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I <br />I <br />I <br />I <br />I <br />I <br />I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> <br /> STATE OF MINNESOTA eso~as-o2 <br /> DEPARTMENT OF PUBLIC SAFETY <br /> LIQUOR CONTROL DIVISION <br /> APPLICATION FOR OFF SALE INTOXICATING LIQUOR LICENSE <br /> T~o ~rr!;__'_' ..... ;-__'~ ' ' -" -11 h n_ ' ........ <br /> Whoever shall knowingly and wllfully falsify the nnswern to the following questionnal~e shall be <br />de~m~! guilty of perjury and shnJl be puntshed accordingly. <br /> la answering the following questions ~'APPLICANTS" shall be governed ns follows: For a Corpora. <br />tiaa one oflker shall execute thin application for all 0~cere, directors and atockholder~. For · p~rtnerahlp <br />on~ of the "APPLICANTS" shall execute this application for all members of the partnership. <br /> <br /> ~.v~.R¥ OV~.STION MUST nE ANSW~.REI). <br /> BUSINESS <br /> APPLICANT'S <br /> HOME <br />PHONE NUMBER ~.~-~ ~ cY5/$/ PHONE NUMBER <br /> <br /> (Indloldun! owner, o~c~e, or <br /> <br />for and in behalf of lrf~ ~ ~ ~ ~ c/c./~ _~T~. , hereby apply for an Off Sale <br /> <br />Intoxicating Liquor License to be located at _4 93/-/~. '77)~c~ <br /> (Street Addre$$ and/or Lot and Block <br />Municipality of ~'o~b':'~ , County of /~/~'a fi'a._ <br />State of Minnesota, in accordance with the provisions of Minnesota Statutes, Chapter 340, commencing <br /> <br /> /~')~t'L~' / , 19~._, and ending <br />2. Give applicants' date of bir~h <br /> ( Da~ ) <br /> <br />Bitthdates of Partners ~ (Day) <br />O[{icet~ of Corporation <br />8. <br /> <br />(ldonth) (Y~r) <br /> <br /> ( Da~t ) ( $f onth) (Year) <br /> <br /> (Day) (tdon~h) (Year) <br /> <br />The residence for each of the applicants named herein for the past five years is as follows: <br /> /b.~/~ -~/fcc~.:e,.~ ~ ~. ~. ,~'. ~,~-~ <br /> <br />4. Is the applicant a citizen of the United States? , , <br /> <br />If naturalized state date and place of naturalization__ <br /> <br />If a corporation, or partnership, state eitizenshila status of all officars or partners, <br /> <br />5. The person who executes this application shall give wi/e's or husband's full name and address <br /> <br />6. What oeeupatiom have applicant and ~ssoeiatea in this appli~tion followed for the ~ast five <br /> <br />7. If a partnership, state name and address of each member of partnership <br /> <br />I <br /> <br /> <br />