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~.a Lis: below the names, addresses and business addresses of each .oerson who is enga]ed in · <br />Mir-':.esota in the 'ousi..',.ess of selling, manufactur,lng, or distributing intoxicating liquor and <br />who is related to the applicant or his spouse closer than second cousin, whether whole or half, <br />blood, or who is a brother-in-law or sister-in-law to the applicant or spouse. I <br /> · <br /> <br />10, On what floor is ~he licensed premises located, orto be located? ,,--/>~ 'C <br /> <br />i ~. rn what zonm~ d:smct ts the orem~ses located? ,~,~zk.)~L~,/ ,~,/~d.,/'"d'/'~'/ <br /> , ~, . , '~. ,~ / . / ' , <br /> is the building located within ,,he prescnoed area f-e'f' such l~,ense? Yes <br /> <br /> Is the premises located c!os,,r than 1,000 feet ~:o a church, sr:de or high school? -- <br /> Yes__ No ?"' . If, yes, 6ire approximate discs.ace of the .premises from such <br /> school and/or church .//'Z.z'V. . <br /> <br /> :e name and address of owner of'building in which the premises is located I <br /> <br /> Has owner ofbuildln~ any relationship, directly or indirectly, with apslicant? ' 4- <br /> Yes .~'"" No ' If yes, state relationship 69~3D /._.~o_/ <br /> _ <br /> Are the real es~a~e* taxes on the real proper'ry on which the licensed premises are located · <br /> <br /> current year <br /> <br /> Has any one a <br /> rejected by any I <br /> date and details. <br /> <br /> ?',: *' o' <br /> Has any one of the orSce, s/shareholders, dur/n~ the five y~ars immediately preceding this · <br /> application, ever had a liquor license revoked or suspended for any violation of, such laws <br /> or local ordinances? , / <br /> Yes No .~'/ [] <br /> If yes, give date and details <br /> <br />12. Is the premises located ~ o. <br /> ~,os,., than 1,000 feet to a church, grade or high school? <br /> Yes No ~ <br /> <br />13. Stare name and address of owner of building in which the premises is located <br /> <br />i4. <br /> <br />15. <br /> <br />-70- <br /> <br />Page 3 of 6 <br /> <br /> <br />