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FOR OFFICE USE <br />Case No. <br />Date Received <br />By <br />CITY OF LINO LAKES <br />APPLICATION FOR INTOXICATING <br />LIQUOR, WINE OR CLUB LICENSE <br />co <br />LICENSE FEES: Off -Sale $ /4, On -Sale 040o Sunday $ 070d <br />Wine $ Club $ <br />PART 1 - General Information <br />oe <br />This application requests information which may be classified as private or confidential <br />under the Minnesota Data Practices Act. This information is required by State law or <br />City ordinance. The information will be used to determine your eligibility for issuance of <br />a license, permit, or identification card. Failure to provide the information will result in a <br />denial of the license. <br />DIRECTIONS: This form must be filled out with typewriter or by printing in ink. <br />If the application is by a natural person, by such person; if by a <br />corporation, by an officer of the corporation; if by a partnership, by <br />one of the partners; if by an unincorporated association, by the <br />manager or managing officer of the association. <br />1. Name of Applicant (name of individual, partnership, corporation or association): <br />ffnt G s a i ti,-.4 0 11.7 i L. z .-< <br />2. Business Name: % /L S 0 N /n /1-/ Ty' <br />Business Address: 8 o© A flke_ s_ /wY fia / Y <br />(Street, City, State, Zip) <br />Business Phone: 45- / 7I—) — % /1'6 <br />(Area Code & No.) <br />IF BUSINESS IS TO BE CONDUCTED UNDER A DESIGNATION, NAME OR STYLE <br />OTHER THAN FULL INDIVIDUAL NAME OF THE APPLICANT, ATTACH TWO (2) <br />COPIES OF THE TRADE NAME CERTIFICATE, AS REQUIRED BY CHAPTER 333, <br />MINNESOTA STATUES, SECRETARY OF STATES OFFICE. <br />PAGE 1 <br />