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CITY OF MOUNDS VIEW <br />APPLICAT10N rw ON -SALT: INTOXICATING LiQUOR LICENSE <br />Phis form ,ra,, prepared by the iinnesota Bureau of Criminal Ap- <br />prehension, Department of Public Safety, pursuant to Minnesota <br />Statutes, 1916, Section 340.13, for purposes of background in- <br />vestigation, it does not supercede any laws, rules or regula- <br />tions of the Division of Liquor Control regarding the issuance <br />-of liquor licenses. failure to provide information requested <br />may result in denial of the application. <br />trade. name - — — <br />licensing per•rod <br />date o application <br />j'hunc, business — <br />1, Type of Application: C_1 Nev; [� Rrnerral [� Transfer <br />2, <br />name�applicanl phone, home <br />J. <br />ome a dress'-- — iiiy state <br />4. <br />date o birt — _ �� place of birt <br />5, <br />address of bus ess location <br />6. legal description <br />7.'Sunday'liquor sales: yes no Seating capacityi 400 <br />B, List owners of building or premise to be licensed: <br />9, <br />corporate or partnership <br />237� rL <br />corporate or partnership <br />e <br />11b <br />10. List all partners, officers or directors, if corporation: <br />name address <br />0 <br />date of birth <br /><,1J;.7 <br />