~~~miri~~::::::" :;'r;.;.... - '.::; ::: ~ {i~;~ ~::::" ::t:}/ Sp,~n~ft:~::I~~~::!:[.:e:::~~5~NSE::tt. AiVA:lldlllllli:iii\III.llilli \\. \\ \ NAME OF ORGA~Jj~TI.III~~;;:i~~ ~S\8" ::::{ ':}:II'::::'::::::'::::'::}{::::}}}':" ,./i ,.:{::}}:{:~::::::::::::}}:::.,.,.:,.::: '::k::":. .:;:;:/ :::::;::::::" .:::;:;. -}:;..\:::::;:;:;:;:;::;.' .,::::::(/ .:::::::::::;:;:;:;:;:;:;:;:;:;:;:;:;;;:;:;:;:;:::::;;;:!ttb. \:::' LOCATION OF E-&NT m:iit:tii:~~~ cillll'{i;IDWE c-,.C"!;c DATE(S) ~F EV~~ .!i~~~~:ai~~.,,:-"!Ii' ~~- :s ~~~~~.I(I.!~;:;(:tO\\:: ............... -. .................. ............................................ ..............-.......................... ...................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................ .................. ............. ....n............ ................. .................. ................ . ... ............. ...................................................... .................................................. ......................................... .....................................-....... .......................................... ............ ....................... ......................................... .... ............................ ............ .................................... ...... ....... ...... .................. ................... ................... ... .-............. ...............u. ................... ................. ................. ................. ..................................................... ..................................................... ....... ....... ......... ...... ..... ........ ... ..... ... ..................................................... ...................................-..-..-........... ................................................... .. ... ........................... ....... ... ... ..n.............................. .. .. .................................. ... ... ... ... .. .. ... .. ... ..... ... .. ... ... .. ... ..... ... .. ... ... .. . . . . . . . . . . . .. ..... .. ... ... ... .. .. ..... .. .. ...... .. ... ... -.. .. .. ..... ... ... ...... ..... ...... ......... .. .. ......... ........... .-.. ... ... ... ......,. .. ... ..... ......... .. ... ........ ... .. ... ... ......... ... .. ... ..... ..... .... ... ....... .. [j:E:SCRIBE WHA TPRECAWTIONS W!i~~ BE:::::(AKEN TO PI3?VE~f SERVicE AND/QR ........ ........ .... ... .. .. ...- ...... .. ....... .................... ... .... .. .. ... .... ................... .. . ................. ............ ... ... n .... ...........n... ......... ............... ........~... ............. , ~........ ........ .......'..... I ...'...... '...........'. c...':, :'" : ',. , .: : :,' : ','., : ,::.::: ::: /:.: ,. )::>" :::{i :. : :',:, '.:.R:>;=..,.: " ::"': :::' .:H:, ,:: : :::::::::::: :::/. :::::: ,:, . ,..' : :,: : .:': ,:. ' ,.:. .,: ::': :::.:::J? :.:' :,:' ",:,: : ,.' ',': QNSUMPI:lQN,Qr...B.EE.,. .ALCO,.,QL.TQ,..IJ.NDERAGED.",.,.ERSQNS ..................'... ...................... .................... .. ...................... ...........................~...... ............................. ....... . . . . .. ........................ ........................... ...................... .... .. . .......... .. ........ . '" ......... ....... ..... ....... ... . .......... . ....... ,. . . .. ........ ........ ....... ..... ". ...... ........ ... .. .. .... ...... ............. .. ~. '\ {J 1\.1 . 1\ t1 ~\/\/ l:~ I:';' e\'\C~'. ~<\. ,.,. ~. ~'^.. ,.,....V~... -~ ~'s... \..~'-'\.\ ~~0 ~~C'\-~A - ,,~.,~ ~VQ~. " S . \.~.~~ ~,~; ~:~~~~:~~~~:~~~;~~~~ ~:~ ~~\~~- ~..~'\~; ~:~\~('~ DATE SUBMITTED: 0-12 -f)~ - --:--- By: ~E> (\(\'\ \ "'<)\'1\ '-- RE: B: OFFICE FORMS\WAIVER.FRM c ~ 0- -7 -----.----- '---..-.-" --.. --:, NOTE: RETURN TO CITY CLERK WlTH LICENSE APPLICATION AND ATTACH MAP .:::;:~~r ..;:;:;:;::.' .:::::::~.' ~ c!J ...:::::::::Jf:~~::rt?:::" . '.'.: :.::::::::~:~~:~t~:~~:~~:~:~:~~:~:~:~::::~:::::::::::::;:::::~:~:~:~~~:~:t:~;~~:~f~~~~~::::::::::"" . :~:::;;:::~:~:;:::~::~~;:::~:::::::::~:~:::::::::::::::::::?::::::::~::::::::::::;::~~:::::;:::;:::~::::~:::~:::::::::::;::::::::;~~:~:::::~:::::::;::::::::::::::::::::::::;~::::::~::::::::::::::::::::::::::::::::::::::::::::::~:::::::~:::::::::::::;::::::::~:::::::::::::::::;:::::::::::::::::::::::::::::::~:::::::::::::::::::::::~::::::::::::::::::;:;::::::::::::::::~::::::::::::~:~:::::::::::~::::::::::::::::::::::::::::~::::::~:~;::;:: .... .... ..::::::::::::::~:~~::~::::::::::::::~:~::::~::::::::.. ..::::::~;:::~::::. ~~~ ~I~~ i~i~i ..::::f:~::::" ..:.:::;~::::::::::::::::::::::::::::::::~:::~~::~~:::::. ;:::i:~::::"":' ~~* )~~~ OeSCRIBE W:HAT PijEcAOTIONS will a:ft~l::TA<<:EN TO PRt.VENT iSER'.(1CE AND/QR t~;t:1EE:t1fst::~tL.mm...tj. ~,....... ... ........:~:}~:i?...".... "if~t...,....".... ..... ':~:I:~r:~:v"'"'''''' "\{:~z0"""" ,..., '::~:~~p?:fW.tJ:;l!'(;}:"':i{t~:::~r''':$'''''':@:;::K''''''....... ....., "....}:?;! ............ "..... -=-~::::::~::C2::~::;:::~:::~::::;;>::::i~::::~:~::::::a~:e:;:::;::r::71~q;i::15;::::::::1:;::::::~::::::::::::~:::::::~::::::::::::::::::::::::::<~ . ~ S<2rve.s. )z-nFQ )s;fm'P;,: J1Y/~~'JJ~Jl{-.I;L, OkY &e.rY~6(2t/e -kId To L2.st J:v- U:L TV.s ,",,', Ptfl'Jer\S L ~c.e ~e 'r aM 01'1 <e-- ~jo, /" eLI'S' () cI ~ 4-Ade.r ---;;< e {2ht&- 0 r /P~ W~ h&/Q/ hCL- ' !/~t/ h.4.J Nt /ho~ C.;7 ~ ?tlZ?(UeM> . /6!,;:o (:: /1' ~ "- cI c.Q~u.1 (S A"'.,{;; e/ DATE SUBMITTED: ~/;r~~ BY:~#~ RE: 8: OFFICE FORMS\SPECB.FRM ;. , NOTE: RETURN TO CITY CLERK WITH LICENSE APPLICATION AND ATTACH MAP REQUEST FOR / WAIVER OF' ~~:!':!,S.!~:~)f8B,BEER GARDEN No CAI3~;y4N:S:TN A.'CifV::PAJJK .:ii':.' :,:}:'::"..~f{.&.R~i;:.::\..:" "',:<\::, ".i/:' S~~~!~.~I~g~.:I.tf~.J;.;lqENSE:::. -.." ................................................................................. .... .......... ............................................,..............................................................'........................................................ ........ NAME OF ORGANt'~ Tlo~i.ljj;jj!:~:!.f.h~:\~..:..:.,j:!~ljl:!jljiLJGh .... ..................... toil .,...,................. ..., ::j}?" ;:[fmtr~jr~tt~itrtMrr~::::.. ~.:- . ..;::::f}~t:/~~~~~~~:~~{rt{(~\t\ '::~{:: LOCATION OF EjtNT,jj!ii!:j~: ~~j!j:jj{ ~a ~ DATE(S) ~F EV~: ~6 \1-11' Z--'~m ...... ........ .....................................................-............................................... ......... ..... ..................................................... .... ........ .................................................................-............................................ ......... DESCRIBE AREA Wf~:ERE~~~~r~~~I~:I[~!J~~!~:-:~1:wfM1f.JlSED .~ND CONSUMED ~~ ~~'~~:NNNrI&tJ - .A \. \ ~ _. f (.:.:::?/Yt..<:::.H,.,.,.c:::;;:2:::::::/:f:'d::::"" _1-\_ . ~."--L- ~v ~ i .J ~:,eX:5ts;;;n\.. \...Y'\. '-f\.LJ . ............... . . ...... .................................................................... ...... ....................... ................................,...................................... . ........ .......... .-.... ..... ... .... ........ ..... .......... ...... ............... ..... ....... ... ........... .... ........... . ...... ..... ......... ... ..... ........ ..... .... ... ..... .... ... .......... .. ...... ..... .... ...... ..... ~(i:~..~::~. :('~;:~;::;;::... .'...H..H'........".,',.,"",...,.."....".".,',..,."..,.,. ,.."".""""H'.. . . . . . . ... .. .................................. ..................... ............. ...........................,..... . ... -.................. . ......... ..... .... .. .. .. ... . ... ..... ..... ...... ..... ..- ... ... .. .... ....... ...... ....... ...... .... .. .. ... .... ....... ...... ........... ........ .'" ... ... .. .... ......... ....... . ........ ......... ... .... .. .. ... .... ................... .. .. ................. ............ ... ... .. .... ................ .......... ..........,... ........... ............. ......... '..'..'.= I " '~ C:, :,:: . " " :: ':: , ..'.. :.PT::,.. ii..... ,}:BEE....: ..,:...': >. :::.'. :.::'.. ::. :.:>, ":":}': ',::,. ./:::,:, ... , > ,. .:.' .:. : :.-:. :: ,':': ::. ::=::,8 :.:: ::: :':.:....::: ... '..::, ..0NSUM ,..,...IQN...0E"...,..., .R .ALCQHOL..TQ,..UNDERAGE.D..,..EBSQNS . ... ~ ... ..... ... ... .... ... ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ...... ... ........... ....... ... ..... ...... ,. ... ... ... ... ... ... .. ... ..... ... ... .. ... .., ...... ... ... .. ....... ..... -...... ....... .. DESCRIBE WHA T:PRECAWTIONS wO! BE:{(Ak.~N TO P5EVENT SERVICE AND/qR ............................. . ............................ . ...................... . .............................. ....,.................... .................... .... .. . .......... .. ......... ... ......... ....... ...... ....... ... . .......... . ....... .. . . .. ........ ........ ....... ..... ... ...... ........ ... .. .. .... ...... .... ... .. .. .... . .... .'. ......... .'. .'. -.' '.' '.' .'. .' ..... .'. .'. .'. '.' 1L '.' "".~., ,'. ,', .,. ..'. '.'. ,',. .,.,.. ,',' ',' \ u~~!"~)kbkty~'LGJ1} ~.~&'l-tvr ~ ~t~t' ,~:~~ ~~~~~(J701 -ii0 j Yl\ 1 J.J \ & \JUt1-. We . l>.JLlt! &\s;b ,~ -ti\L. V\V\\2-~ 0 (~J-u j2~IJL 0(f'U!<1 & I ~~ l JvlcJYLi~ -fA IV . DATE SUBMITTED: OS!t>>f'oc, j} ~ ~ ..}-- U~ :Jzcfl rJ-f.f' RE: B: OFFICE FORMS\WAIVERFRM ~~ z o ~ ~ o (/) (j ~ tTJ \D M0- p-- ~ ('0 E ('0 t:l::r::~ c:>tI1 <tijcn tI1z';3 BoY"' ) ~to totTjtTJ tTJ?OtTJ ""OtTJ~ rt::d~ ~~g] ~u~ o~~ pO r n ~ ~ .. NOTE: RETURN TO CITY CLERK WITH LICENSE APPLICATION AND ATTACH MAP REQUEST .FOR SPECIAl..,.