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2007-11-28 CC Packet
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2007-11-28 CC Packet
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<br />(i <br /> <br />Minnesota Department 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. TrY 651-282-6555. Fax 651-297-5259 <br /> <br />RENEWAL OF LIQUOR, WINE, CLUB OR 3.2% LICENSES <br /> <br /> <br />..-N?~~~il1be a~\ledort~edimtilihe ~20 Retailer IDc.~ree isteciet~byMNLiq~conkl ;(3;2%Li~ mmpt) <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 />cancellation. <br /> <br />License Code <br />City/County where license approved. <br /> <br />CMBS <br /> <br />License l'~iod Ending <br />Lent et~v III e <br /> <br />12/31/20~ <br /> <br />1958 <br /> <br />Licensee Name <br /> <br />Mountain Enterprises Inc. <br /> <br />Tr~ i 0 Inn <br /> <br />Licensed Location address <br /> <br />Trade Name <br /> <br />7082 Centerville Rd <br /> <br />City, State, Zip Code <br /> <br />Hugo, MN 55038 <br /> <br />Business Phone <br /> <br />651/426-2956 <br />LICENSE FEES: Off Sale $ <br /> <br />On Sale $ <br /> <br />Sunday $ <br /> <br />100.00 2500.00 200.00 <br />By signing this renewal application, applicant certifies tbat there bas been DO change in ownership on the above named <br />llcensee. 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 />Applicant's signature on this renewal confirms the following: Failure to report any of tbe followine- 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 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 attached a liquor liability insurance certificate that corresponds with the license period in city/county <br />wbere license is iss . " or $100,000 surety bond may be submitted in lieu of liquor liabil- <br />ity. (3.2% liquor li han $25,000 at on sale, or $50,000 at ol'l'sale). <br /> <br /> <br />City Clerk/County Auditor Signature Date <br />(Signature certifies that renewal of a liquor, wine or club license has been approved by the city/county as stated ahove.) <br /> <br />County Board issued Ii <br /> <br /> <br />license). <br /> <br /> <br />(Signature certifies lie ee or associates have not been cited during the past five years for any statellocalliquor I w <br />(criminal/civil). Report violations on back, then sign here. <br /> <br />PS 9093-05 <br />
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