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FOR OFFICE USE <br />Case No. <br />Date Received <br />By <br />CITY OF LINO LAKES <br />APPLICATION FOR SALE OF NON - INTOXICATING <br />MALT LIQUOR LICENSE <br />LICENSE FEES: Off -Sale $ <br />On -Sale $ <br />PART 1 - General Information <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 />I . Name of Applicant (name of individual, partnership, corporation or association): <br />OP -4‘01s, <br />2. Business Name: 1.0,./10,0:x �/P C.�o �•-S� <br />/`yAolf y Cow Fiefs t eEc •6a <br />-1.47 e/o7`, <br />Business Address: .S S.Qv.,filei- Zcile <br />(Street, City, State, Zip) <br />Business Phone: (6./ 2) 75 7- 3 Q2o <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 />