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RECEMM <br />APPLICATION FOR RENEWAL OF ANNUAL INTOXICATING LIQUOR, <br />WINE, CLUE AND 3.2 PERCENT MALT LIQUOR LICENSES OCT 2 4 2016 <br />City of Orono <br />2750 Kelley Parkway, P.O. Box 66 CM OF ORONO <br />Crystat Bay, MN 55323 <br />Phone: (952) 2494800 <br />Directions: This l rm must be filled out wifh iypelwriter or by printing in ink If the application is by an <br />individual person, by such person; if by a corporation, by an oflrcer 0woof, if by a partnership, by <br />one of the partners; if by an unincorporated assoaWbn, by the manager or managing officer. <br />License year: 2017 (January 1 - December 31) <br />License type: (check all that apply) <br />❑ On Sale Intoxicating Liquor ($5,000.00) ❑ Club ($200.00) <br />❑ Wine ($2,000-00) ❑ 3.2% On -Sale ($100.00) <br />❑ Sunday Liquor ($200.00) ❑ 3.2% Off -Sale ($50.00) <br />4WOff Sale Intoxicating ($950.00) <br />1. Complete the following information for the Licensee. <br />Licensee (Name of Individual, Partnership, Association or Corporation — Legal Name of the Business Entity) <br />NOW Name <br />i <br />Wood Enterprises Inc. <br />Title <br />Owner <br />nuts of Birth <br />Business Trade Name <br />City <br />Mound <br />Navarre Liquors <br />Phone <br />952-472-2124 <br />First Name <br />Business Address (must be physical street address, no PO boxes) <br />Last Name <br />CRY <br />State Zip Code <br />3421 Shoreline Drive <br />Navarre <br />MN SS392 <br />Mailing Address riifdifferent) <br />First Name <br />city <br />State Zip Code <br />PQ Box 50 <br />Date of Birth <br />HomeAddress <br />Contact Name <br />Phone <br />E -Mall Address <br />Rick Wood <br />952-471-8800 <br />navarrieliquors@yahoo.com <br />2. If the above named licensee is an individual, oomplete the following: <br />First Name Middle Name Last Name I Date of Birth <br />Home Address <br />Phone <br />City state Zip Code <br />Email <br />If the above named licensee is a partnership, association, or corporation, complete the following for each <br />prartnerloffloer: <br />A. <br />B. <br />C. <br />First Name <br />Richard <br />NOW Name <br />i <br />Last Name <br />Wood <br />Title <br />Owner <br />nuts of Birth <br />Home Address <br />2660 Lakewood Lane <br />City <br />Mound <br />State Zip Cade <br />MN 55364 <br />Phone <br />952-472-2124 <br />First Name <br />Middle Name <br />Last Name <br />Tide <br />Date of Birth <br />Home Address <br />Clty <br />state Ep Code <br />Phone <br />First Name <br />Middle Name <br />Last Name <br />Tide <br />Date of Birth <br />HomeAddress <br />City <br />State Zip Code <br />Phone <br />Page 2 <br />