Agenda - Council - 05/28/1985 - Laserfiche WebLink

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(612) 296-6430 STATE OF MINNESOTA DEPARTMENT OF PUBLIC SAFETY LIQUOR CONTROL DIVISION ST. PAUL, MN 55101 APPLICATION FOR RENEWAL OFF-SALE INTOXICATING LIQUOR LICENSE I I I Whoever shall knowingly and willingly falsify the answers to the following questionnaire shall be deemed guilty of perjury and shall be punished accordingly. In answering the following questions "APPLICANTS" shall be governed as follows: For a partnership one of the partners shal' execute this application for all members of the partnership. For a corporation one officer shall execute this application for a! officers, directors and stockholders. PART I I BUSINESS PHONE NUMBER Name of: (individual) (partner) (officer of corporation) APPLICANT'S HOME PHONE NUMBER ~'7-'~/'0~::~{ , for and in behalf of (name of individual) or I (namesof partner,) E // or '~/~ L "-' ' .~ /['/~-' , trade name (name of corporation make application for RENEWAL of Off-Sale intoxicating liquor license located at: ~str~t address - or -- Iot~nd bilk numar) / ' City of~~f , Zip Code ~e~ ,Countyof ~Check { ~ } box i~ no chan~es since last applgin~ for renewal of license. If there has been a chan~e; that is, chan~e in ownet- o~nership; addition of ~artner; administrator or administratrix to an estate named; chan~e of officers, director~ or stockholders in corporation; chan~e o~ location; or ne~ liquor establishment, then form ~S ~13~, ~pplication for O~-Sale Intoxicatin~ Uquor Ucense, must be executed instead o~ this form {see gout citg c~erk for form PS Will applicant be ~ranted OmSale ~ ; Sundag On-Sale ~- Intoxicatin~ kiquor ki~nse in con~uncdon with the Of~-Sale Intoxicatino Eiquor kicense ~or this Io~tion? I I I PART II FOR CORPORATION: (names of officer,% directors and stockholders) c, (Over}