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10. Slale whether any peasen olher Ihan applicants t/as any right, lille or interesl iu the furniture, <br /> <br /> I~xtu.'es, rrr equipn~enl tot whici~ li,;unse is applied, and if so give name and details. NO __ <br /> <br />11. }.{ave applicants any interest whatsoever, directly o~ indirectly, in any other liquor eslablishment in <br /> <br /> the Stale of Minnesola? ___N_c~ ...... Give name and address of such establishment <br /> <br />12. Furnish name and address of one hank reference <br /> <br />13. Under whal classification is Ihe license applied for: EXCLUSIVE OFF-SALE LIQUOR STORE, DRUG <br /> STORE, COMBINATION ON & OFF LIQUOR, OR GENERAL FOOD STORE ExcJu. Oil'-Sale LJq:_. <br /> <br />14. Are The premises now occupied, or lo be occupied, by the applicanl entirely separate and <br /> exclusive Irom any other business establishment? Yes <br /> <br />15. It' a drug store, slate length of time tile store has been in operation n/a <br /> <br />16. State whether applicant bas, or will be granted, an On-Sale Liquor License in conjunction with tt~is <br /> Off Sate Liquor License, and for the same premises No <br /> <br />17. State whether applicant bas, or will be granted, a Sunday On-Sale Liquor License in conjunction <br /> <br /> with the regular On-Sale Liquor License No <br /> <br />18. State whether applicant has, or will be granted an Off-Sale Non-Intoxicating Malt Beverage (3.'2) <br /> License in coujunction with this Of[ Sale Liquor License No <br /> <br />19. <br /> <br />During the past license year has a summons been issued under the Liquor Civil Liability Law (Dram Shop) <br /> <br /> M.S. 34OA.802. [~I Yes ~_i No. Il yes,.~a~t~(;~lm,,'~f the summons. <br /> <br />Subscribed and sworn to beforr~n~.-thl~., r,c. ..... ~ ).l)~e~)~ certify that I have read the above <br /> <br />My commission expires ~/,I' rl'~ ¢7- -,o,~ ........ <br /> <br /> REPORT ON APPLICANT OR APPLICANTS BY POLICE DEPARTMENT <br /> <br /> This is to certify that lhe applicant, and the associates, named herein have not been convicted <br />within the past fivo years for 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 />C L;¢ .~D Title <br /> <br />(If you have no police department, either the <br />Marshal or the Conslable shall execute this report <br />on tile applicant.) <br /> <br /> <br />