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k . fj <br />Minnesou Department of Public Safety <br />Alcohol and Gambling Enforcement <br />444 Cedar Street. Suite 133 <br />St. Paul. MN 55101-5133 <br />•651-296-6979 • TTY 651-282-6555 • Fax 651-297-5259 <br />RENEWAL OF LIQUOR, WINE, OR CLUB LICENSE <br />No license will be approved or released until the $20 Retailer ID Card fee b received by MN Liquor Control <br />Licensee: Please verify your Iicen.«e information contained below. Make corrections if necessary and sign. City <br />Clerk/County Auditor should submit this signed renewal w>th completed license and licensee liquor liability for the new <br />license period. City Cierk/County Auditor are also required by M.S. 340A.404 S. 3 to report any license <br />cancellation. <br />License Code <br />City/County where license approved D o n o <br />Licen«.Nam. Navarre Liquors Inc. <br />License Period Ending lS/31/2000 |pa 6641 <br />Trade Name <br />3A21 Shoreline Dr <br />Licensed location ndd«S|^^^^_.^^_ MN SS392 <br />Ciqt,Sut«.2ip(J^5g, C71-S800 <br />Business Phone <br />150.00 <br />LICENSE FEES: Off SaicS On Sale $Sunday S <br />By signing this renewal application, applicant certifies that there has been no change in ownership on the above named <br />licensee. For changes in ownership, the licensee named above, or for new licensees, full applications should be used. <br />See back of this application for further information needed to complete this renewal. <br />Applicant’s signature on this renewal confirms the following: Failure to report anv of the following will result in fines. <br />1.Licensee confirms it has no interest whatsoever, directly or indirectly in any other liquor establishments in <br />Minnesota. If so. give details on back of this application. <br />2.Licensee confirms that it has never had a liquor licei.^e rejected by any city/township/couniy 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 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 cf this renewal, then sign below.^ <br />4.Licensee confirms that during the past five years it or its employees have not been cited for any civil or criminal <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 the Liquor Liability <br />Law (Dram Shop) MS 340A.802. If yes, attach a copy of the summons, then sign below. <br />6.Licensee confirms that Workers Compensation insurance is in effect for the full license period. <br />Licensee has attached a liquor liability insurance certifleate that corresponds with the license period in city/county <br />where license is issued. SlUO.OOO in cash pMccurities or S^MHirODIksiirety bond may be submitted in lieu of liquor <br />UabUlt>-. _ , . <br />WltioQLicensee Sign <br />(Signature certifies all above intormation to be <br />City Clerk/County Auditor Signature______ <br />Date <br />ai^icense h^lxen approved by city/county.) <br />Date <br />(Signature certifies that renewal of a liquor, w ine or club license has been approved by the city/county as stated above. <br />County Attorney Signature_________________________________________________Date____________ <br />County Board issued licenses only (Signature certifies licensee is eligible fer license). <br />Police/Shcriff Signature Date <br />(Signature certifies licensee or associates have not been cited during the past five years for any staie/local liquor law violations <br />(criminal/civii). Report violations on back, then sign here.909' 98 <br />at M.WLi kM ^m —------------