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1. Name or names and address or addresses of the person or persons applying, if the applicant is a firm, the name and address of every partner of the firm and ifa company the registered name and address there of; the names of the Commissioners, Managers and Managing Agents, and if there is a Managing Commissioner, his name. |
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2. The name of the place and the site on which the building or buildings housing the Manufactory is/are situated to constructed; the following particulars, with distinguishing letter or number or letter and number of each to be furnished
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3. Approximate date from which the applicant desires to commence the manufacture ofcountry liquor. |
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4. The number and lull description of the vats, and other permanent apparatus and machinery which the applicant wishes to set up or work, or has-already set up (give distinguishing letter or number or letter and number of each). |
Place ..................................................
Dated ... ..... _________
Signature's of the applicant's