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MINNESOTA DEPARTMENT OF PUBLIC SAFETY Ps•9114(11.8S) <br />PHONE (612) 296 -6434 LIQUOR CONTROL DIVISION <br />333 SIBLEY • ST. PAUL, MN 55101 <br />APPLICATION FOR COUNTY OR CITY ON SALE WINE LICENSE <br />NOT TO EXCEED 14% OF ALCOHOL BY VOLUME <br />EVERY QUESTION MUST BE ANSWERED. If a corporation, an officer shall execute this application. If a partnership, <br />a partner shall execute this application. <br />Applicants Name (Business, Partnership, Corporation) <br />gffeeY ScdTr Q,A /6-6..1 <br />Trade Name or DBA <br />Totrs ht. V AA.)eeAS CwN €OY CCU ' <br />Business Address <br />/o, I' 9246 <br />Business Phone <br />( 61a ) if'/ -sa 71 <br />Applicant's Home Phone <br />(tea )¢50-3o51 <br />City <br />Nan/ Sr. "'tut, <br />County <br />ieNviscY <br />State <br />/t.i4 <br />Zip Code <br />.5-5 IO1 <br />Is this application <br />New ❑ Renewal ❑ Transfer <br />If a transfer, give name of former owner <br />License period <br />From 7— --gZTD j,--9 <br />If a corporation. give name, title, address and date of birth of each officer. If a partnership. give name, address and date of birth of each partner. <br />Partner /Officer Name and Title <br />Address <br />D08 <br />Partner /Officer Name and Title <br />Address <br />DOB <br />Partner /Officer Name and Title <br />Address <br />DOB <br />Partner /Officer Name and Title <br />Address <br />DOB <br />CORPORATIONS <br />Date of incorporation <br />State of incorporation <br />Certificate number <br />Is corporation authorized to do business in Minnesota? <br />❑ Yes ❑ No <br />If a subsidiary of another corporation, give name and address of parent corporation <br />BUILDING AND RESTAURANT <br />Name of building owner <br />7 9mes <br />Owner's address <br />Are Property Taxes delinquent? <br />❑ Yes ® No <br />Has the building owner any connection, direct or indirect, <br />with the applicant? ❑ Yes ki No <br />Restaurant seating capacity <br />/bb <br />Hours food will be available <br />No. of people restaurant employs <br />No. of months per year restaurant <br />will be open f a <br />Will food service be the principle business <br />❑ Yes ® No <br />Describe the premises to be licensed <br />)(>k. E. Li `[ FLE CM i pA Eve koUND t4,e& PLAzA- <br />1 <br />If the restaurant is in conjunction with another business (resort, etc.), describe business <br />CoMEOY ccua <br />OTHER INFORMATION <br />1. Have the applicant or associates been granted an on -sale non <br />up" license in conjunction with this wine license? 21 Yes <br />2. Is the applicant or any of the associates in this application' a <br />which will issue this license? ❑ Yes Z No <br />If yes, in what capacity? . (If the applicant <br />- intoxicating malt beverage (3.2) and /or a "set- <br />■ No <br />member of the county board or the city council <br />is the spouse of a member of the governing <br />body, <br />3. During <br />■ <br />or another family relationship exists, the member shall not vote on this application.) <br />the past license year has a summons been issued under the liquor civil liability (Dram Shop) (M.S. 340A802). <br />Yes jj No If yes, attach a copy of the summons. <br />age <br />