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i ^ <br />!• <br />$ <br />• • <br />r <br />y <br />hf <br />.1 <br />.» <br />\m Mifloesott Deputmeitt of Public Safety <br />Akohel and Gmbitiig Enftafccneiil <br />444 Cedar Street, Suite 133 <br />StPaul.MNS3l01-S133 <br />631-296^79 • TTY 6S1-282-6SSS • Fax 651-297-5259 <br />RENEWAL OF LIQUOR, WINE, CLUB OR 3.2% LICENSES <br />No Uceae will be approved or KletMd uetU the $20 Rcuilw ID C«d fee ii received by MN Liquor Control • (3-2H LtceaMt exenpl) <br />UcMiac: Please verify your Hoense informatiOD contained below. Make corrections if necessary and sign. City <br />Cletk/County Auditor should submit this signed renewal with oompleied iiceiise and licensee liquor liability for the new license <br />period, aiy Cleili/Couniy Auditor are also required by M.S. 340A.404 S. 3 to report any Ucense <br />License Code.20NSS License Period Ending lg/3116397 <br />City/Counqr where license approved. Ut' o n o <br />Licensee Name StoF Fonhsgon, Ron <br />Trade Name _ i., • i *Orono Public Golf <br />Licensed Location address <br />£&5 Orono Orchard Rd Sough <br />City. State, Zip Code <br />Orono, MN 55391 <br />Business Phone <br />952-473-9904 <br />LICENSE FEES: Off Sales On Sale S ^fOO.CO <br />0.00 .JM90- 0.00By aigMug this renewal appUcMloa, appEcaot oertiflee that there has been no change la ownership on the above naaicd <br />liccnacc. Far changes In owoership, the hccnsec aaroed above, or for new Ucensaas, hill applications should be used. See <br />------1.—..— ir in rftiwirir rhil rrnfrat <br />Sundays <br />Annilcanfari—aiiira Ml this renewal cerUriM the fbUowina! Failure to renort aw of the following will result In Jhies, <br />1. Licensee confirms it has no interest whatsoever, directly or indirectly in any other litpior establishineius in <br />Minnesota. If so, give details on back of diis application. <br />2. Licensee confirms that it hu never had a liquor license rejected by any city/township^county in the state of <br />Minnesou. If ever rejected, please give entails on the back of this renewal, then sign below. <br />3. Licensee confirms that for the past five years it has not had a liquor license revoked for any liquor law violation <br />(state or local). If a revocation has occurred, please give details on the back of this renewal, then sign below. <br />4. Licensee confirms that during the past five years it or its employec.s have not been cited fbr any civil or crimina! <br />liquor law violations. If violations have occurred, please give details on back of this renewal, then sign below. <br />5. Licensee confirms that during the past license year, a summons has not been issued under die Liquor Liability <br />Law (Dram Sl^) MS 340A 802. If yes, attach a copy of the summons, then sign below. <br />6. Licensee confirms that Woikets Compensation insurance is in elfiect for the fkili license period. <br />LiosMee has uttached • liquor Nnbilily bMumnee certificalc that corrapouds with the license period in diy/couuty <br />where Ikease is Issued. 8100.M0 In cash or securities or SlOOjOOO surety bond may be submitted in lieu of hqnor liabil <br />by. (3 Uqaor licenses are exeni^ IQitSiary^ than $2S|MW at on sale, or $50,M8 at off sale). <br />1 Sigtiaw [iiw 0^Data y ** Ov*T <br />(Signature certifies all above infbtmw>udn‘& be conecilmd license has been approved by city/coumy.) <br />(Signature cettifim that renewal of a liquor, wine or club license has been approved by the city/coutuy as stated above.; <br />rnuntv Attorney Sifnamre __________________________________________________Dltt--------------------- <br />County Board issued licenses only (^ <br />Eoli^(ShS{if[.SigBiQiQt <br />(Signature certifies licensee'or <br />ceitifieslicensee is eligible for license). <br />Dai. /r /^i/0. <br />ive not been cited during the past five years for any state/local liquor law violations <br />(criminal/civil). Repon violations on back, then sign here. <br />PS 9093-98 <br />•aaifi liH.. <br />• # <br />• •• <br />. <br />I