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11-28-2016 Council Packet
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11-28-2016 Council Packet
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5/29/2019 3:02:05 PM
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11/28/2017 3:51:57 PM
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9. Applicant and his associates in this application will strictly comply with all the laws of the State of <br />Minnesota governing the taxation and the sale of intoxicating liquor, wine, or 3.2 percent malt liquor or <br />beer and the Orono City Code, and I hereby certify that I have read the foregoing questions and that the <br />answers to said questions are true of my own knowledge. <br />10. As the parson executing this application for this license, I acknowledge that an investigation will be <br />conducted for use in determining my qualifications. 1 hereby expressly authorize release of any and all <br />information which any organization, company or person may have, including information of a confidential <br />or privileged nature. i hereby release the City and any organization, oompany or person furnishing <br />Information to the City, as expressly authorked above, from any liability for damage which may result <br />from furnishing the information requested. <br />11. In accordance with M.S. 13.04, the information requested on this form will be used by the City of Orono <br />In the issuance of your license or processing of your renewal application. Per Chapter 30 of the Orono <br />Minnesota City Code, a computerized criminal history inquiry and/or a driver's license history inquiry on <br />the applicant may be conducted to verify the information provided with the application. The information <br />that you supply on this form will become public information when received by the City of Orono. Under <br />Minnesota law (M.S. 270.72), the City may be required to provide the business tax identification number <br />and social security number of each applicant to the Minnesota Commissioner of Revenue. <br />Signature of <br />Print Name <br />Title <br />Date <br />For Office Use Only <br />Review by Administration: <br />❑ Approved ❑ Denied ❑ NA By. <br />Review by Po[W Department: <br />❑ Approved 0 Denied ❑ NA By: . <br />Page 6 <br />
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