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17. <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 X If yes, give date and details <br /> <br />I <br />I <br />I <br /> <br />18. <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 X l'fyes, give date and details <br /> <br />19. <br /> <br />Has the applicant any interest whatsoever, directly or indirectly, in any other liquor <br />establishment in the State of Minnesota? Yes No X If yes, state name <br />and address of each establishment(s). <br /> <br />I <br />I <br /> <br />20. <br /> <br />Furnish the name and address of at least three business references, including one bank <br />reference. <br /> <br /> Robert Carlson~ Rema~.3351 Rg. und Lake Blvd., Anoka, MN 55303 <br />Name Address <br /> Stanley bi. dorgenson, 1622 93rd Lane NE, Blaine, MN 55449 <br /> <br />I <br />I <br />I <br /> <br />21. <br /> <br />22. <br /> <br />Name Address <br /> U.S. Federal Cred~.t Union; 6303 01d Central Ave. NE, Fridle¥, fqN 55432 <br /> <br />Name Address <br /> <br />Does the applicant possess an unexpired retail dealer's identification card issued by the <br />Liquor Control Connmissioner? Yes No X If yes, give number <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 X No If no, state <br />details about other occupants. <br /> <br />I <br />I <br />I <br /> <br />23. <br /> <br />Give Federal Retail Liquor Dealer's Tax Stamp Number, if any. <br /> <br />Page 34~f 4 <br /> <br />Applied For <br /> <br />I <br />I <br /> <br /> <br />