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<br />~ <br /> <br />':,. .' <br />1" <br /> <br /> <br />Minnesota. Department of Public Safety <br /> <br />Alcohol and' GambliDg Enforcement <br />444 Cedar Street, Suite 133 <br />St. Paul, MN 55101-5133 <br />651-296-6979 · TrY 651-282-6S55 · Fax 651-297-5259 <br /> <br /> <br /> <br />T .v.m-' Pl~ verlfy your license infOrmation contai!1ed below. Make corrections if necessary and sign. City , <br />Clerk/Count.y Auditor should submit this signed renewal with completed licenSe ,and liceDseQ liquor liability for the new <br />license period. City Clerk/County Auditor are also required by M.S. 340A.404 S. 3 to report any JiceDse <br />cancellation. <br /> <br />License Code , nN!=lR License Period Ending 'I ~ /3 'I /~t1ItlJlID# <br />City/County where license approve4- Cent erv i 11 e <br /> <br />1=.:?73 <br /> <br />Licensee Name <br /> <br />Wiseauvs Pizza Inc. <br /> <br />Trade Name <br /> <br />Wiseauvs Pizza <br /> <br />Licensed Location address 7095 20t,h Ave S <br /> <br />City. State. Zip Code <br /> <br />Centervil1e. MN 55038 <br /> <br />Business Phone <br /> <br />651/653-1077 <br /> <br />LICENSE 1i'R1i'_~: Off Sale $ 0. 00 On Sale $ 2500. 00 Sunday $ 21Z!0. 00 <br /> <br />By signing t1ds renewal application; 'applicant certifies that there hfIS been nO clumge In oWnership on the above . <br />nam.ed B.censee. For cbanges In ownership, theHcensee named above, or for.new Hcensees,.foII appHcatio~ ~~:aId <br />be USed. See back: of this application for further information needed to '*Dplete this renewal. . . <br /> <br />A,ppHcant's ~AftrrP. on this renewal confirms the fonowing: Faflnftl! to ~port ~ of the followinlJ will result In t'InAL <br /> <br />1. Licensee confirms it bas no interest whatsoever. directly or indirectly in 8!1Y other liquor esta],l~Ahm~ in <br />Minnesota. If so. give &taiIs on back of this applicatiOn. .' . <br />2. Licensee confirms that it has never had a liquor license rejected by any cityltownsbiplcounty in the state of <br />. Minnesota. If ever rejected. please give details on the back of thiS renewat.. then sign bel<;>w. <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 occorred. please give details on the b~k of this renewal. then sign below. <br />4. Licensee confi:t.ms that during the' past five years it or its employees ~venot been cited for any civil or rniTninlll <br />liquor law violations. If violations have 0CCll1'I'ed. please give details on b!lCk of this renewal. then sign below. <br />S. Licensee confirms that during the past license year. a summons bas not ~ issued under the Liquor LiabiIity <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 fall license period. <br /> <br />LiceDSee has attached a liquor IiabDity insurance certificate that corresponds with the HcenSe period In city/county <br />where license Is Issued. $100, In cash or securities 100,000 surety bond may be submitted in Heu of Hquor <br />Uability. . <br /> <br />, ". <br /> <br /> <br />'()~ z5- 0 <br /> <br />Licensee Si Date <br />(Signature above information to be coriect and license bas been approved by city/county:) <br /> <br />" . <br />City Clerk/County Auditoi Signature Date <br />(Signature certifies that renewal of a liquor. wine or club license has been approved bj the city/county as stated above.) <br /> <br />County A.ttorI)ey Signature Date <br />County Board issued licenses 0 <br /> <br />PoliceJSperlff Signature Date <br />(Signature certifies licensee or associates have not been cited during the past five years for any stateI1 <br />(criminal/civil). Report-violations on back, then sign here. <br /> <br /> <br /> <br />PS 9093-98 <br /> <br />( <br />~. <br />