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10. Sure mm• and sddren of owner or ownan of building' wherein the budneia will he locata is <br />iy <br />11. Has happlicant; if psrtmnhip, .my partner; it corpantien, my officer or director; it club, any club <br />officer or dractor, aver had a license under the Rinnapta Liquor Cordsof Act mokM or wpendad or been <br />convicted for my violation of State Laws or loin ordinances; it p, give bets and details AId <br />12. Is applicant; It parmanhip, any partner; If corporation, my officer a director; If club, any club officer <br />or director, a member of the pq lunimg body of IN munklpHity or county in which this permit is to ber <br />barred; It W. in what capacity Yes <br />10. Has appllcenL if pamwNhip, any ptrovr; It corporation, any oNlcar or director; If club, any club <br />officer or director. any interest whauaner, directly of Imlrecdy. In my liquor ntabiblunent in the State <br />of Minnesota //n Give name and addrm DI ouch nteblbhmant <br />14, Fumbh the'nape'and add. of at least three Wainer ratenncnA'Inctudingom bank nfar m: <br />MM�. i/i0. /Jrl fat. !A 7) a a,2, it* lis- atiz jio, <br />/ /er n aim- lrl4sb/. � i�-i/rn. /�i bi <br />LIIA°R R/SYMnef.S i W �/ifiiJ/If �%yi�. <br />w`� - <br />15. Wit Intoxicating liquor be sold on the promises _L= <br />Is. let Slate whether appl_cation is: 1. Original -,X_ g: Renewal 0. Transfer <br />Ibl State whellnr dancing will be permitted an the premise AM <br />17. Am the pnmon now pc�upI If or to be occupied, entirely separate and exclusive from any other <br />bus. .,,birth..., <br />1 S. St." Vale name to beusedf1A <br />18. Stare whether an "On Sale" or "Off .Sees" Non Intoxicating Malt Beverage License her at will be granted in <br />conjunction to this Wameu and for the tame pmmhnVC <br />_ <br />20. Has there been icount or will there bei�w.. i SM.00 Federal Recall Liquor Dollar's Special Tax Stamp <br />lowthe alb of liquor on thne Pronnes A/A <br />71. Has your, local government an onlumece regubting the consumption and display of intoxicating liquor <br />gl. It operating under toning ordinance how is location of Wilding classified <br />1�w.'wW : YM Yr'/M. •I IM~i W�w�s Y w: is II ��"eY .~eve <br />YYw'..— IM"w everev l.or—iii'ai <br />4�aws ,wWY• in wY ewwX..1 IS Hustlers Uwpa Ml TNaT •NV I..l WL4 astare pur beet MDT allow idea <br />YLL by IMleirs"ewn uww war . w axxxxx Lv al sera, rYr• <br />LL111. <br />NO CONSIDERATION WILL BE GIVEN TO <br />THIS APPLICATION UNLESS APPROVED AS <br />HEREINAFTER PROVIDED: <br />II applicant is located In the Caunly, in. Chairman <br />of the Bard of County Commmionen or his <br />Rprrnammu a Intl' pprov bath epic of the <br />appl'GIioN. <br />II applicant is located in a whicipaity. Ma <br />P,nldent of ibe Council or her Repreerntauvx atoll <br />approve Win copies of this imps Can. <br />Islen••••I an•vY•• <br />bed end swyr Iy belser m• t day <br />of <br />My Cornmi nppnpires <br />sm'�Mewan� War�ul' <br />IMII"Pay cgMal <br />M �� arraar aY _ <br />