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Form B-Revised 11/71 <br />STATE OF MINNESOTA <br />LIQUOR CONTROL COMMISSIONER <br />ON FOR OFF SALE INTOXICATING LIQUOR LICENSE <br />' �6 <br />%,,,.This application and the bond shall be submitted in duplicate <br />Whoever shall knowingly and wilfully falsify the answers to the following questionnaire shall be <br />deemed guilty of perjury and shall be punished accordingly. <br />In answering the following questions "APPLICANTS" shall be governed as follows: For a Corpora- <br />tion one officer shall execute this application for all officers, directors and stockholders. For a partnership <br />one of the "APPLICANTS" shall execute this application for all members of the partnership. <br />EVERY QUESTION MUST BE ANSWERED. <br />1. I Geraldine Manteuffel as ((612) 489-0722) owner <br />(Individual owner, officer, or partner) <br />for and in behalf of Little Canada Liquors, Inc. , hereby apply for an Off Sale <br />Intoxicating Liquor License to be located at 2826 Rice Street, Little Canada, MN 55117 <br />(Street Address and/or Lot and .block Number) <br />Municipality of Little Canada _ County of Ramsey <br />State of Minnesota, in accordance with the provisions of Minnesota Statutes, Chapter 340, commencing <br />19 , and ending , 19 . <br />Give applicants' date of birth l l th November 1927 <br />(,pay) (Month) (Year) <br />Officer - Geraldine Manteuffel <br />Birthdates of Partners (Day) (Month) (Year) <br />or <br />(,jay) (Month) (Year) <br />Officers of Corporation <br />(Day) (Month) (Year) <br />3. The residence for each of the applicants named herein for the past five years is as follows: <br />20 Years - Geraldine Manteuffel 1978 Adolphus, Maplewood, MN <br />4. Is the applicant a citizen of the United States? <br />Yes <br />N/A <br />If naturalized state date and place of naturalization_.... <br />If a corporation, or partnership, state citizenship status of all officers or partners. <br />Corporation » all stock owned by applicant. <br />5. The person who executes this application shall give wife's or husband's full name and address <br />Husband - Eugene L. Manteuffel - address same as applicant. <br />6. What occupations have applicant and associates in this application followed for the past five years? <br />Liquor Store Manager & Waitress for 21 years. <br />7. If a partnership, state n, <br />Clark's exhibit no, <br />meting 4-14-76 <br />urn <br />APR '14 1976 <br />CITY OF <br />