05-09-1979 Council Agenda - Laserfiche WebLink

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Pe 0068 On STATE OF MINNESOTA - DEPARTMENT OF PUBLIC SAFETY LIOUOR CONTROL DIVISION APPLICATION FOR RENEWAL OFF —SALE INTOXICATING LIQUOR LICENSE This application and bond shall be submitted in duplicate Whoever shall knowingly and willfully falsify the answers to the following questionnaire shall he deemed guilty of perjury and shall be punished accordingly. In answering the following questions "APPLICANTS" shall be governed as follows: For a partnership ono of the partners shall execute this application for all members of the partnership. For a corporation one of icor shall execute this application for all of ficers, directors and stockholders. PART I 'I II / ,I tI BUSINESS PHONE NUMBER 4'R 4 -44'14, APPLICANT'S HOME PHONE NUMBER 'i' KL{ 04 -(I I, WU{YCO Yclt . © v 1oc '>` 5 for and to behalf of Ilnaisiduall 10011neq (officer olwrnomrron) (name of individual} Oh_ Imams of Pennvsl 131.oc,n'1 L.IcJ000 'E. �C. pr them( oieo,(w,ah inn( `1 intoxicating liquor license located at a -15112 N4 kC 'Si jo YE_ .4 JCs make applicat on to RENEWAL of Off•Sale (Weft address - or - IDs and block number) city of L. tEle_ C141n4cl 21) Code SS 117 ,countyof Rtfn Sep/ commencing '14 Ml' 30 19,c1 and end' e '`a 1'l o 3 c' 1988 B Check 111 box If no changes since last applying for renewal of license If there has been a change; that is, change in ownership; addition of partner; administrator or admmrstratrix to an estate named: change of officers, directors or stockholders in corporal Mn; change of locatbn; or new liquor establishment, then form PS 9136, Application for 0f45a1e intoxicating Liquor License, must be executed instead of this form (see your city clerk for form PS 91361. PART II FOR CORPORATION. 1114f' 4 le'l lblucnn I era me,M o l llm,r. direcron and thockn oldrrrl fT10y lc 13100`'n PART 111 a. State whether applicant, or any of his associates in this application, have ever had an application for a liquor lice rejected by any city or State authority; if so, give date and details 11 G b. Has the applicant, or any of his associates in this application, during the live years immediately preceding this application ever had a license under the Minnesota Liquor Control Act revoked for any violation of such laws or local ordinances; if so, give date and details no c. State whether applicant, or any of his associates in this application, during the past five years were ever convicted of any Liquor Law violation or any crime in this state, or any other state, or under Federal Laws; if so, give date and deta Is I] O Applicant, and his associates in this application, will strictly comply with all the Laws of the State of Minnesota governing the taxation and the sale of intoxicating liquor; rules and regulations promulgated by the Liquor Control Director; and all ordinances of the City; and I hereby certify that i have read the foregoing questions and that the answers to said questioners are true of my own knowledge. 2`Rci �i (7. (.d -( .0 2)11 Irrpne meet Banrcml Subscribed and sworn to before me this �_dayof 1gL rrr_(r (Noha,e P itt My commsion exit es ANNETTE FREEM /u )101101' PUalle - 1.1l1011S5Ie RAMSEY COUNTY REPORT ON APPLICANT OR APPLICANTS BY POLICE DEPARTMENT This is to certify that the applicant, or his associates, named herein have not been convicted within the past live years for any violation of Laws of the State of Minnesota, or City Ordinances relating to intoxicating Liquor, except as he einafte stated Approved 8y Inamo of caul POLICE DEPARTMENT TITLE Of you have no police department, either the Marshal or the Constable shall execute this report On the applicant.)