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10/17/2007 WED 15:14 FAX 6127823302 Canon 6870 <br />City 0f St. Anthony <br />3301 Silver Lake Road <br />SI, Anthouv, MN 55432 <br />(612)789-888[ <br />li'a: <br />lill0xicnti�Liquortl�il�e <br />S ldti <br />veno <br />Invesfigtuive_Fcc <br />Ill �-e}linafiye_ hee <br />APPLICATION FOR ON-SALL <br />INTOXICATING LIQl10R & WINE LICENSE <br />."'000 <br />200 <br />one year <br />S 500_in-sLte_non_fefunclllble <br />$2.500 out ofslatc Io n �xinunn of $10 OOU <br />Receipt it <br />License tr <br />MNTax ID0 <br />un l A PRIVACY N011t'G: "Ilse U ue you supply on this f""' ,,I] its us,d to assess your quail ficalions forlhc licrnst. 1'ou are not legally required to <br />provide this data, but tvcttill not h, e61c to gmilt it,, lice.... .... )"ut il. If Beats. is granted, Ihcdau you have supplied will constimle a public record <br />;'II -olio's play be is.ncd to onymie ieque_tinn them. The required data allows us to dislinguisll you from other applicams; to iftwify you in our license <br />h1 lot nay dial Jell i'e the perso t t'Jw applied for the Bemis.. to wtilxl you irony additional infurntatiou is requirod; to dctem:inC whether you <br />m� ct <br />311Y minin8un ryc requircmems ,, d io dcicr... i e if airy mnviciiou you may hnvc on accord might affect your suitability as a liceesc holder four <br />acs km v adores wd Icl,irPoi c nunua.r mill be coiuFlered public dnia unless .,¢ni request dos iidoiineli0u m be private :nut ;m dlmvnliva <br />.Will nd Ideplbrc imn.r (sec'clow) <br />H, it,, sig" bclmv to iudicete Ibat Voll hrrca read Ihis notice: <br />' g'f ww <br />I n toed 111,11 lly res d,na. addlxss -oil dglhonc llmolm 1s ctlu i l,r^d 1), ivJ lta My: Lruontc Wdress and lulephmic monbcr u -c is follows. <br />Ad Irss <br />I. Rebecca Robbins Tilden <br />(f as Officer <br />u'sl noddle Hun last nanw ol'puson makntg applic cion) (Inde ideal ottncr, olltccr of mrhmrJ <br />lot mid ill bellalfolApplebee' s Restaurants North LLO': <br />(Individual/Ptnuuship/Goipornion) <br />Ilercby submit this application lot all Ou-sale Intoxicating Liquor' & Wine License for: <br />Applebee's Nieghborhood Grill & Bar <br />(Name of ieslaw.mt or hotel) <br />log Itti a1 <br />2800 39th Ave NE, St. Anthony, MN 55421 <br />_.._ (Sh'wVAdth'ess and/or pial and l'arc,l Numbm) <br />for the safe of intoxicating liquor in accordance With the provisions of Minnesota Statutes, Chaptci 340 and the St. <br />Anthony Ciy Code, Chapter 1000. <br />Mitt ills <br />'— — ---....—'-----and ending . <br />......_ - ------ - -_. ..---. .. <br />_ <br />-C-t-Iroc APp7P-erG Re Gtanrantc Ncx th-LLC. _ <br />(Cign Durr IfwSon Makii 1, A)pliccoou (Nam, oflndividual lirmet'nhip, Corporation Or Association) <br />Slnle44nrrcTcrtT 1 <br />oV�a IlWas <br />cowuy of llwaecyrrtr• ) <br />0 c YISo-vt <br />Subo-i lad, acknowledged anal <br />LAURA GREGORY <br />PUBLIC -STATE OF <br />13y. <br />In suppm t of said appllcatlon ant m accOrt ancc wtf 1 to requirements asset forth ill said Chapters, f sere is <br />attached hereto, ill duplicate, all applicable parts and personal information forms, liability iusueance policy, <br />wool leers compensation policy, band, license coal investigative fees. <br />0018/030 <br />1 17 <br />