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STATE OF MINNESOTA <br /> Combination Application for Retailer's (On-Sale) (Off-sale) <br /> Non-Intoxicating Malt Liquor License <br /> <br />To the C.{tv o f Rarrlsev County of Anoka <br /> Name of license authority (County) (City) (Village) <br /> <br />of e~-7~JC~z~, , State of Minnesota, hereby make application for'a Retaileds (On-sale) (Off-sale) Non-intoxicating Malt <br />Liquor License to sell such Malt liquor under and pumuant to an ordinance (resolution) passed by City/Village Council, County <br /> <br />Board of ; and Chapter 340, Minnesota Statutes 1945, as amended, providing for licensing and regu{ating <br /> <br />the sale of non-intoxicating malt liquor. <br /> <br />During the pazt five years, my residence has been as follows: <br /> <br /> was bo , 1.1114 ,at <br /> <br />Month Day Year City Village <br /> <br />Burrough Town State or Country <br /> <br />[ am a (native) (naturalized) citizen of the United States. <br /> <br />[ am roamed. My (wife's) (husband's) name and address is <br /> <br />[ am (proprietor) (manager) <br /> <br />Firm was incorporated <br /> <br />in State of <br /> <br />Corporation is authorized to do business in Minnesota. <br />L cens for . ff Loj <br />follows: <br /> <br />(street) (highway) located as <br /> <br />The license will be in connection with <br />which has been in operation <br /> <br />The establishment is located on the <br /> <br />The taxes on the property are not delinquent. <br /> <br />Months Years <br />,/('~//~ floor. The business premises are owned by ,t~.5 c~9 <br /> <br />I am ,/~///k~ engaged in the retail sale of intoxicating liquor. <br /> <br />[ have had an application for license rejected az fellows: <br />I have never been convicted of a felony nor of violating any National or state liquor law or local ordinance retating to the <br />manufacture, sale or transportation, or possession tbr sale or transportation of intoxicating liquor. <br /> <br />Gambling or gambling devices will not be permitted on the licensed premises. <br /> <br />I am the owner of the leasehold, furniture fixtures, and equipment in the premises for which the license is applied, except <br /> <br />151 <br /> <br /> <br />