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'pa]l~ in which this license is to be issued? No If mo, in what capacity?. <br /> <br /> Ucant for license is the spouse of a memb ,er of thc ~:,vcrr ir ~ body, or where'other family relationship <br />iexists, such member shall not vote on this application. ' .-:.-. :.., · -.. .... <br />16.1iLate"' whether any person other than applicants has any right, title or interest in the furniture, fixtures, <br />or equipment in the premises for whlcb license is applied, and if so, give nrane and detaUs <br /> <br />,17.~[ave applicants any interest whatsoever, di~ectly.or indirectly, in any other liquor establishment in the <br /> <br />State of ~Lhanesota?__ . Give name and m:~dress of such esfmbliskment <br /> <br />18. lvoa-n~sh the name and ~ddrcss of at I ,trast three busL-Jess references, Inc]udlng one bank ~eterenee <br /> om Barsness - Prior L_ake SCare Bank <br />I Tc~n Packard - Prestdent~ Norris Creameries <br /> <br /> ten Pederson - R, <br /> <br />!19. Do you possess a retail dealeFs identification card issued by the Liquor Control CommissiOner 'which <br />'wfl~xp[re December 31st of this year? Give ~lumher of same N/A <br /> <br />20. Does applicant inDend to sou intoxicating liquor to other than th~ consumer?. N]A <br /> <br />21. 'cate whether applicant intends to possess, operate or permit the possession or operation of, on the <br /> <br />lic ed premises or in any room adjoining the licensed premises, an>' slot machine, dice, gambling de,flee <br /> <br />apl~atus, or permit any gambling therein No <br /> <br />~.l[nder what classification is the license applied for: EXCLUSIVE LIQUOR STORE, DRUG STORE, <br />3R.~ENERAL FOOD STOR~?_ _G~ene.ral [nod. Store_ <br /> <br />~.~re the premises now occupied, 'or to be occupied, by the applicant entirely separate and exclusive from <br /> <br />my other buuiness establishment? Yes <br /> <br />~' I a drug store, state length of time the store has been in operation <br />.5. State trade name to be USed Brooka~%u~rot~ ff q~ <br />§..{tare name of person that witl operat~ ~tore Dennis Go Carlson <br />~. State whether applicant has, or will be granted, an On-sale Liquor License in conjunction with thLs <br />)fill r i No <br /> e Liquor License and for the same p em ses___ <br /> <br />~Tal[~tate whether npplic~nt Ires, o~ wl]I be /grun[ed, s Su.day On.ale Liquor License in conjunction with the <br /> On-sale Liquo~ License No <br /> <br />~.{te whether applicant has, or will be granted, an "On-sale Non-Intoxicating ]~lalt Beverage" (3/2) Li- <br />:ense in conjunction with this Off-sale Liquor L~cense, and for the same premises No <br />~.l',ive Federal Retail Liquor Dealer's Tax Stamp Number N/A <br /> <br />10. Do you intend to deliver liquor by vehicle?. No If so, state the number of the Vehicle Permit <br />s~I f~r the r,~.ent )'e~r F~y the Liquor Control C'nmmlsslnner <br /> <br /> <br />