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~. CEDAR ST-,~0ITE 100 t- gafety <br />ST, P~Ut. ~ 55101-215~ <br /> .N 55101 <br />(612)296-6430 TTY(612)282-6555 <br /> <br />RENEWAL OF LIQUOR, WINE, OR CLUB LICENSE <br /> '. ... . <br /> <br /> Licensee: Please verify your lic.~mse information contained below. Make corrections if necessary 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 Ciork]County Auditor are also required by M.S. 340A.404 S. 3 to report any license <br />cancellation. <br /> <br />License Code ONSS License Period Ending 06/30/96 <br />City/County where licen~ approved R ams e y <br /> <br />.1I)# 8388 <br /> <br />Li~nseeN~ne American Oolf Corp. <br /> <br />TradeNmae Links At Northfork <br /> <br />Licensed Location addrcss 9333 153rd Ave NW <br /> <br />City, State, ZipCode Ramsey, MN 55303 <br /> <br />Business Phone ( 6 1 2 ) 2 4 1 - 0 5 0 6 <br /> <br /> ~LI.CJENSEFI3ES: OffSale$ Ongale$ 4,000.00 Sundays 200.00 <br /> <br />By signing this renewal;application, applicant certifies that there has been no change in ownership, corporate officers, <br />partners, home addresses, 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 signature-on this renewal confirms the following: Failure to report any of the following will result in <br /> <br />1. Licensee confirms that it has never had a liquor license rejected by'a~y city/township/county in the state of <br /> Minnesota. If ever rejected, please give details on the back of this renewal, then sign below. <br />2. Licensee eonfmns that for the past five years it has not had a liquor license revoked for any liquor law violation <br /> (state or local). If a revocation has occurred, please give details on the back of this renewal, then sign below. <br />3. Licensee confirms that during the past five years it or its employees have not been cited for any civil or criminal <br /> liquor law violations. If violations have occurred, please give details on back of this renewal, then sign below. <br />4. Licensee co ~a,fimas that during the past license year, a summons 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 confirms 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 is issued. $100,000 in cash or securities or $100,000 surety bond may be submitted in lieu of liquor <br />liability. <br /> <br />J~icensee Signature, Date <br />(Signature certffies all'above information to be correct and license has been approved by city/cotmty. <br /> <br />_City Clerk/Coma_h, Au~litor Si~ature Date <br />(Signature certifies that an on-sale intoxicating liquor license has been approved by the city/county as stated above). <br /> <br />Coun _ty Attorney Sign}tttre <br />County Board issued licenses only (Signature certifies licensee is elig/ble for license) <br /> <br />Date <br /> <br />police/Sheriff Sign ara, re <br /> <br />Date <br /> <br />(Signature certdies licensee or associates have not been cited during the past five years for any state/local liquor law <br />violations (criminal/c~Vil). Report violations on back, then sign here. PS 9093-94 <br /> <br />I <br /> <br /> <br />