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STATE OF MINNESOTA
<br /> Combination Application for Retailer's (-g}-tr~":r~ (Off-sale)
<br /> Non-lntoxtcatlng Malt Liquor License
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<br />Tothe City of Ramsey Conn~yof Anoka
<br /> N~e of H~e au~ority (Co~) (Ci~) ~lllage)
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<br />I. Glenn S, Keller ,of~eCi~y,V~ge, orTo~of ~1 P~.e~ County
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<br />of ~ ~50 . S~a~ of ~hereby m~ application for a Retfiler% ~ (Off-s~) Non-~xieat~g
<br />M~t ~quo~ Lice~e to sell such M~t ~quor ~der ~d pursuit ~ ~ o~d~ (~olution) p~s~ by City. iLl,ge Co~c~,
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<br />Co~ Bo~dof ~ey ; ~d Chapl~ 340, M~o~ Sa~t~ 1945, ~ ~endM, providing for lic~mlng ~d
<br />regulating ~e sma of non-~loxieat~g malt ]iq~or.
<br />~g~ep~ifiwya~s, myresid~n~h~n~Mllows: 580~ ~ ~dge~ ~
<br />~ 79912
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<br />was born 1/4/52
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<br />Month Day Ye, at City Village
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<br /> Burtough Town State or Counn'y
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<br />I a.rn a (native) (rr~'~31z~) citizen of the United Statc~;.
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<br /> married. My (wife's) 0m~bax~f's) name and address is
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<br />~ ~ t~.~..~> (~) ~esid~t of ~ Cities S~res, Inc.
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<br />F~n~ was m~rated 7/14/94 in S~ of. Delaware
<br />Corporation i~ authorized ~ do busings in Minnesota.
<br />L.icensa is for 'IWLn Cities Stores, Inc. (d/b/a/ Oasis Market)
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<br />as follows:
<br />14550 Armstrong Boulexrard, R~0sey, M~ 55303-7138
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<br />located
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<br />The license will b¢ in connection with Conv~"Lio_A"IC~/C-.-.-.-.-.-.-.-.-.~S S,',',',',',',',','~re
<br /> ~g S~re, C~e, Resmur~t, Howl, Club
<br />which h~ ~n ~ o~ration, . ,
<br /> Month~ Yeg$ '
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<br />Thc ~xes on thc prop~y ~re not delinquent.
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<br />] ~ engaged in the retail sale of intoxicating Liquor.
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<br />I have had an application for license rejected as follows: See Exhibit A attached h~reto
<br />] have: never be~n convicted of a felony nor of violating any National or state, liquor law or local ordinance relating to the
<br />manufacture, sale or transportation, or possession for sale or transportation of intoxicating liquor.
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<br />Gambling or gambling devioe~ wilt not be permitted on the licensed premises.
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<br />I am the owner of the leasehold, furniture fixtures, and equipment in the premises for which the license is applied, except __
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<br />I have no intention or agreement to (xartsfer the license to another pcr~on.
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<br />I submit thc following names of ~r~ons, including a ba~, for reference, wi~ whom I have h~ b~Mcss relations
<br /> ~st B~S
<br />follows:
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<br />I do not possess and will not purchase a $25,00 Federal Retail Liquor Dealers Spe~i~d Stamp.
<br />I dO .,'qot intend to engage in the sale of intoxicating liquor and will have a Federal Occupation Tax Receipt in
<br />accord~.ncc with thc ordinance governing this licm'~c, My Federal T~ S~unp Receipt is No. nr~l
<br />I will comply stricl]y with thc provisions of the ordinance relating to thc sale at' soft drird<s for h~ixin',," p~scs tang will
<br />serve patrons in ful} view of pub}ia.
<br />] agree lo w~ve my Constitutional Rights against sec'ch and seizure and will freely permit peace officers to inspect my
<br />premises a~d agree to the forfehure of my license if found lo have violated the provisions of the ordinextce (resolution)
<br />providing for the granting of this license,
<br />I hereby so]enm}y swear that the foregoing statements arc true end correct lo the best of my knowledge end that
<br />comply with all the provisions of the ordinance under which this license is grante3,
<br />Subscribed and swom ta before me this ~(..~7~ dayof ~/~-~'~-~/ . 199~
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<br />No~e- Lsw~ 1949, Chspter ?0~. provides that appllc~n! must hsYe attained the age o£ 21 ye~s and must ~ tha proprlemr of
<br />the est~bllshment where such business is to be conducted.
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