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9. Applicant and his associates in this application will strictly comply with all the Iowa of the State of <br />Minnesota goveming 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 1 have read the foregoing questions and that the <br />answers to said questions are true of my own knowledge. <br />10. As the person executing this application for this license, I acknowledge that an investigation will be <br />conducted for use in detwmining my quaffimbons. I 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 authorized 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 drrier'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 idenfiflagon number <br />and social security number of each applicant to the Minnesota Commissioner of Revenue. <br />Any falsification of answers taAM above auestions will result In denial of the a 1lcatlon. <br />Signature of Applicant Title <br />Print Name Date <br />� ,G, ..t �,�:�� ra�.,�wn .'Aly"tr �'?e -� .. �a•e j=1�,y]��j M.�.Y';Y.: •. _r �r •+� .�`4"S •'�� �.iti+•5 �ti'. 1 �Y.�r•,�.,..+ <br />,� . �','. �,.'r n•1•+h•r. ,r. .. :tet:. a .r' yrt'. �•,'e kl... <br />ROnriew by Admririshrat bm <br />0 Appaved Denied ❑ l�fA <br />Rem by 12611= Q erd: <br />�c <br />0 4 �enied D NA <br />Pegs 4 <br />