Laserfiche WebLink
ST. P0O. m 55I01-215« *IN 55101 <br />(612)296-6430 TTY(6l2K»^-6555 m <br />RENEWAL OF LIQUOR. WINE, OR CLl^ LICENSE <br />LktiuMi Please ven^ voor Ikeise informatiaii contaBcd below. Make correctioiis tf neoessap aad sicn. Oi> <br />CkA/Comiy Auditor sh^ submit this signed renewal with completed license and licensee liquor babdit> for the new <br />license period. City CerWCounty AudHor are also required by M.S. 340A.404 S. 3 to report any license <br />cancePatloD. <br />License Code.ONSS Lic«ss Pniod Brim. i:/31./9S ID #----3m <br />Cily/Comty where license apprmed 0r o no <br />LicenseeName Jitwnie ’s Inc. <br />Trade Name Jimmin ’s Lounge <br />LicensedLocatioaaddress 3380 Shoreline Dr/3ox 36 <br />Citj. State. Zip Code Navarre, MN 55 392 <br />Business Phone (612) 471-7666 <br />I iCFNSE FEES; Off Sale S On Sales 4,000.00 Sunday S 200.00 <br />Bv signing this renewal appUcation. applicant cemfies that there has been no change in owne^p. <^rpwtc office^ <br />pamSThome addresses, or telephone numbers. If changes have occurred during the past U months, please give detaiL> <br />on the back of this renewal then sign below. <br />Applir.nrs Signature on this renewal conflrma thf fpUtfwing; FttUttrt ttt rtPim 4nv 9f lilt f9ih>wiBt ^Ul my llifl <br />fines. <br />2. <br />Licensee confirms that it ha.s never had a liquor Ucense rejected by any city /towiLship/county m the slate of <br />Minnesota. Ifeverrejectei please give details on the back of this renewal then sign below <br />Licensee confirms that for the past five years it has not had a Uquor license revoked for any liquor Uw violation <br />(sute or local) If a rev ocauon has occurred, please giv e details on the back of this renewal, then si^ below. <br />3 Licensee confirms that during the past fiv e y ears it or its employ ees have not been cited for any civil or c^al <br />bquor Uw violations. If violations have occurred, plexse giv e details on back of this rraevval then sign below <br />4 Licensee confirms that dunna the past Ucense vear. a summons has not been issued under the Liquor Liability Law <br />(Dram Shop) MS 340A.802. If yes, attach a copy of the summons, then sign below. <br />5. Licensee confirms that Workers Compensation insurance is in effect for the full Ucense period. <br />Licensee has attached a Uquor Uabiiity iniurmnce certificate that corresponds with the <br />where Ucense is bsued. S 100,000 in cash or securities or 51004)00 surety bond may be submitted in lieu of Uquor <br />liability. <br />correct and Ucense has been approved by city/county-. <br />(sl^^mre Smfiw Aat'm Jn^'l^toxicating Uquor license has been approved by the city/<»unty as Staled above)? <br />(^'ntiruv Attnniev Signature DateCOUnrv >\norncY ----------------------------^ <br />County Board issued licenses only (Signiture certifies Ucensee is dinMe for <br />.' / " Hate f 1^!Pr.lice/Shenff Signature-----------J <br />" ■ oertTbeen cited during <br />3 oack. then sien hereviolations (cnminal'civiJ). Report violations on PS 9093-94 <br />i