09-25-2017 Council Packet - Laserfiche WebLink

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14. Will there be a charge for drinks? ❑ Yes & No 15. Will there be food available? AYes ❑ No Describe the type of food, how it will be served, and the hours food will be available. 16. Applicant and his associates in this application will strictly comply with all the laws of the State of Minnesota governing the taxation and the sale of intoxicating liquor, wine, or 3.2 percent malt liquor or beer and the Orono City Code, and I hereby certify that I have read the foregoing questions and that the answers to said questions are true of my own knowledge. 17. As the person executing this application for this license, I acknowledge that an investigation will be conducted for use in determining my qualifications. I hereby expressly authorize release of any and all information which any organization, company or person may have, including information of a confidential or privileged nature. I hereby release the City and any organization, company or person famishing information to the City, as expressly authorized above, from any liability for damage which may result from furnishing the information requested. 18. The information requested on this form will be used by the City of Orono in the issuance of your license or processing of your renewal application. The information that you supply on this form will become public information when received by the City of Orono. Under Minnesota law (M.S. 270.72), the City may be required to provide the business tax identification number and social security number of each applicant to the Minnesota Commissioner of Revenue. ANY FALSIFICATION OF ANSWERS TO THE ABOVE QUESTIONS WILL RESULT IN DENIAL OF gpo�j(Title) va— For Office Use Only Review by Administration. ❑ Approved ❑ Denied ❑ NA By Review by Police Department, ❑ Approved ❑ Denied ❑ NA By Comments. Td' Page 3 {-f lJ✓�0'f� Cane; -( �.' � , -J9 , 44"42�s r 16. Applicant and his associates in this application will strictly comply with all the laws of the State of Minnesota governing the taxation and the sale of intoxicating liquor, wine, or 3.2 percent malt liquor or beer and the Orono City Code, and I hereby certify that I have read the foregoing questions and that the answers to said questions are true of my own knowledge. 17. As the person executing this application for this license, I acknowledge that an investigation will be conducted for use in determining my qualifications. I hereby expressly authorize release of any and all information which any organization, company or person may have, including information of a confidential or privileged nature. I hereby release the City and any organization, company or person famishing information to the City, as expressly authorized above, from any liability for damage which may result from furnishing the information requested. 18. The information requested on this form will be used by the City of Orono in the issuance of your license or processing of your renewal application. The information that you supply on this form will become public information when received by the City of Orono. Under Minnesota law (M.S. 270.72), the City may be required to provide the business tax identification number and social security number of each applicant to the Minnesota Commissioner of Revenue. ANY FALSIFICATION OF ANSWERS TO THE ABOVE QUESTIONS WILL RESULT IN DENIAL OF gpo�j(Title) va— For Office Use Only Review by Administration. ❑ Approved ❑ Denied ❑ NA By Review by Police Department, ❑ Approved ❑ Denied ❑ NA By Comments. Td' Page 3