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OFF -SALE LIQUOR APPLICATION <br />4. Type of license applicant seeks: <br />On -Sale On -Sale "Special Event" <br />INDIVIDUAL <br />5(a). If applicant is a natural person (individual), <br />and business address and telephone numbers. <br />True Name: 16/LS'O `' <br />(Last) <br />rLLj falai <br />(First) <br />Off -Sale <br />state full name, residence <br />Residence Address: i 4 (as )./..4--/y . L. <br />. . <br />(Street) <br />IIS- \ 1 Ak( IY' <br />S-.5- <br />(City, State, Zip) <br />Business Address: <br />C,(It3 41er,�i�� <br />(Street) <br />(Full Middle Name) <br />Phone:_ <br />( ea Code & No.) <br />(City, State, Zip) <br />Phone: <br />(Area Code & No.) <br />5(b). The full name, residence address and telephone number of the manager <br />charge of the individual owner's premises at such time as the <br />absent. (A resident manager is required if the owner is not <br />City Code, <br />True Name: <br />Section 701, Subd. 4) <br />(Last) (First) <br />in <br />owner is <br />a resident, <br />Residence Address: i (G /AS 4,I <br />ii (Street) <br />f <br />_i }'A r r 1 �-' � K C_ (4) 1 dam' . <br />(City, State, Zip) <br />PARTNERSHIP <br />6. If the applicant is a partnership, state full names, residence and business <br />addresses, telephone numbers, and interest of each member of the <br />partnership. <br />(Full Middle Name) <br />Phone:CI <br />(Area Code & No.) <br />a. Full Name: <br />(Last) (First) (Full Middle Name) <br />ResidenceAddress: <br />(Street) <br />Interest <br />Phone: <br />(Area Code & No.) <br />Business Address: <br />(City, State, Zip) <br />(Street) <br />Phone: <br />(Area Code & No.) <br />(City, State, Zip) <br />PAGE 2 <br />