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vm <br />STATE OF MINNESOTA o.s arse rto r> <br />DEPARTMENT OF PUBLIC SAFETY <br />LIQUOR CONTROL DIVISION <br />APPLICATION FOR OFF SALE INTOXICATING LIQUOR LICENSE <br />This application and the bond shall be submitted in duplicate <br />Whoever shall knowingly and wilruliy falsify the amwets to the following questionnaire shall be <br />deemed guilty of perjw7 and &hall 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 Shan execute this application for all members of the partnership. <br />EVERY QUESTION MUST BE ANSWERED. <br />BUSINESS APPLICANT'S HOME <br />PHONE NUMBER y�y" i I �- — PHONE NUMBER y8�1 4 a►� <br />1. I nARtrL MERRAl iETERS�t�+-. PARTtJc� <br />(Individwa owner. O&tr. or partner) <br />for and in behalf of- NARLE*; E CZ+t+RRO PE i E R'i E N hereby apply for an Off Sale <br />Intoxicating Liquar License to be located at -- <br />(Siren Addicts and/or Lot and Nock Number) <br />Municipality of L t T'S LE C P+ti aD*'1 Connty of 5 E b . <br />State of Minnesota. in rdance with the provisions of Minnesota Statutes, Chapter 340. commencing <br />19—. and ending 19— <br />2. Give applicants' date of b' 31 f`fl A V 1C1.1 4 <br />(DI y) (Month (Yogi) <br />Is rE8. t944 <br />Brrthdates of Partners (D,v) (Month) (Y•a►) <br />or (LOV) (Month) ry—) <br />Officers of Corporation <br />(mv) (Month) (Year) <br />3. The residence for each of the applicants named herein for the past five veam is as fo11ov� <br />4aib LARK f+vE• f%AFLF- U.IOOV j M,NV <br />L M gj%AsT QL00 AUE.• LtT•fc•E GR0A9A ,fhiNtJ' <br />4. Is the applicant a citizen of the United States" 1! E S <br />If naturalized state date and place of naturalization_ <br />It a corporation. o nership, state citizenship status of all officers or partners. <br />vHt'fRLLtiG CtIL'ARO — +- \ \Lt=r► <br />6. The person who executes this application shall give vr'ife'a or husband's full name and address <br />�NA2LCNc Rtt\ARO C)E'T=RS�t�1~ '�rt�• Pt•+�51C�A1.14�,�, �AL�G — <br />Lt-r•r�E Cflt..AtR !t'1ft-�: SSfi7 <br />6. What occupations have applicant and associates in this application followed for the palt five years" <br />Lt.\VAoLCSP.LE �REAQ �•5 iR+3�.'T�� <br />7. If a partnership. state ,tame and address of each member of partnership <br />p�:., EL RR+•t_L QE'EE'25� N -- �,cic {�<1S'TRRL�A1�, A�"•E • • <br />1-riT�C Cfi*�A9R M,%Vti• S5)17 <br />S11 tk(ZLC1,;C C\1L� O PGT>~t�SE� •— �0�� ��\S��Prttl4t,.' A���' . <br />f+"1+Ntj' S151 0, <br />CLERK'S EXHIBrT rf0. 1286 d <br />�'ETL'!C,- i +-9-77 <br />