~!A,$.~::,>>:,:.,P n LICENSE .,:,::::::::~~t~:{:[~~~~Ji~{:~~::~::::::::::::::::::':':':':':':':::::::::::::*::::::::::Jt~~t:i~h~~::~~tt~::::::"" NAME OF ORGA~I~~~~i,~' .::::::;:.:" ... '::::::::.. .:::~:~::" "::~:~::::. LOCA Tl0N OF EVENT :::~!~t .~~~lr .::~:~:~~ .::~~~~~~~ DA TE(S) OF EVE~:IT .:.:." ;.:=:.:-. ...~ ~ DESCRIBE AREAtHE~~:ll"D A~ CONSUMED Beer/Wine willlbe dispenR;.Wf~J.5i!:i Jf~~t up in the largf/d: tent and :~.:.:.. ..,:.:~::.:-:.:.:.:-:.~.:.:.:.:.:.:.:::.~.:-:: . ..................::::~:::;::.:::-:.... .::::~:: consumed at tabl:'1::,~nd :t!lllfli'I!,..,.,.JIIII~r::::::'~I!!:.:~~:~:~::~::!!~~!Il::umb~r~a tables next to the tent. ( See Pi'~'~~, ar':~~iIIIIIIIII.;II';'lllIill~"~'"il'flll~II!)lllf!IJ~;W~::;.. Af1~~Ji~lt "::;:~~~t~::.:.. . ....;.~:::;::::::~i{:*~~~~~~g~~;~~lj~~~J~~~~~[:~f::~~:;~:;::::..., . ..:-::~j~;~:;'" '-:';';':':'.. ....,..,:".:.:,:,.~:..;.;..l~-:.. ..:.:::;::~*;~::::::-:..... . ":'::::::~E:r:~~~~:~~~~:~:~~:~~:~~:E~~~:~:~:1:~:1:~:~:~~:~f~@~~:~~~:~~~~~~:~~~E~~~1}l~;::'::;':'''' ::::~::~:~t:::~~;::::::~;:;:::~:::~~:::::::::::~:~:::::::::~:3:~::::~~:*:::~~:::::~:~~::::::~~*~:~:~t;:::~;:~:~~~i~:~~:~::::~~::::::::~::::::::::::;:;:::;::::::::::::~::;::::~:::~::::::::::::::::;~::;~;::::::;;::::::::::;:;::;::::::;:~::::::;:::;::~~:::::;::::::::~:;~:::::;:;:::::;::::~:::::::::::::;~::~::~::::::::3:::~~:~~:::~~:~::::::::::~::::~::~*:::::~:::::::::::~:::~::3~:::::::~~:~::::: ,4:::ri:i:i::~:'~::~::~~::~:::~\\~:.. .Af'~::i::::' ii ti ~~i ..;:~p:::.,. ,::~:~:::~:::i:;:::~::~;::::::::::::::~~::::~:::h, <-f~::;"w ~f1: ~~ DESCRIBE WHAT PReCAtJTIONS WIlt. 8ft'TAKEN TO PREVENT /SERVlCE AND/OR t:1,1EEN~t~1J 11 ::.:::.<-.....~"::- ~~\" ~ ::: ~: E:~ .;:::: ~ .-:~:..:.....:..,::;.. ::: <:;; ................. .'. .;, -:. :~ ::: :;:........... l :~~: ,l l\ .......f...... r.......... ~r........\ ::: :::............:. .:.....'...... ::: ~: ~i~ ~~ \./ '~:i:: /t........:\. ~1 t~:~~~~~~~ ~~ "\~:. Both co-managers in the beer tent will make sure all the approved temperary bartenders will adhere to age regulations when serving. If th~e is any dought an identification card will have to be sholm. DATE SUBMITTED: 0-5 -{){P By: J\J..\Y 3J 2CCb ~ 9-P~ RE: B: OFFICE FORMS\SPECB.FRM .' " ST.J05APHAT PAR\SH PICN\C . AUG. \ q ~ 2.0 J 2.006 'NOTE: RETURN TO CITY CLERK WlTH LICENSE APPLICATION AND ATTACH MAP REQUEST ,FOR SPECIA~.....!;!..A~~:::::~:.:,~.n LICENSE ...-.................".......................0:................-................... NAME OF ORGANI~"m~, ' "-- ::::::::1' LOCA TJON OF EV~NT .;.:.$:. ........ :::::~~EO:R:fE~~_D At CONSUMED o rJ\ J---V\~_J .~.. 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"\ =* }' l::;o .......f..... ~r.......... ~r......\ LrJ \~ n ~ cJ~i:..ci1;~J(d. j~ ~;..~ ~:::~ -e f\i~.~6~i~.)) .h~~~~ L~cJ +0 lCLxrl--tt JOt.) ~" , . ~~ LA ~d:- l~ h:J /JurJ)' (C) t!;;J'1-5?SS- (&:>),;J31-0;?-?o rUD~ tt WI'}hJ:J.t 0 ,).OJ,f.!JLMlJ , b'+fi. {KdJi ~i(i"M ::::c'vv~ t tA(Mb-:O.l~ ~ w~o /Je;/m t)~d /AJ/1h DATE SUBMITTED: (y ) R/d0 By: r:;~ IblU~df . RE: B: OFFICE FORMS\SPECB.FRM "