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CITY OF MOUNDS VIEW <br />APPLICATION 1.011 011-SALE 111TOY.ICAT11;G Ll1 luk I.R.HiSE <br />c <br />This fm•nl was prepared by the hlinnesola Bureau of Criminal Ap- <br />prehension, Department of Public Safety, pursuant to Minnesota <br />Statutes, 1916, SocLlun 340.13, for purpn;os of background in- <br />vcsligaliun. It does noL supersede any laws, rules or regula- <br />tions of the Division of Hquor Control regarding the issuance <br />of liquor licenses. Failure to provide iufm7nation requested <br />may result in donial of the application. <br />trade name <br />llccusing perlad ---. <br />1. Type of Application: Now IJ Renewal <br />Lt <br />name o app scant <br />date if appliFddo <br />qy- <br />phunu, Uii%incss <br />LJ Transfer <br />Phone, home <br />c �I ) <br />>tonie��ress -I y slate <br />4 J�, . 3G <br />atd-e of birth place 'of LlTrrh <br />/t 11 11 <br />5, — Lccj Y- IUi�itl.,L-LLL-0 /ILIA <br />address of business location 3 �,, p{- <br />uroplN77: n 1AWO. 'r4, L'. 36, rr.c''� tv <br />L, lrryal dr.,r.ripLioncFLi.l"/// of 5•lpJ, I/`/ -fS.cBJe'c7 1 G' neon) or <br />— _ ---------- -......... <br />7. Sunday liquor sales: yes-s�- no Seating capacity:_ eo <br />©. List owners of building or promise to be licensed: <br />;I�' 1!1e 16✓11Ilk <br />I <br />10. List all partners, officers or directors, if corporation: <br />name <br />address <br />date of birth <br />