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r MINNESOTA DEPARTMENT OP PUBLIC SAFETY <br />LIQUOR CONTROL DIVISION <br />ROOM 44Q 333 SIBLEY STREET <br />ST. PAUL. MN SStOt <br />PHONE 6t3-39S-S1S9 <br />APPLICATION FOR OFF SALE INTOXICATING LIQUOR LICENSE <br />OR THE RENEWAL OF AN OFF-SALE INTOXICATING LIQUOR LICENSE <br />APPLICATION TYPE □ NEW OR TRANSFER COMPLETE SECTIONS 1. 2 and 4 <br />CHECK ONE C8 RENEWAL - COMPLETE SECTIONS 1. 3 and 4 <br />6641 Orono OFSL <br />12/31/91 <br />Navarre Liquors Inc.$ 150.00 <br />3421 Shoreline Or $ 0.00 <br />Navarre, MN 55392 S 0.00 <br />IF NAME AND ADOBE SS SHOWN AB£ <br />NOT COBBECT make CHANGES IN <br />SPACES BELOW <br />8 <br />E <br />C <br />T <br />I <br />O <br />N <br />1 <br />^ - NX'V>V>V> . <br />If a corporation, an otiicar than macula this app»cation. If a partnership, a partner shall execute this application <br />I T»aOB N atw Of PiiA <br />X-Vj ^___^______________________________________ <br />ADpHCAnt 9 Hom« PhonoLiCPnSB P*r*oOi <br />F'om <br />TSUtB I <br />Os*» 0* wtfi <br />'\X-M <br />2<o Cootsrsxv <br />m iifHPvRiuti AopHcmnt) <br />M a eorporaUofr MMa nima. data of birth, address, tilla. and shares held by each officer <br />boi.AdOrvgg ^ <br />» ViVv><A <br />C'fv <br />oli\MdTMS CrtyX rti« <br />o6t AdOrMM Cny t«m 8Fm« <br />bof Addrwaa C-v Tiiid SiM/M <br />t <br />I <br />8 <br />8 <br />C <br />T <br />I <br />O <br />N <br />1. If a corporation, data ol incorporation, <br />authorizad capitalization_________ <br />.. state incorporated m annount of <br />amount of paid in capital . if a subsidiary of any <br />Other corporation, to ttata..give purpose of corporation <br />_________________________________if incorporatad urtder the laws trf another state, it corporation <br />authorized to do buainoas in the State of Minnesota?_______Number of certificate of authority------------ <br />2. Oaacriba premieea to which licertse applies: such as (first floor, second floor, basement, etc ). <br />____________________________Of i* entire building, so state___________________ <br />& la attabliahfnent locattd naar any state university, state hospital, training school, reformatory or prison? <br />_____________ ■■ suia appitwlmaie distance___________________ <br />4. Stale name and address of owner of building. <br />has owner of buMding any connection, diractly or indirectly, with applicant?. <br />& Is ippticani, u any of the aseocislee m thfe eppilcation. e member of the governing body of the <br />miiniripaHty in which ‘K ' license is to be issued?___________If so m what capacity--------------------- <br />8 StMa whalhtr any p lar man applicants has any right, title or interest in the turniture, natures, or <br />eouipmaid for whic* is applied, and if so give name and details----------------------------------------- <br />7. Have applicanis any interest whstsoever. direetty or indirectly, in any other liquo' establishment m the stale <br />of Mlnnaaota?________________Give name and address of such sstsbiishmenl.^----------------------------