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MINNESOTA DEPARTMENT OF PUBLIC SAFMIfbr Control will notPtw?Av)91Qf9) PHONE (612) 296-6434 LIQUOR CONTROL DIVISION release any license until the $20 �,. L� • ST. PAUL, MN 55101 Retailers Identification Card fee i8 reolved by MN Liquor Cott APPLICATION FOR COUNTY OR CITY ON SALE WINE LICENSE NOT TO EXCEED 14% OF ALCOHOL BY VOLUME --L/-I EVERY QUESTION MUST BE ANSWERED. If a corporation,an officer shall execute this application. If a partnership, a partner shall execute this application. Applicants N, ne(Business.Partnership.Corporation) Trade Name or DBA S 4C ResS NER Business oAaoress Business Phone Applicant's Home Phone W I v - KC— O" ( (12 ) 871 - I It? ) ( 6iZ ) 8"11— )1-3i City County State Zip Code 91 ANTN hENN - IN R11P,11-St-4 MN Is this application If a transfer,give name of former owner License period [a'New❑ Renewal❑Transfer From ' q 4 Tc 1°IS If a corporation,give name,title,address and date of birth of each officer.If a partnership,give name,address and date of wrtn of each partner. Partner/Officer Name and Title Address DOB e a 3 - NPLS MN Partner/Officer Name and Title Address DOB Partner/Officer Name and Title Address DOB Partner/Officer Name and Title Address DOB CORPORATIONS Date f incorporation State of incorporation Certificate number (HgR;r-R-M Is corporation authorized to do business in Minnesota? (, 6 9 4 MINN a logZ 8y a98 RYes ❑ No If a subsidiary of another corporation,give name and address of parent corporation BUILDING AND RESTAURANT Name of building owner Owner's address 5S)I g AP(ICHE PLAZA Irni LIT D 1 9449EM IR MN Are Property Taxes delinquent? Has the building owner any connection,direct or indirect. Restaurant seating capacity E]Yes RNo with the applicant? ❑ Yes CSAO 00 Hours loud will be available No.of people restaurant employs No.of months per year restaurant Will food service be the principle business 100 Rm rC Ott PM will be open —12 vnn}h s Yes ❑ No Describe the premises to be licensed - P TSI D► N AMC-RIC Rr-1 R>?S'fAV12AN i If the restaurant is in conjunction with another business(resort,etc.).describe business QTS )N SHOP INCr CENTRC— OTHER INFORMATION 1. Have the applicant or associates been granted an on-sale non-intoxicating malt beverage (3.2) and/or a "set- up" license in conjunction with this wine license? C3Ws ❑ No 2. Is the applicant or any of the associates in this application a member of the county board or the city council which will issue this license? ❑Yes J� No If yes, in what capacity? * (if the applicant is the spouse of a member of the govern body, or another family relationship exists, the member shall not vote on this application.) 3. During the past license year has a summons been issued under the liquor civil liability(Dram Shop)(M.S. 340A802). ❑Yes f5�No If yes, attach a copy of the summons.