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CITY OF I:L~MSEY <br />.4~PLICATION FOR ON-SALE INTOXICATING LIQUOR LICENSE <br />(Corporate Application) <br /> <br />x;kqnoever shall knowingly z%!si~ any answer to the following questions shall be deemed guilty of <br />perjury and shall be punished accordingly. <br /> <br />EVERY QUESTION MUST B E ,CNSW~P~D <br /> <br />1. i, ;,~ u ~ ~'" ,C ~-Y'c~i~', , as art officer of t;he Minnesota corporation known <br />as ~.~m~'.'u 2 k P~c,-4'ne,,,'5 ~7 ~rY'4 do hereby apply for an on-sale intoxicating liquor license <br />and spe~ai Sunday license to sell intoxicating liquors as defined by law at retail only for <br />consumption on the premises wkrich has the following address: <br /> / <br /> <br />and which is legaqly <br /> desc, ibed as follows: <br /> <br />"Fnis application is made in accordance with provisions of Mimnesota Statutes and ordinances of <br />the City of Rarnsey. <br /> <br />-68' <br /> <br />Anach plat plan of area showing dimensions, location of buildings, street address, parking <br />fac{lit/es ~nd the locations of and dimensions to the nearest church building and school grounds. <br />Also attach floor plan of dining room, or dining rooms, which will be open to the public, and <br />show dimensions and indicate the number of persons intended to be served in each of said rooms. <br /> <br />State full name, bL"'thdare and address of each shareholder and officer of the corporation: <br /> <br />N arn~e 7 Bir'thdate <br /> <br />Add-ess <br /> <br />, <br /> <br /> Circle One). <br /> <br />Address ,. ~Officer: Circle One) <br /> <br />Address ~' ~(~.~_reholde-F/..~Officer - Circle One) <br /> <br />Sq~,are. hol~d~r"ficer- Circle One) <br /> <br />(Attach additional sheet if necessary) <br /> <br />Page 1 of 6 <br /> <br />I <br />I <br />I <br />I <br /> <br /> <br />