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11. If title Is a transfer application give name, address, of persons, partnership or <br />C,'W'G ivs nuldiAg Ike*" for She Past year. <br />I.00sco, iI.C, 217, illvllwav 10 Mourlds View. MN 5r 112 <br />12. We Owns the tavern fixtures? <br />10. lines vending er eechentut smaleeent device coxgan, Ms nr .1II mare maChlnel on <br />the Ilcersed promote? <br />Advnoc,r 'artcr <br />14. Are you A Minnesota resident? © yet 13 No 1'uto',sr t <br />If not, .here resident. dates of residency <br />15. Have you ever been Convicted of violating Federal, State or Local liquor laws <br />and/or regulations? O yes ED Mo <br />If yes explain fully on separate sheet of paper <br />16. List four business references Currently familiar with you <br />and your business interests. <br />Name Address Phone <br />Norman CI h 950 becater Avenue 54/-5050 <br />Earl OoLle 112 Central Ave NF. 171-3222 <br />S. T.Moven, Attny 7500 Buone Ave 424-"4e6 <br />David Rosen 6030 Wayzata Blvd 546-4419 <br />17. <br />Aspllcsnt, and his assuriates in this APPIicsdon, will strictly comply With all <br />tee Laws of toe State Of Minnesota governing t"e taxation and the sale Of IhidA- <br />Icatin9 liquor; rules aid regulations prvwlgited tl ine Uglier Control [chaise- <br />sioner, And all onfriantes of the municipality; And I hereby certiy, that I <br />read thehave foregoing guestio" and that the anLwers to said guescions are true of <br />my Our mnowled7e. 1 further understand that in Investl9stion fee rot to exceed <br />$500.00 shall be charged an Applicant by the city or county If the Investigation <br />IS conducted within the state, er the cost not to exceed S10,000.00 It tan Inves- <br />ligation Is regulnd outside the state. <br />....cant_ <br />gnature o pp Cant <br />Subscribed and sworn to before ma this <br />L11 day of il;, svi ru 19Ec . <br />no ry Pv c <br />MY Comalsslon expires <br />ti-% <br />Y tL' �'ANMt 11' r 1'rAr ywa <br />��) VrY ,t!)YI11 <br />w, cw.inw I,r,r. hY A Ia♦ <br />• raw <br />briar <br />