Agenda - Council - 09/10/1985 - Special

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I I I ! I I ! I I i I I I I I I I SI'AI'IE OF MINNES(yl A ~ DEPARTMENI' 0I" PUULIC SAFETY '. --" LIQUOR ('ONTROL DIVISION ~' APPLICATION FOil OFF SALE INTOXICATING LIQUOR LICENSE Whoever shall knowingly and wilfully falsify the answers to the following questionnaire shall be deemed guilty of perjury and shall be punL~hed accordingly. In answering the following questions "APPI,ICANTS" shall be governed as follows: For a Corpora- tlon one officer shall execute this application for all officers, directors and stockholders. For a partnership one of the "APPIACANTS" shall execute this application for all members of the partnership. EVERY QUESTION bIUST lie ANSWERED. BUSIN t..SS ~'~ Z '7 - ¢) c'/.a~ c~. APPLIC.&NT'S HOME zz/.' PtlOnE numuar I'IJONE nuMuEr .z//z///_ , :~ for and in behalf of /VI y J- E t_ F Intoxicating Liquor License to be located at (~ / .3 I ([ndi~duol o~n~r, oRi~.~r, or , hereby apply for an Off Sale l~unictpality of /~)~ ~ ~ ~ ? , County of _ /q Fd 0 State of Minnesota, in accordance with the provisions of ~Jnnesota S~tu~s, Chapter B40, commencing , 19~, and ending ., 19~. ~. Give appli~nts' date of b~h ~ ~C F ~ ] ~ ~ (D~) (Month) Bitlhdales of Partners [ ~ ~ l ( Da~ ) (Month) (Year) OU (Month) Of(~ce~s o( Corporation ( Daq ) (Month) ( Y ~r ) 8. The residence for each of the applicants named herein for the past five y~rs is ~ follows: 4. la the applicant a citizen of the United States ?.___)/.a~_ ~ If naturalized state date and place of naturalization__ If a corporation, or partnership, state citizenship status of all officers or partners. The person who executes this application shall give wife's or husband's full name and address . What occupations have applicant and associates in this application followed for the past five years?_ 7. If a partnership, state name and address of each member of partnership Al, ~.