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<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 />651-296-6979' TTY 651-282-6555' Fax 651-297-5259 <br /> <br />RENEWAL OF LIQUOR, WINE, CLUB OR 3.2% LICENSES <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 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 ONSS <br />City/County where license approved. <br /> <br />License Period Ending <br />Centet'vi lIe <br /> <br />j P /3:1 /;?0l7J$D# <br /> <br />F,;:'7.~ <br /> <br />Licensee Name Wiseguys Pizza Inc. <br />Trade Name <br />Wiseguys Pizza <br />Licensed Location address <br /> <br />City, State, Zip Code <br /> <br />7095 20th Ave S <br /> <br />Business Phone <br /> <br />Centerville, MN 55038 <br /> <br />651/653-1077 . <br />~- ~-~-LI(;ENSE-FEE&-eff-Sale-$ --On-Sale-$-- -5unday-$ <br /> <br />By signing this renewal applic!lUoWY/applicant certifies that there has b~ftiliWlb~e in ownership on the a~D~d <br />licensee. For changes in ownership, the licensee named above, or for new licensees; full applications should be used. See <br />back of this application for further information needed to complete this renewal. <br /> <br />Apj)1icant's si2Dature on this renewal confirms the followine: Failure to report any of the followine will result in fines. <br /> <br />1. Licensee confirms it has no interest whatsoever, direcdy or indirecdy 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 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.802.1f 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 license 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 licen s are empt if sales are less than $25,000 at on sale, or $50,000 at oft' sale). <br /> <br />b.' ll/ - D5 <br /> <br /> <br />D <br /> <br />(Signature cenifies all above information to be correct and license has been approved by city/county.) <br /> <br />Cily Clerk/County Auditor Signature Date <br />(Signature cenifies that renewal of a liquor, wine or club license has been approved by the city/county as stated above.) <br /> <br />Counly Attorney Signature Date <br />County Board issued licenses only (Signature cenifies licensee is eligible for license). <br /> <br />Police/Sheriff Signature Date <br /> <br />(Signature cenifies licensee or associates have not been cited during the past five years for any state/localliquor law violations <br />(criminaVcivil). Repon violations on back, then sign here. <br /> <br />PS 9093-98 <br /> <br />/J/ <br />