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f <br />> <br />Minoetott Depanoiem of Public Safety <br />Akoliol m4 Ganbliiig Enforcemeat <br />444 Cedar Street, Suite 133 <br />SLPaul,MN3SIOI-S133 <br />651.296-6979 • TTY 651-282-6555 • Fax 651-297-5259 <br />RENEWAL OF LIQUOR, WINE, CLUB OR 3.2% '^CENSES <br />Ko licaate will be approved or ideated until the $20 Retailer ID Canl fee U received by MN Liquor Coaml • (3-2% Liceuet exenipt) <br />Lfceane : Pleaie veri^ your licenie information contained below. Make corrections if necessaiy and sign. City <br />Cleik/County Auditor abouki aubroit thia aigned renewal with oompleaed licenae and licenaee lu|Uor liability fir the new licenae <br />period. Chy CIcrfc/Coanty Auditor arc also required by M.S. 340A.4(M S. 3 to report any Ucciue <br />caariallailM. <br />Licenae Code.MCLONSL <br />Ciiy/Couniy where license approved.urono <br />License Period Ending lS/31/£iZl0fo^______ <br />Licensee Name <br />Trade Name <br />Woodhill Country Club Inc <br />Uoodhill Country Club <br />Licensed Location address <br />£00 Woodhill Rd <br />City, State, Zip Code <br />Orono, MN 55391 <br />Business Phone <br />95£/A73-7333 <br />0. 00 £00. 00 £00. 00 <br />By stgalng this renewal application, applicant certUlei that there has been no change in ownership on the above named <br />lieenaet. For changes in ownership, the iiccnsce aaaMl above, or for new licensees, Bill applications should be used. Sec <br />back of this appUcatioa for further Informatioa needed to complete this renewaL <br />Sundays <br />/kpplkant*if r* IhiT I Jlal.Ji.i_LI confirms the foBowina; Failure to report any of the foltowing will result in lines. <br />1. Licenaee confirms it hu no imereai whatsoever, directly or indirectly in any other liquor establishments in <br />Minnesota. If so, give details on back of this applicatioa <br />2. Ucensee confirms that it has never had a liquor license rejected by any city/township/coumy in the state of <br />Minnesota. If ever rejected, please give details on the back of this renewal, then sign below. <br />3. Licensee confirms that for the put five years it hu not had a liquor license revoked for any liquor law violation <br />(state or local). If a revocation hu occurred, please give detaib on the back of this renewal, then sign below. <br />4. Licensee confirms that during the past five yean it or its employees have not been citrd for any civil or crimiiu>l <br />liquor law violations. If violations have occuned. please give details on back of this renewal, then sign below. <br />5. Licensee confirms that during the put license yeu, a summotu hu not been issued under the Liquor Liability <br />Law (Dram Shop) MS 340A.802. If yu. attach a copy of the summons, then sign below. <br />6. Licensee confirms that Worken Compeuation insurance is in effect for the Bill license period. <br />LIcetHN hu attached a liqnor liability insurance omilcal* that cormponds with the license period in ctty/county <br />where Uesme to tosned. $106^ in cash or sccurittos or $100,600 surety bond may be suhmittod in lieu of liquor liabil- <br />ity. (3J% liquor licensu arc exempt if salu are icu than $25,000 at on sale, or $M,000 at off sale). <br />^ *1 ^ <br />gg Siynamrg ^ C Date \C> ’I.icgru <br />(Signature certiflu all above information to be correct and Ucense hu been approved by city/county.) <br />AuHiior SiguRfiire Darg <br />(Signature certifiu that renewal of a liquor, wine or club license hu been approved by the city/county u stated above.) <br />QOI^ytfy Aftomgy .^ignanirg______________________________________ Dafg____________ <br />County Board issued licenses only (Sig^ture cenifies lj( <br />Poitea/Sl^iff Stfiiafure <br />is eligible for license). <br />2/7^5 <br />(Signature certifies licensee or associates hove not been cited duiing the put five years for any state/local liquor law violations <br />(criminal/civil). Repon violations on back, then sign here. <br />PS 9093-98 <br />i