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<br />@ <br /> <br />Minnesota Deparlment of Public Safety <br /> <br />Alcohol and Gambling Enforcement <br />444 Cedar Street, Suite 133 <br />St. Paul, MN 55101-5133 <br />651-201-7507. ITY 651-282-6555 · Fax 651-297-5259 <br /> <br /> <br />RENEW AL OF LIQUOR, WINE, CLUB OR 3.2% LICENSES <br />.,,'~oliCeose win~apP,ra.~(()I:'~~the$20 R~ IDeai-d fQeis~~ by ,MN UqtiOr Control' (3.2% i.i~ exeinPt), <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 liability for the new license <br />period. City Clerk/County Auditor are also required by M.S. 340A.404 S. 3 to report any license <br />canceUation. <br /> <br />License Code <br />City/County where license approved. <br /> <br />ONSS <br /> <br />C License Peo,riQd Ending <br />entet"Vli!e <br /> <br />12/31/20~ <br /> <br />200E.5 <br /> <br />Licensee Name <br /> <br />Sahawk of Minnesota Inc. <br /> <br />Sager's Bar & Grill <br />Licensed Location address <br /> <br />Trade Name <br /> <br />7098 Centerville Rd <br /> <br />City, State, Zip Code <br /> <br />Centerville, MN 55038 <br /> <br />Business Phone <br /> <br />E.51/E.53-7791 <br /> <br />LICENSE FEES: Off Sale $ On Sale $ Sunday $ <br />0.00 2500.00 200.00 <br />By signing tbis renewal application, applicant certifies that there bas been no cbange in ownership on the above named <br />licensee. For cbanges in ownership, tbe licensee named above, or for new licensees, fun applications should be used. See <br />back of this application for furtber information needed to complete this renewal <br /> <br />A,pplicant's si~ature on this renewal confirms the followine: Failure to report any of tbe followinl: 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 city/township/county in the sate 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 convicted of any criminal <br />violations or imposed with any civil penalties. If so, please report on back of this application. <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 bas attacbed a liquor liability insurance certificate that corresponds with the license period in city/county <br />where 6cense is issued. $100,000 in cash or securities or $100,000 surety bond may be submitted in lieu of liquor liabil- <br />ity. (3.2% liquor les are less than $25,000 at on sale, or $50,000 at 011 sale). <br /> <br />(Signature certifies <br /> <br />'I :'" II I <br /> <br /> <br /> <br />. I . It. . III. ..... I . <br /> <br /> <br />be correct and license has been approved by city/county.) <br /> <br />City Clerk/r.ounty Auditor Signature Date <br />(Signature certifies that renewal of a liquor, wine or club license has been approved by the city/county as stated above.) <br /> <br /> <br />(Signature certifies licensee or aSSOCIates ave not C1 <br />(crlminaVcivil). Report violations on back, then sign here. <br /> <br />PS 9093-05 <br />