11-28-2016 Council Packet - Laserfiche WebLink

Home Browse Search

9. Applicant and his associates In this application will strictly comply with all the laws of the State of Minnesota goveming the taxation and the sale of Intoxicating liquor, wine, or 3.2 percent malt liquor or beer and the Orono City Code, and I hereby certify that 1 have read the foregoing questions and that the answers to sold questions are true of my own knowledge. 10. As the person executing this application for this license, I acknawiedge that an Investigation will be conducted for use in determining my qualifications. I hereby expressly authorize release of any and all Information which any organization, oompany or person may have, including Information of a confidential or privileged nature. I hereby release the City and any organization, company or person furnishing Informetlon to the City, as expressly authorized above, fr m any liability for damage which may result from furnishing the Information requested. 11. in accordance with MA 13.04, the information requested on this form will be used by the City of Orono in the Issuance of your license or processing of your renewal application. per Chapter 30 of the Orono Minnesota City Code, a computerized criminal history inquiry and/or a driver's license history Inquiry on the applicant may be conducted to verify the information provided with the application. The Information that you supply an Ihts farm will become public information when received by the City of Orono. Under Minnesota law (M.S. 270.72). the City may be required to provide the business tax Idenb9cation number and social security number of each applicant to the Minnesota Commissioner of Revenue. f gngoM to theues Ganeral Marager Signature of Applkint Title Christopher J. Gerardl Print Name Date Review by Administration [1 Approved 0 Denied Review by Police Degiftant [3 Approved . Derued For oto Use Only ❑ NA By. ❑ NA By Pape 4