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i :1.1 i 1 .J <br />10 Siatfi ndmt and addrm of ov*ncr or ovMtcrs of tiuildinq whorom the will be located <br />-Ae-V ^r>W _Ci J) J>tUn . <br />*0^-J /»OV <br />11. Has a|i|<licani. if parinot%hi|i, .my |>aiiiicr; if corpar.iiiun. any olliccr or director, il club. ai<y iluli <br />officiir dirricuw. rrver h »l ^ liciMtse under thi Mmncsot<i Lipnor Control 'Vet revoked or siistmnrled .w l*een <br />cnnvicie.. lot .iny viul.ditm ol Si.do L.iws or local oidinomus. if so. uivc ..idc and details A'Oi~<._invicif <br />12. Is ai>|iliruni; il portnersbip. any p.irtnoi. d toi|iOf.ition. .iny olliccr or director; if club. .»ny club hIIii .m <br />or rtirrndor. a inomhr.-r of the qu*/Rrning Imdy of llio muriiia|tafily or county in which this (MMinit is lo itc <br />issui;d. if to. m what capacity •>_____| <br />13. M.iS attplicant; if parinc'ship. any p.iMnvr. if corpor.ition. any officer or director; d club, any emh <br />officer or diriKtor. any interest wliatsoover. directly or indiicctly, in .uty liouur usiablishntcnt m die wi.ne <br />ol Minnr*soia Vlwu>.j/\ Givi: name and i.ddrcss of tii';li esl.ihlislmient___________________________ <br />14. Furnish the name and address of at least three Imisiiiuss rclercncos. includimi one tvmk reference <br />W. «sW- flyj i Cjb-.^c'tv-.^'^**^ <br />'"•a^V Li <br />M/Q OoX^ 6rtc<- SA /n^Au- <br />c)2^^0 iJdr ^tvor<- yKa/- <br />IS. Will intoxicating liquor he solrl on the premises (JV- eJo^m-o ~Krt</*W~ t-f <br />18 la) State wlieihct applic.iiion is: 1. 0rir|inal J\ 2. Renewal <br />Owncs^ ** j»^AvZ3 I 1^0 ux- <br />Transicr <br />lb) Slate whether dancinii will he iiormiiied on the itrenmes A/O i <br />17 Are the premises now occupied, or to be occupied, entirely senarate ^d . xclusivo from any oiliet <br />busiiir^s r^ialiti'.limcnt ur-c- f; ^ Av-A "Tt-v \d< <br />IB. State liado name to lio tiscrl • <br />19. State whether an "On-Sale" or "OH Sale" Non lnioxic.ilini| Mall Reveragn License has or will bo qr.inii<d in <br />coniunciion to this Ixisiness and lor ilie same piemises A/cs________. <br />20 Has rlicre Itcen issued, or ivill tbero be issued. ,i Sr>4.00 Feiler.il Retail Lirtuor Dealer's Special Tax Si.tinp <br />lor the liilu ol li<|uor on these premises_______A/O_________________________________________________ <br />21. Has your lrx:al i|;ivciiinH:ni .in ordinance legul.iiinri the cr.osiiinpiion and depl.iy of inioxicaiinq liquor <br />22. II o{iera:irii| un-.ler ^ornmi nnlinaiH:i! Iicvr is Ioc.iikmi ol IhiiIiIuiii classified <br />:•} <br />-.5 <br />I !».•<•» rmi.ly iXal I •.-j.l x>a HmiMtIj.Kl mmv ................... 1I..1 jyn>i>€tuan. »..rt il<«i iIm s..imwi «>• iiim ol my umo S..4.»tMl«a I <br />l.utlfW undMsivui (Ml inonf al loltm mluinuiMM m« iIhi 4ui.i'cjii<n.. m il»> IjtliM* la giva aMiincni .nlo'inaiMn canii.luia* c<um lot ika <br />.nuntauia .irMKul.nn lira eaimii. ir IS ruilllltn UNOtRSTOOn tll.sr ANY RCRMIT ISSUiO MinCUriOkR OOfS NOT AlLUtV Til* <br />SAL* or INTOXICAIiMQ LIQUOII. EnclataU n iMvmaAl al SIOO 00 aavkWa lu lha Liguai Caniial O.taclar •• piotiOt^ Sv M S IM/ Sacitaa <br />1*0.113. <br />NO CONSIDFRATION WILl RE GIVEN TO <br />THIS APPLICATION UNLESS APPROVED AS <br />HEREINAFTER PROVIDED. <br />II applicant is located in the County, the Chairman ^ <br />of the Board of County Commissioners or his <br />Representative shall approve both copies of the <br />aiiplication. <br />|N*m« sfl C <br />lS<tn«lsa<« •! Awm«rii«0 A^OM«.*AII <br />13^Suliscrilied and swum to before mo this day <br />of f^AniA^ h_____________19 9 U. <br />If aptilieani is located in o Municipality, the <br />President ol the Council or his Representative shall <br />approve both copies of this a|»plication <br />ir.MuUMi al llta Caun... a. it.< <br />Uxtu-o. <br />IN«lA*«r ^ulaiKl <br />My Cuiiunission expires ^ ~ <br />III ctMlMlM •■••••