Withdrawal Form

City of Chandler — Study Session (2025-06-23)

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Received

JUN Q 3 2025
City of Chandler 25 6 2 li met Me?
Tax & License Division

DILC USE ONLY

Job #: NO wo
APPLICATION WITHDRAWAL Date Recep, vies

CSR: LO

Asizona Dept. of Liquor Licenses and Control
800 W. Washington St. 5% Moor Phoenix, AZ 85007
(602) 542-5141

Type or Print with Black Ink
Job #340168

Repinski Jared Michael

Ant Middie

License Number:

Agent / Individual Name:
Last

Premises Name (Doing Business As-DBA):
141 § Arizona Ave., Chandler AZ 85225

‘Street City
P.O. Box 6252 Chandler AZ 85246

REASON FOR WITHDRAWAL <aaa
Construction delays - plan to refile in a few months

Tap N Taco

Premises Address:
State ip Code

Malling Address:

(USE BACK OF PAGE iF NECESSARY}

Declaration:
|, {Print Name} Jared Michael Repinskl , declare under penalty of perjury that | am

authorized by the licensee to submit this application. | have read the contents of this application, ang to the best
of my knowledge belleve all statements made on thls application fo be true, correct and compet

REVIEW 0 Lr fe
Customer Service Representative e-) Zz

Investigations (Pending Applications) Alte Read #100 L ] 06/03/25

Licensing Manager Quergfer Bensen 06/02/25 |
Liquor Board (Hearing files only)

DISPOSITIONS

C1 Letter Attached C1 intent to Halt

C1] Revoked-Order#, DlApplication Denied #

(1 Reverted-Order# ClApplication Withdrawn

11/22/2022

Individuals requiring ADA accommodations please call (602}542-2999