application permit · E-4

Approval of Tobacco License - Kwik Star

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11/26/25, 11:09 AM License Administration Start Date : 22-Dec-2025 End Date : 30-Jun-2026 License Fee : 56.25 Types of Sales : Over the Counter Type of Establishment : Convenience store/gas station Types of Products Sold : Cigarettes, Tobacco, Vapor Products, 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 ZIETLOW, SCOTT 1301 7TH ST SW ROCHESTER M REINHART, THOMAS 504 COUNTRY CLUB LN ONAL WAGNER, DAVID W4460 OBER RD STODDARD W Suppliers List Kwik Trip, Inc. Distribution Center - License Number 862100090 & 862600091 Decision Select the decision of whether you approve or deny this permit application. Iowa Department of Revenue will be issuing a permit number if this application is approved. However, the local authority has the option to also issue a permit number. If the local https://govconnect.iowa.gov/TAP/Licensing/_/#27 2/3

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