Approval of Tobacco License Renewal – Dollar General Store #31819 — E-5

7/13/26, 9:49 AM License Administration Start Date : 11-Jul-2026 End Date : 30-Jun-2027 License Fee : 75.00 Types of Sales : Over the Counter Type of Establishment : Convenience store/gas station, Grocery store Types of Products Sold : Cigarettes, Tobacco, Alternative Nicotine Products Do you intend to make retail sales to : Yes ultimate consumers? Do you have other permits issued under : No Iowa Code chapter 453A at this retail location? If yes, provide permit number(s) in the next step: Ownership Details Owner Position Single Line Address BRINING, ZACHARY Owner 100 MISSION RIDGE DR GOOD HARTSHORN, BRIAN MANAGER 100 MISSION RIDGE DR GOOD Suppliers List A list of suppliers for cigarettes, tobacco, alternative nicotine, and vapor products must be included with all retail tobacco permit applications. Applicants may submit this information in text form or as a PDF upload. Local authorities may review this information during the application review process. Super Foods Decision Select the decision of whether you approve or deny this permit application. Can I help? Iowa Department of Revenue will be issuing a permit number if this application is approved. https://govconnect.iowa.gov/TAP/Licensing/_/#9 2/3