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17. <br /> <br />18. <br /> <br />19. <br /> <br />20. <br /> <br />21. <br /> <br />22. <br /> <br />23. <br /> <br />Has the applicant, during the five years immediately preceding this application, ever had <br />a liquor license revoked or suspended for any violation of such laws or local ordinances? <br />Yes No v/" If yes, give date and details <br /> <br />Has the applicant, during the past five years, been convicted of any liquor law violations <br />gross misdemeanor or felony,., or any Federal laws'? <br />Yes No v/ If yes, give date and details <br /> <br />! <br />I <br /> <br />Has the appl!cant any interest whatsoever, directly or indirectly, in any other liquor <br />estabtisl'unent in the State ofMirmesota? Yes~ No ~'/ I£ yes, state name <br />and address of each establisltrnent(s). <br /> <br />I <br />I <br /> <br />Furnish the narne and address of at least tlwee business references, including one bank <br />reference. <br /> <br />Name Address <br />Name Address <br /> <br />Name ~rs~ ,~,~o,,~, ~,,,,~ ~a ~ ~ Address q~4 <br /> <br />Does the applicant possess an unexpir:d retail dealer's identification card issued by the <br />Liquor Control Commissioner? Yes No / If yes, give number <br /> <br />I <br />I <br /> <br />Are the premises now occupied, or to be occupied, by the applicant entirely separate and <br />exclusive from any other business establishment? Yes ,.//' No If no, state <br />details about other occupants. <br /> <br />I <br />I <br /> <br />Give Federal Retail Liquor Dealer's Tax Stamp Number, if any. <br /> <br />Page 3 o1'4 <br /> <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />