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<br /> STATE OF MINNESOTA
<br /> Combination Application for Retailer's (On-Sale) (Off-sale)
<br /> Non-Intoxicating Malt Liquor License
<br />
<br /> C:?.r,
<br /> t0 Name eT l'eense'authority (County) (City) (Village)
<br />I, [/)a~ ~'..~,,' L#'O~f$ C/~'~/ . of the City, Village, or Town of ~,~q f..~y . ,County
<br />
<br />of,?~,# . State of Minnesota, hereby make application for a Retailer's (On-sale) (Off-sale) Non-intoxicating Malt
<br />
<br />Liquor License to sell such Malt liquor under and pursuant to an ordinance (resolution) passed by City/Village Council, County
<br />Board of~and Chapter 340, Minnesota Statutes 1945, as amended, providing for licensing and regulating
<br />the sale of non-intoxicating malt liquor.
<br />
<br />During the past five years3 my residence ~s been as follows:
<br />
<br />I was bom at
<br /> Month Day Year City Village
<br />
<br />Burrough Town State or Country
<br />
<br />I am a (native) (naturalizetl) citizen of the United States.
<br />
<br />I am married. My (wife's) (husband's) name and address is
<br />
<br />I am (proprietor) (manage0
<br />Firm was incorporated in State of
<br />
<br />Corporation is autho,~zed to do business in Minnesota.
<br />Licenseis for ff t~t,~ $.~,/,; L t o ~.~ ~t t, t.,n~,_l~' ,~', ¢.,,3~ ' '.~eet) (highway) located as
<br />follows:
<br /> 7 q,,z ~ ! ~1'''r ~ ,aa,,
<br />
<br />The license will be in connection with 3'..~4r
<br /> Drug St~re, Cafe, Restaurant, Hotel, Club
<br />which has been in operation /~'~"tt' ~--~ o
<br /> l~on'ths~ Years
<br />
<br />The establishment is located on the floor. The business premises are owned by
<br /> C; zv , ~ &,,,.,,.,.,. (_:,,.t,... / ~,.
<br />The taxes on the property are not delinquent.
<br />
<br />I am engaged in the retail sale of intoxicating liquor.
<br />
<br />I have had an application for license rejected as follows:
<br />I have never been 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.
<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 />I have no intention or agreement to transfer the license to another person.
<br />
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