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1000^ <br />CITi Of MOUNDS VIEW <br />2401 Highway 10 <br />Mounds View, MN 55112 <br />LICENSE APPLICATION FORM <br />s USINISS NAMt Loose Ends on 10 — — <br />Date of application March 1, 1986 <br />Phone 784-5555 - <br />IuSINESS ADURESS 2375 Highway 10 <br />(street) <br />Mounds View MN 55112 <br />city) (state) (tip code) <br />OWNERS/CORPORATE OFF ICE•$/ASSOCIATES/PARTNERS (name and title:) <br />Steven M. Hauck <br />David E. Arone <br />Pres/Sec —_ <br />TYPE OF LICENSE KEQUESTEU: On -sale Intoxicating Liaunr License <br />HAVE YOU EVER HAD A LICENSE REVOKED? NO If yes, attach explanation. <br />KEpeRENCES; CITIES wHERE PKEVIOUSLY OR CURRENTLY LICENSED /0I SAME <br />ACTIVITY (name of city and year(•) licensed) <br />Minneapolis 1960-1986 <br />Applicants for the following license must complete the applicaSls section <br />on the reverse aldP of this form: <br />amusement devices, bowling alleys, dance hall#, garbage collection, <br />g•sollne stations, kennels, and roste"ants. <br />uuuauuuuuuu•.•u.•u•au•••u••uuu•u•uuu••••uuu•u•u <br />I hereby certify that information provided on this application is true and <br />correct and understand that any misrepresentation made hereto may be <br />grounds for denial of this application. <br />Applicant's name Arone ►ul^ Mr- <br />(pleses print) Lmat Tst <br />Date of birth 12/ 03 / 53 <br />so day yr <br />Applicant's signature <br />