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CC PACKET 09272005
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CC PACKET 09272005
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7/30/2015 11:55:56 AM
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5/7/2014 3:40:27 PM
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City Council
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Council Agenda/Packets
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City Code Chapter Amendment
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019 <br />PART IIT - PERSONAL INFORie1 knON <br />City of St. Anthony Liquor- &'Nine License Application <br />``his section should be completed by each individual, partner, officer, manager, proprietor or other <br />agent in charge, and each person who by combined ownership or control has an interest in a <br />corporation or association. in excess of five percent ON <br />T'ruc,Name <br />GUY LEON PETERSON_ <br />-Date of Birth4/26/66 place of Birth MINNESOTA <br />—�----------�-- — — -- <br />— - <br />Current Home Address 1 14693 WACO ST ANOKA MN 55363 — <br />Ci Stat_'_...ezZi <br />_-.... _ - - <br />Other Names UsecVM ts' — - — <br />Marital Status S atus Smole X Married Divorced <br />Souse's hra0Nanle SANDRA PETERSON ..._�_ <br />Date of Bir r —.. 1 Place ofl3ir(h I <br />%tome Address 14693 WACO S ANOKA MN 55363 _ _..._ <br />( itv State, �1,J - —� <br />_- . _.. ._— .. _ _— <br />No SP) s No <br />Are you or your spouse 3 registered voter'? Appl c,rnt XYes . XY <br />Location: RAMSEY MN i i,ocation: RAMSEY, MN <br />Residence Address for Preceding 10 Years: <br />SAME <br />_j <br />c rv, s'Lte,-- <br />_. <br />Name, Address andPhono Number of hadiv du is Employers and Partners for Preceding 10 rear,_) <br />kWALTER f-ORSCHEN 763-421-4209 <br />Names, Addresses and Phone Number of Spouse's limiDloyers and Partners for Preceding 10 Years: <br />--------- - ------ - - <br />Has applicant or spouse, or a parent or sibling or child ever been convicted of any, crime or <br />violation of any ordinance other than traffic? If so, please furnish information as to the tune, place <br />and offense for which convictions were had: <br />NONE= <br />\`arae. home address and business address of each person who is engaged in ivruu esora in we <br />busuress of selling, manufacturing or distributing liquor and who is nearer to kin to the applicant or <br />pone than second cousin, whether of the whole or half blood, computed by the rules of civil law, <br />or who is a brother-in-law or: sister-in-law of the applicant or the 1pp icant's sLouse. <br />Military Service (Upon r_egncst, yon may be asked to provide discharge papers) - —_ . Yes___X , No <br />
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