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STATE OF MINNESOTA <br />DEPARTMENT OF PUBLIC SAFETY <br />LIQUOR CONTROL DIVISION <br /> <br />PS 090G8.02 <br /> <br />APPLICATION FOR RENEWAL OFF-SALE INTOXICATING LIQUOR LICENSE <br /> <br /> This application and bond shall be submitted in duplicate <br />Iwhoever shall knowingly and willingly falsify the answers to the following questionnaire shall be deemed guilty of perjury and <br /> shall be punished accordingly. <br />lin answering the following questions "APPLICANTS" shall be governed as 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 for all <br /> officers, directors and stockholders. <br />! <br /> <br />IPART I <br /> <br /> BUS NESS PHONE NUMBER <br /> <br />II, Lo~-~v~ ,.~. <br /> Name of: (individual) (partner) (offfcer of corporation) <br /> <br />APPLICANT'S HOME PHONE NUMBER <br /> <br /> · for and in behalf of <br /> (name of individual) <br /> <br /> or <br />I (names of partners) <br /> or ~ '~- L Li~LLJ~O~S,"-~Q_. ,tradename /I~ .~. L Li~uc)(-~ <br />i (name of corporation) ~ <br /> <br />(street address -- or -- lot and block number) <br /> <br />make application for RENEWAL of Off-Sale intoxicating liquor license located at: <br /> <br /> N/ 'vJ, <br /> <br /> City of <br />I ' <br /> commencing '~-U-~ ~ I, , 19 ~, , and ending _--~'L~L¢'I ~__ ._~0 , lg (~ ~) . <br /> <br />J~Check ( ,/ ) box if no changes since last applying for renewal of license. If there has been a change; that is, change in owner- <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 ; Sunday On-Sale <br /> (Yes or No) <br />with the Off-Sale Intoxicating Liquor License for this location? <br /> <br />(Yes or No) <br /> <br />Intoxicating Liquor License in conjunction <br /> <br />PART II <br /> <br />FOR CORPORATION: <br /> <br />(names of officer~, directors and stockhot~ers} <br /> <br />fOyer) <br /> <br /> <br />