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

Home

I I I I I I I i (612) 296-6430 STATE OF MINNESOTA PS 90~8.03 DEPARTMENT OF PUBLIC SAFETY LIQUOR CONTROL DIVISION ST. PAUL, MN 55101 APPLICATION FOR RENEWAL OFF-SALE INTOXICATING LIQUOR LICENSE Whoever shall knowingly and willingly falsify the answers to the following questionnaire shall be deemed guilty of perjury shall be punished accordingly. In answering the following questions "APPLICANTS" shall be governed as follows: For a partnership one of the partners sh~ execute this application for all members of the partnership. For a corporation one officer shall execute this application for ~ officers, directors and stockholders. PART I BUS,NESS P.ONE NUMBER ~-S-- 5 '- ~'~- ~/y Name of: (individual) (partner) (officer of corporation) APPLICANT'S HOME PHONE NUMBER , ~/~- 7-,5 / , for and in behalf of (name of individual) or (names of partners) (name of corporation) make application for RENEWAL of Off-Sale intoxicating liquor license located at: Istreet address - o~ - lot and block numberl City of /K.'/:) Y'~ g ¢-~ ~, , Tip Code 3-_~_~.~ ~- , County of I I commencing ~-'--C, ~<~' t [~"~heck ( ,/ ) box if no changes since last applying for renewal of license. If there has been a change; that is, change in owne'- ownership; addition of partner; administrator or administratrix to an estate named; change of officers, directors or stockholde'~ in corporation; change of location; or new liquor establishment, then form PS 9136, Application for Off-Sale Intoxicating Liquo' License, must be executed instead of this form (see your city clerk for form PS 9136). i Will applicant be granted On-Sale ; Sunday On-Sale (Yes or No) with the Off-Sale Intoxicating Liquor License for this location? (Yes or No) Intoxicating Liquor License in conjunctio~ I I I PART II FOR CORPORATION: (names of officer~,, directors and stockholders) (Over)