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Application For Liquor License Form - Board Of County Commissioners Of Williams County Page 2

The applicant herein does hereby consent that the Chairman of the Board of County Commissioners, the Sheriff and any police officer of the County of

Williams aforesaid, or any person or persons duly authorized by the Board of County Commissioners of said county may enter upon the premises described in this

application at any hour of the day or night, and that they and any one of them shall have free access to the said described premises and every part thereof for the

purpose of inspecting the said premises and the records of this applicant relating to the purchase and sale of alcohol and alcoholic beverages, and applicant does

hereby waive any and all rights that (s)he may have under the Constitution of the United States and the Constitution of the State of North Dakota relative to

searches and seizures without issuance of a search warrant, and the applicant does hereby agree that such immunities shall never be claimed by her/him, and that

such search, seizure, and inspection may be made at any time without a search warrant. Do you agree to each provision of this paragraph? ________.

The amount of the remittance accompanying this application is $_____________________.

Dated at ________________________, North Dakota, on this ______day of ______________, 20__.

_______________________________________

Applicant

STATE OF NORTH DAKOTA )

) ss.

COUNTY OF WILLIAMS

)

__________________________________________________, being first duly sworn, deposes and says that (s)he is the applicant who is described in and who

executed the foregoing and above application, that (s)he has read each question and statement therein contained and knows the contents thereof, and that (s)he has

made the answers set forth in said application, and that each one of said answers is true of her/his own knowledge.

___________________________________________

Applicant

Subscribed and sworn to before me on this _____day of ________________________, 20__.

___________________________________________

(SEAL)

Notary Public for Williams County, North Dakota

My Commission Expires:

(Liquor Application 12-99)