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STATE OF MINNESOTA
<br /> DEPARTMENT OF PUBLIC SAFETY
<br /> LIQUOR CONTROL DIVISION
<br /> ST. PAUL. MN 55101
<br /> (612J 296-6430
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<br />APPLICATION FOR OFF SALE INTOXICATING LIQUOR LICENSE
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<br />EVERY OUESTION MUST BE ANSWERED. If a corporation, an officer shall execute this application. If a
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<br />paflnership, a partner shah execute this application.
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<br /> ._!~ uj, .RJ '~_e..T_. ~__i q.uq~ S.~_...]
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<br /> lZ~21 St, r~ancis Bird.
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<br /> CLty of Ramsey
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<br />_. Da.] e..WJ _z-~__ ~_. :]a~es __,}.o sjy. r~ ...............
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<br />II a coH}olalion, state name, date of birth, address, title, arid shares held by each officer.
<br />If a partnership, stale names, address and dale o( birth of each partner.
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<br />i,~,;;,,,,, ,,,i .... ¢ [l';¥,T- -I ~""
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<br /> [lale [.~Wirz ~7/6/5~ 17201 St. Francis Bvd.
<br />m,,m,,,,,um,.~, ,,.~ ~q-~' ~Do~
<br /> James W~ Jos]yn I/~/z/z-~3a~9 140th Ave N.W.
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<br />Anoka Pres./751
<br />Ramsey V.Pr./200
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<br />Andover
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<br />tqgr./~?
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<br />City nile Stlales
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<br /> 1. Ifa corporaliolh date of incorporation 7-03-89 ,stateincorporaledin MN amount of
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<br /> authorized capitalization , amount of paid in capital , if a subsidiary of any
<br /> other corporation, so state N/A give purpose of
<br /> corporalion retail liquor (oFf-sale) if incorporated under the laws of another
<br /> state, is corporation aulhorized to do business in the State of Minnesota? rm/a Number of
<br /> cerlificate of aulhority ___~__3_~-__j_3_?._(_~_n.!__.
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<br />2. Describe premises to wMch license applies; such as (lirst floor, second floor, basement, etc,)
<br /> .................................... or if entire building, so state _ejxt_~_~'e__b__uJ~!d~_ng .
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<br /> If operaling under a zoning ordinance, how is the Iocalion of the building classified? __co,,mezcial_?
<br /> Is establishment located near any state university, state hospital, training school, reformatory or
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<br /> prison? _ ._o/A ..... state al)proximate distance
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<br />5, State name and address of owner of building Lyle A. Wirz 3321 SI;. Francis Bvd. Anoka
<br /> has owner of huilding any connection, direclly or indirectly, with applicant?
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<br />6. Slate whether applicant, or any of the associated in this application, have ever had an application
<br /> for a Liquor License rejected by any municipality or State autl~ority; if so give date and details
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<br />7. Has the applicant, or an,,, of the associated in this application, during the five years immediately
<br /> p~eceding lhis application ever had a license under the Minnesota Liquor Control Act revoked for
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<br /> any violalion el such laws or local ordinances; if so, give date and delails No.
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<br />8, State whether applicant, or any of the associates in this application, and employees while
<br /> employed by applicant during the past five years were convicted of any Liquor Law in this state,
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<br /> or under Federal Laws, and if so, give date and details No.
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<br />9. Is applicant, or any of the associates in ti'tis application, a member of the governing body of the
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<br /> municipality in which this license is to be issued? No If so in what capacity
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<br />FOR OFFICE USE ONLY
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