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X 14. <br /> <br />10. Stale whether any person other than applicants has any right, titJe or interest in the furniture, <br /> <br /> fixtures, or equipment t~r whmh license-is applied, and if so give name and details. <br /> ~ - <br /> <br />11. Have applicants any intel'est whatsoever, direclly or indirectly, in any other liquor establishment in <br /> the State of Minnesota?: ,/V'O Give name and adctress of such establishment. "- <br /> <br />12. Furnish name and address of one bank reference ../ <br /> <br /> 13. Under what classificationiis the license applied for: EXCLUSIVE OFF-SALE EIQUOR STORE, DRUG <br /> 'STORE, COMBINATION QN & OFF LIQUOR, OR GENERAL FOOD STORE ~,t'~.L~,~,/£ O/-/'-.-~'~Z~' . <br /> <br /> Are the premises now oc0upied, or to be occupied, by the applicant entirely separate and <br /> exclusi've trom any other business establishment? <br /> <br /> 15. tf a drug store, state length of time the store has been in operation <br /> <br /> 16. State whether applicant h~s, or will be granted, an On-Sale Liquor License in conjunction with this <br /> Off-Sa~e Liquor License, arid for the same premises ---- <br /> <br />17. State whether applicant ha~s, or will be granted, a Sunday On-Sale Liquor License Jn conjunction <br /> with the regular On-Sale Liquor License . <br /> <br />18. State whether applicant has, or will be granted an Off-Sale.Non-intoxicating Malt Beverage 13/2) <br /> License in conjunction witt~ this Off-Sale Liquor Li~:e-r~se ' ~/~/~ .............. <br /> <br /> JL <br /> <br />19. During the past license year ~as a summons been issued under the Liquor Civil Liability Law (Dram Shop) <br /> M.S. 340A.802. ~ Yes No. If yes, attach a copy of the summons. <br /> <br />Subscribed and sworn to before me this <br /> <br /> _ day of , , <br /> <br />I hereby certify that I have read the above <br />question and that the answers are true of my <br /> <br /> REP,~R~'."QD~ APPLICANT OR'APPLICANTS BY.POLICE DEPARTMENT <br /> <br /> This is to certify that the a~pplicant, and the associates, named herein have not been convicted <br />within the past five years fo~ any violation of Laws of the State of Minnesota, or Municipal <br /> <br />Ordinances relating to IntoxiCating Liquor, except as hereinafter stated <br /> <br />Approved By: <br /> <br />" ~_ o,. ~,, Z~ ,., P~ice Department <br /> <br />(If you have nO police department, either the <br />Marshal or the Constable shall execute this report <br />on the applicant.) <br /> <br /> <br />