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City of Grand Junction
webforms@gjcity.org
CO
,
US
Liquor License Survey
Full Name
First Name
Initial
Last Name
Unique ID from Address Label
Do you certify you are 21 years of age or older?
Choose One
Yes
No
The Address on the mailed Notice is my:
Residence
Business
Concerning the liquor license application as described in the Mailer
Choose One
I Support the new license being issued
I Oppose the new license being issued
Please feel free to include any additional comments.
disregard this
