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<br />.' <br /> <br />.. <br /> <br />STATE OF MINNESOTA <br />COUNTY OF ANOn <br /> <br />CITY OF CENTERVILLE <br />Application No. <br /> <br />RENEWAL APPlICATION FOR LICENSE TO SELL <br />TOBACCO PRODUCTS AT RETAIL . <br /> <br />Theundersigned, residing at ~() ~tfmtheCityof ~ / ~ <br /> <br />intheCountyof ~ . . State of Minnesota, Residence Telephone: (~ k$'3 t!>8Sf HEREBY <br /> <br />a <br />MAKES APPLICATION FOR LICENSE to be issued to PAUL MONTAIN, MOUNTAIN ENTERPRISES, <br /> <br />INC. DBA TRIO INN, to sell tObacco products at retail at 7082 CENTE:RVlL.L.E ROAD, Business Telephone: ( <br />~"o1) IQlt ~~mthe~qfCenterville,AnokaCounty,.Minnesotafor thetermofone(l)yearbqVnningwiththe <br />1st dJq of JIlfIlUIrJ, 1H5, subject to the laws of the State of Minnesota and the ordinances and regulations of said <br />~ of CentenilIe pertainiDg thereto, and herewith ~ $75.H in payment of the fee therefore. <br /> <br />BJ signing this renewaltlpJJlicatlon, tIJ1Plicat certifies t1uIt there 1uIs been fUJ clumge in ownership, <br />. corportlIe of.Iicers, orJ.1lll11let'& If clumges IItIve oeetm'etl tlurhIg the ptlSt 11111Onths, complete in its entirety the <br />tlttIIChetl TIlX Uetmuu:e Inf017lUltion, then sign below. <br /> <br /> <br />~d~/i i?~~~ <br />SlgJtitore Ar<< /II(J~ ~/N <br />Name (Print) <br /> <br />Date: <br /> <br />FOR OFFICE USE ONLY (Do not write below this line) <br /> <br />Report by Pollce DepartmeDt <br />.This is to certify that the applicant and the associates, named herein have not been convicted within the past five years of any <br />:iolation offedera1, state or local law, ordinanMprovision, or otherregolation relating to tobacco or tobacco products, ortobacco <br />le1ated devices, or any felony within the last ten years. . <br /> <br />SigJISltore <br /> <br />Title <br />