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C.d.r S,,.,. STATE OF MINNESOTA <br /> 1612j 296-6159 DEPARTMENT OF PUBLIC SAFETY <br /> <br /> I rpLICATION FOR PERMIT TO ONLY ALLOW CONSUMPTION & DISPLAY OF INTOXICATING LIQUOR <br /> <br /> (This Application Shall Be Typewritten and Submitted Before June 1st of each Year) <br /> <br /> In answering the following questions "APPLICANT" shall be governed as follows: <br /> <br /> I For a Partnership. one of the partners shall execute this app. lication for all members of the partnership. <br /> For a Corporation, one ofbcer shah execute this application for all officers, directors, and stockholders. <br /> For a Club, one of the club officers shall execute this application for all the members. If additional <br /> space is required, use a separate sheet of paper, indicating by number the question answered. <br /> <br /> .~ (FEG FOR PERMIT - $100.00) <br />I ~ EVERY QUESTION MUST BE ANSWERED <br /> <br /> 1. I, PatrJcJa S:.tudcr , as l'rcsident , <br /> <br />I and in behalf of Tho Party }~ouse~ ~nc. <br /> <br /> ]by apply for a permit allowing consumption and display of intoxicating liquor to be I~ated at <br /> 9~3'~ i~ .'hu~ 10 , Municipality of ;~se~ , <br /> <br />I t Office of ~nol:~ , County of ~o]ca , <br /> <br /> te of Minnesota, in accordance with the provisions of M.S. 340.119. <br /> <br /> 2. Will business be operated as a private club or public place Public <br /> I state type of business Food 5ervSce~ CatcrSng~ Banque%s~ ReceptSons <br /> <br /> 4. FOR A PUBLIC BUSINESS: If a partnership, state name and address of each member of pa,'tne~hip; if <br />a~>rporation, state name and address of officers and directors. <br /> <br /> Pat:'~cJ:* Smudcr 22301 Sug~sh ~. H.W. ~: ~ver~.l,~. <br /> S:~u~I ~'.:der d~1' 22301 Sug~bush ~. I.O.U. ~: f~ver~ ~. <br /> <br />~ .'~F)OR A PRIVATE CLUB: Date club was organized , is dub incorporated <br />number of members __ , length of time in present location __ , is club building owned or <br />sed , what is the membership dues , what are the requirements for <br /> bership <br /> club maintain lockers to be used by members for storing intoxicating liquor ~ . Names of ali <br /> <br />officers and/or directors of the club: <br /> <br />EncJose with this application a copy of the Constitution and By-Laws of the club and current list of bona <br />fiI <br />members. <br />f applicant or any partner, corporation officer or director, club officer or director, is not a citizen of the <br />United States, list such non-citizens <br /> <br /> Irate name of person who will operate or manage business: <br /> <br /> C~round level floor <br /> I Dn what floor is the establishment located, or to be located <br /> <br /> ~,ow are the premises classified under the zoning ordinance <br /> <br />I <br /> <br />I <br /> <br />for Violations by: <br /> <br /> <br />