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10. State whether any person other than applicants has any right, title or interest in the furniture, <br /> fixtures, or equipment for which license is applied, and if so give name and details. <br /> SIMON T . SIMON (BUILDING OWNER) OWNS WALK IN COOLER, SHELVES , COUNTERS . <br /> 11. Have applicants any interest whatsoever, directly or indirectly, in any other liquor establishment in <br /> the State of Minnesota? NO Give name and address of such establishment <br /> NORTHEAST STATE BANK <br /> 12. Furnish name and address of one bank reference <br /> 77 N. E . BROADWAY STREET , MPLS , MN. 55413 TEL # 612-379-8811 <br /> 13. Under what classification is the license applied for: EXCLUSIVE OFF-SALE LIQUOR STORE,LDRUG <br /> SmoR' <br /> STORE, COMBINATION ON & OFF LIQUOR, OR GENERAL FOOD STORE EX. OFF SALE <br /> 14. Are the premises now occupied, or to be occupied, by the applicant entirely separate and <br /> exclusive from any other business establishment? YES <br /> 15. If a drug store, state length of time the store has been in operation <br /> N/A <br /> 16. State whether applicant has, or will be granted, an On-Sale Liquor License in conjunction with this <br /> Off-Sale Liquor License, and for the same premises NO <br /> 17. State whether applicant has, or will be granted, a Sunday On-Sale Liquor License in conjunction <br /> with the regular On-Sale Liquor License <br /> NO <br /> 18. State whether applicant has, or will be granted an Off-Sale Non-Intoxicating Malt Beverage (3/2) <br /> License in conjunction with this Off-Sale Liquor License NO <br /> 19. During the past license year has a summons been issued under the Liquor Civil Liability Law (Dram Shop) <br /> M.S. 340A.802. ❑ Yes -No. If-yes,—attach-a-Copy-of-t e-summons._ <br /> Subscribed and sworn to before me this I hereby certify that ave rea• e . •••- <br /> question and that the answers are true of my <br /> day of S " 19 C 3 own knowledge. <br /> 4taryPub& / <br /> t- 3 I- :;: a ;., BARBRA J.NA(. NSON (Signature of applicant) <br /> My commission expires NOTARYPUBLIC-MINNESOTA <br /> ANOKA COUNTY <br /> '•• My Commission Expires Jan.31.2000 <br /> REPORT ON APPLICANT OR APPLICANTS BY POLICE DEPARTMENT <br /> This is to certify that the applicant, and the associates, named herein have not been convicted <br /> within the past five years for any violation of Laws of the State of Minnesota, or Municipal <br /> Ordinances relating to Intoxicating Liquor, except as hereinafter stated <br />