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05/2a/2oi2 THv 10:3a FAx 651 63a 5137 City ot Arden Hiii� <br />�j005/005 <br />List the n�mes �nd addresses of three charactex references: <br />Name Address �--�j� <br />� P �L� `; � ���r✓ ,� � /%/ <br />-.i�. c� 1-� �_�:—'`J u�.�('riL� �c e� L,fi lc �`A- �sGt it.,.. <br />� � .��� "�J�''���✓ L- � -f �l_ � �= � ll.s <br />S� ���ur� <br />�pplicant, s�rid �ny+ asaa�c�at�s in this rxppf�.c�t�i�n, �a�ll ��r'tctBy corrzpl� +a�ith a�l tYae la.��� o�'th� <br />Sta�t�. �� ��nn�s�ta govei�xir�g th� #ax�tiort $��d t}�e sale �f in#�xi�at�ra� �iquar; ��l�s anc� <br />r����a#i�or�s prnmul��ted 1��' tl�� Liq�ot' �oz�t�•ol �'�rnmissiot��r; arrd ��l art�,it�a���es ��`t�e <br />mtui�+�ip�l�i�r, aud i hereb�r c+�tify th�t � tta+v� re��i tli� �`o�'�going y�ie�tion� �d tl�at �h� �r��v�ra to <br />�aic1 quests�n� e:re tru� af rn}� +�wn kn�'�rt�dge. � fuz�her �an��r�ta�r��i that �z� ��.v�sr�g�li�n f�� aat <br />ta� ex�eed �5�� shall l� ch�r�ed a�n applic�nt b�r tSt� �it� az' �ol�nt�r if �� investi��t�an �� <br />��n,�duc#,�� vv�thir�'t��'�t�t�, or the ��st n�t t� �xc��d �10,04� 1�i�e pnV�Stigati�r► i� ret�tur�d <br />out�id� ��a� s�t�, <br />� unders�and tlx�t I m�y vvdthclt$w this ,�p�lfe�tson at �s� ��rne �efare th� lic�r�� is i,�su�tl, but th� <br />lie�tt�e �ril] not be iss��d until ��ta �'�ly Cier[c i�ec��iv�s �he �rop�r t#�c�uzx��d���t�o�i a�d �pecified <br />�ual fe�a. <br />o al�oholfc b+e'w�r� ea rn� be� e��+m+e�l ia �Ci nr �oun ar� <br />Applie� t �ignatur�: .i C: _ `�'� � �'`` .°<:�:. �at�; - . - �' <br />� <br />� <br />Notax-v Public <br />�, <br />Subscribed and sworn to before me this �_ day of �%2CY-c.�► ► 2�� <br />i <br />� <br />Notary Public: � �cf My commission �xpires; f���f �. �i <br />(Ml�st place notary stamp i►� box} <br />gp��qpi ANN EI$ENBflAUN <br />PJotary Public <br />Minn�sota <br />' My Commission E�xpfres Jan. 31, 2013 <br />