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LIGiUO~ ~ DI¥1$10N <br /> ~ Safely <br />444 OEDAR ST-~tJITE 100 L SIO1N <br />ST. PAUL ~ 55101-2156 , .MN 55101 <br /> (612)296-6430 TTY(612)282-6555 <br /> <br />RENEWAL OF LIQUOR, WiNE, OR CLIJB LICENSE <br /> <br /> Licensee: Please verify your license information contained below. Make corrections ffnecessary and sign. City <br />Clerk/County Auditor Should submit this signed renewal with completed license and licensee liquor liability for the new <br />license period. City Clerk/County Auditor are also required by M.S. 340A.404 S. 3 to report any license <br />cancellation. <br /> <br />License Code OF SL <br />City/County where lie. ease approved <br /> <br /> License Period Ending 06/30/96 ID// 2255 <br />Ramse¥ <br /> <br />Licensee Name Judy's Discount 10 Liquor Inc. <br /> <br />TradeName Judy's Discount 10 Liquor <br /> <br />Licensed Location ad&ess 7129 Hwy 10 NW <br /> <br />City, State, ZipCode Ramsey, MN 55303 <br /> <br />BusinessPhone(612) 427-9060 <br /> <br /> LICENSE FEES: Off Sale $ 2 0 0.0 0 On Sale $ Sunday $ <br /> <br />By signing this renewal application, applicant certifies that there has been no change in ownership, corporate officers, <br />partners, home ad&eases, or telephone numbers. If changes have occurred during the past 12 months, please give details <br />on the back of this renewal, then sign below. <br /> <br />Applicant's signatu~ on this rene.wal, col)firms the following: Failure to report any of the following will result in <br />t'mes. <br /> <br />1. Licensee coOt'n-ms that it has never had a liquor license rejected by'any city/township/county in the state of <br /> Minnesota. If ever rejected, please give details on thc back of this renewal, then sign below. <br />2. Licensee coltfirms that for the past five years it has not had a liquor license revoked for any liquor law violation <br /> (state or local). Ifa revocation has occurred, please give details tm the back of this renewal, then sign below. <br />3. Licensee colfftrms that during the past five years it or its employees have not been cited for any civil or criminal <br /> liquor law violations. Ifviolatitms have occurred, please give details tm back of this renewal, then sign below. <br />4. Licensee confirms that during the past license year, a s~mmons'has not been issued under the Liquor Liability Law <br /> (Dram Shop) MS 340A.802. If yes, attach a copy of the summons, then sign below. <br />5. Licensee ctmfu-ms that Workers Compensation insurance is in effect for the full license period. <br /> <br />Licensee has attached a liquor liability insurance certificate that corresponds with the license period in cRy/county <br />where license b issued. $100,000 in cash or securities or $100,000 surety bond may be submitted in lieu of liquor <br />liability. <br /> <br />Licensee Si~ature Date <br /> <br />(Signature certifies all above information to be correct and license has been approved by city/county. <br /> <br />City Clerk/County Apditor Signature Date <br />(Signature certifies that an on-sale iatox/cating liquor license has been approved by the city/county as stated above). <br /> <br />Coun .ly Atlomey Si_m)ature <br />County Board issued licenses only (Signature certifies licensee is eligible for license) <br /> <br />Date <br /> <br />?olice/Sher/ff Signature <br /> <br />Date <br /> <br />(Signature certifies licensee or associates have not been cited during the past five years for any state/local liquor law <br />violations (criminal&Nil). Report violations on back, then sign here. PS 9093-94 <br /> <br />I <br /> <br />;SSI <br /> <br /> <br />