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2003-11-12 CC Packet
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2003-11-12 CC Packet
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<br /> <br />. (7 3 - 2CfS"tj at) <br /> <br />Minnesota Department of Public Safety <br />Alcohol and GambIiDg Eufon:ement <br />444 Cedar.Street, Suite 133 <br />St Paul, MN 55101-5133 <br />651-296-6979 · TrY 651-282-6555 · Fax 651-297-5259 <br />RENEWAL OF LIQUOR, WINE, OR CLUB LICENSE <br /> <br /> <br /> <br />Licensee: Please verify your . license information contained below. Make corrections if necessary and sign. City <br />Clerk/County Auditor should submit this signed renewal with completed license and licensee liquor ~ty for the new <br />license period. City Clerk/County Auditor are also required by M.S. 340A.404 S. 3 to report any Hcense <br />cancellation. <br /> <br />License Code ONSS Licens~ Period Ending 12/31/200310# <br />City/County where license approved.C e n t e r v 1 11 e <br /> <br />Wiseguys Pizza Inc. <br /> <br />6273 <br /> <br />Licensee Name <br /> <br />Trade Name <br /> <br />Wiseguys Pizza <br /> <br />Licensed Location address <br /> <br />7095 20th Ave S <br /> <br />City, State, Zip Code <br /> <br />Centerville, MN 55038 <br /> <br />Business Phone <br /> <br />551/653-1077 <br /> <br />LICENSE FEES: Off Sale $0. 00 <br /> <br />On Sale $ <br /> <br />2500.00 <br /> <br />Sunday $ <br /> <br />200.00 <br /> <br />By signing this renewal appHcation, applicant certifies that there has been no change in ownership on the above <br />named licensee. For changes in ownership, the licensee named above, or for new licensees, full applications should <br />be used,. See back of this application for further information needed to complete this renewal. <br /> <br />A'ppHcant's dgnatnre on this renewal confirms the following: FaDure to report any of the following will result in fines. <br /> <br />1. Licensee confirms it has no interest whatsoever, directly or indirectly in any other liquor establishments in <br />Minnesota. If so, give details on back of this application. <br />2. Licensee confirms that it has never had a liquor license rejected by any cityltownship/county in the state of <br />Minnesota.. If ever rejected, please give details on the back of this renewal, then sign below. <br />3. Licensee confirms that for the past five years it has not had a liquor license revoked for any liquor law violation <br />(state or local). If a revocation has occurred, please give details on the back of this renewal, then sign below. <br />4. Licensee confirms that during the past five years it or its employees have not been cited for any civil or criminal <br />liquor law violations. If violations have occurred, please give details on back of this renewal, then sign below. <br />5. Licensee confirms that during the past license year, a summons has not been issued under the Liquor Liability <br />Law (Dram Shop) MS 340A.802. If yes, attach a copy of the summons, then sign below. <br />6. Licensee confirms that Workers Compensation insurance is in effect for the full license period. <br /> <br />Licensee has attached a liquor liability insurance certificate that corresponds with the license period in city/county <br />where Hcense is issued. $100,~ in cash or securities or $100,000 surety bond may be submitted in Heu of liquor <br />UabiUty. .l <br /> <br />Licensee Si Date /0 ~ II - 03 <br /> <br />(Signature certifies ormation to be correct and license has been approved by city/county.) <br /> <br />City Clerk/County Auditor Signature Date <br /> <br />(Signature certifies that ~newal of a liquor, wine or club license has been approved by the city/county as stated above.) <br /> <br /> <br /> <br />County Attorney Signature <br /> <br />County Board issued lice <br /> <br />Police/Sheriff Signature ..~_. 0 <br /> <br />(Signature certifies licensee or associates have not been ci <br />(criminalIcivil). Report violations on back, then sign here. <br /> <br /> <br />Date <br /> <br />for license). <br /> <br />PS 9093-98 <br />
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