Laserfiche WebLink
l(J. State whether any person other than applicants has any r[ght, tit{e or interest in the furniture, <br /> fixtures, or equipment tor which I~cen~e is ltpplied, and if ~o give name end details. ~ <br /> /¢~ <br /> <br />11, Have applicants any interest whatsoever, directly or indirectly, in any other liquor establishment in <br /> the State of Minnesota? ~/~s Give name and addreu of ,uch establishment <br /> <br />~2. Fu~ish name and address of one bank reference ~ <br /> <br />3. Under what classification is the license applied for{EXCLUSIVE OFF-SALE LIQUOR STORE,~DRUG <br /> STORE, COMBINATION ON A OFF LIGUOR, OR GENERAL FOOD STORE <br /> <br />4, Are the premises now occupied, or to be occupied, by the applicant entirely separate and <br /> exclusive from any other business establishment? . Y ~' _¢ . <br /> <br />5. If e drug store, state length of time the store has been in operation <br /> <br />State whether applicant has, or will be granted, an On-Sate Liquor License in conjunction with this <br />Off-Sale Liquor License, and for the same premises ~ o <br /> <br />7. State whether applicant has, or will be granted, a Sunday On-Sale Liquor License in conjunction <br /> with the regular On-Sale Liquor License <br /> <br />State whether applicant has, or will be granted an Off-Sale Non-intoxicating Malt Beverage (3/2) <br />License in conjunction with this Off-Sale Liquor License <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. [] Yes [~No. If yes, attach a copy of the summons. <br /> <br />Subscribed and sworn to before me this <br /> ~"~ dayof /~' /'i ~' ~ ~ ~ l..' ,t9 <br /> <br /> I/votary PuOhc) <br /> <br />My commission expires <br /> <br />I hereby certify that I have read the above <br />question and that the answers are true of my <br />own knowledge. <br /> <br /> REPORT ON APPLICANT OR APPLICANTS BY POLICE DEPARTMENT <br /> <br /> Tids is to cagily' that the applicant, and the associates, named herein have not been convicted <br />within the past five~years for any violation of Laws of the State of Minnesota, or Municipal <br /> <br />Ordinances retatin9 to imoxicadng Liquor, except as hereinafter stated <br /> <br />Police Department <br /> <br />Approved By: <br /> <br />Title <br /> <br />{If you have no police department, either the <br />Marshal orthe Constable shall execute this report, <br />on the applicant,) <br /> <br />I <br />I <br />I <br />I <br /> I <br /> ! <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> <br /> <br />