Laserfiche WebLink
(612) 296-64~ ~rATE OF MINNESOTA <br /> DEPARTMENT OF PUBLIC SAFETY <br /> LIQUOR CONTROL DIVISION <br /> ST. PAUL, MN 65101 <br /> <br />APPLICATION FOR .RENEWAL OFF-SALE INTOXICATING LIQUOR LICENSE <br /> <br />Whoever shall knowingly and willingly falsify the answers to the following questionnaire shall be deemed guilty of perjury ar, d <br />thall be punished accordingly. <br /> <br />in ,nswering the following questions "APPLICANTS" shall be governed es follows: For a partnership one of the partners shall <br />execute this application for all members of the partnership. For a corporation one officer shall execute this application tot all <br />officers, directors and stockholders. <br /> <br />PART I . <br />BUS1NESS PHONE NUMBER 7'JC'--~ ~ ~ '~ V q ,,, APPLICANT'S HOME PHONE NUMBER <br /> <br /> Name of: ~ (parlnerl (~fficer of corP~'~-._~ ' (name ol individuall <br /> <br />or <br /> <br />(names of partners) <br />or ~ ~C[~)'~ ~F-l~ C_, .. ,trade name ~1 ~ ~ L / ~uo~ . <br />(na~ of corporalion) ' <br /> <br />make application for RENEWAL of Off. Sale intoxicating liquor license located at: <br /> <br /> /d ¢' AY. . <br />{St'rea! ~ddress - or - lot ~nd bilk numar) <br /> <br /> Zip Code ~-~~ ~ , County of ///~/'O K/~ <br />19 ~ . and er,ding 5 --,.~ (:~ . 19 ~ <br /> <br />,,,~Check ( d } box if no changes since applying a change; that is, change in owner- <br /> last <br /> for <br /> renewal <br /> of <br /> license. <br /> If <br /> there <br /> has <br /> been <br /> ownership; addition of partner; administrator or administratrix to an estate named; change of officers, directors or stockholders <br /> in corporation; change of location; or new liquor establishment, then form PS 9136, Application for Off-Sale Intoxicating Liquor <br /> License, must be executed instead of this form (see your city clerk for form PS 9136). <br /> <br /> Will applicant be granted On-Sale/ ' ~ ~0 ; Sunday On-Sale t'J,O Intoxicating Liquor License in conjunction <br /> IYe~ or Nol {Yes o, No} <br /> with the Off.Sale Intoxicating Liquor License for this location? <br /> <br />PART II <br /> <br />FOR CORPORATION: <br /> <br />(names of officert, directorl Ind it~khol~rl) <br /> <br />(Oved <br /> <br /> <br />