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61 <br />Minnesota Department of Public Safety <br />Alcohol and Gambling Enforcement <br />444 Cedar St., Suite 100L <br />St. Paul, MN 55101 -2156 <br />296 -6430 • TTY 612- 282 -6555 • FAX 612 - 297 -5259 <br />RE 1� Wj L OF LIQUOR, WINE, OR CLUB LICENSE <br />No license will be approved or released until the $20 Retailer ID Card fee is received by MN Liquor Control <br />Licensee: Please verify your license information contained below. Make corrections if necessary and sign. City <br />Clerk/County Auditor should submit this signed renewal with completed license and licensee liquor liability for the new <br />license period. City Clerk /County Auditor are also required by M.S. 340A.404 S. 3 to report any license <br />cancellation. <br />License Code MCLONSS License Period Ending 06/30/ 1998 ID # 1025 <br />City /County where license approved Lino Lakes <br />Licensee Name <br />Trade Name <br />VFW 6583 <br />Circle -Lex VFW Post <br />Licensed Location address 7868 Lake Dr <br />City, State, Zip Code <br />Lino Lakes, MN 55013 <br />Business Phone ( 612) 784 -9313 <br />LICENSE FEES: Off Sale $ <br />On Sale $ 100. 00 Sunday $ 200. 00 <br />By signing this renewal application, applicant certifies that there has been no change in ownership or the above named <br />licensee. For changes in ownership, the licensee named above, or for new licensees, full applications should be used. <br />See back of this application for further information needed to complete this renewal. <br />Applicant's signature on this renewal confirms the following: Failure to report any of the following will result in fines. <br />1. Licensee confirms it has no interest whatsoever, directly or indirectly in any other liquor establishments in <br />Minnesota. If so, give details on back of this application. <br />2. Licensee confirms that it has never had a liquor license rejected by any city /township /county in the state of <br />Minnesota. If ever rejected, please give details on the back of this renewal, then sign below. <br />3. Licensee confirms that for the past five years it has not had a liquor license revoked for any liquor law violation <br />(state or local). If a revocation has occurred, please give details on the back of this renewal, then sign below. <br />4. Licensee confirms that during the past five years it or its employees have not been cited for any civil or criminal <br />liquor law violations. If violations have occurred. please give details on back of this renewal, then sign below. <br />5. Licensee confirms that during the past license year, a summons has not been issued under the Liquor Liability Law <br />(Dram Shop) MS 340A.802. If yes, attach a copy of the summons, then sign below. <br />6. Licensee confirms that Workers Compensation insurance is in effect for the full license period. <br />Licensee has attached a liquor liability insurance certificate that corresponds with the license period in city /county <br />where license is issued. $100,000 in cash or securities or $100, 000 surety bond may be submitted in lieu of liquor <br />liability. <br />Licensee Signature ' d <br />/ Date <br />certifies all abov information to be correct and license has been approved by city /county. <br />City Clerk /County Auditor Signature Date <br />(Signature certifies that renewal of a liquor, wine or club license has been approved by the city /county as stated above. <br />County Attorney Signature Date <br />County Board issued licenses only (Signature certifies licensee is eligible for license). <br />Police /Sheriff Signature Date <br />(Signature certifies licensee or associates have not been cited during the past five years for any state /local liquor law <br />violations (criminal /civil). Report violations on hack, then sign here. <br />>s (ni&)3 -96 <br />