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<br />Minnesota Department of Public Safety
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<br />Alcohol and Gambling Enforcement
<br />444 Cedar Street, Suite 133
<br />Sl Paul, MN 55101-5133
<br />651-296-6979. TrY 65.1-282-6555. Fax 651-297-5259
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<br />RENEWAL OF LIQUOR, WINE, CLUB OR 3.2% LICENSES
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<br />Licensee: Please verify your license information contained below. Make corrections ifnecess~ 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 Hcense
<br />canceDation.
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<br />UcemeCooe OFSL
<br />City/County where license approved.
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<br />License Period Ending
<br />Cent el'"'v i 11 e
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<br />12/31/20050#
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<br />15089
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<br />Licensee Name
<br />Trade Name
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<br />GNAW Inc.
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<br />Centerville Liquo~s
<br />Licensed Location address
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<br />*7093 20th Ave S
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<br />City, State, Zip Code
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<br />,Business Phone
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<br />Centerville, MN 55038
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<br />651/426-6674
<br />LICENSE FEES: Off Sale $ On Sale $ , Sunday $
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<br />By Signing this renewal applicAA~;aigbcant certifies that there has hi.. g.Ichange in ownership on the a"v~Wamed
<br />HceDSee. For changes in ownership, the ~censee named above, or for new licensees, roD appHcations should be used. See
<br />back of this application for forther information needed to complete this renewal.
<br />
<br />Applicant's sil!D8ture on this renewal confirms the foDowine: FaDure to report any of the foDowine wiD result in fines.
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<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 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 violatiom. If violations have occurred, please give details on back of this renewal, then sign below.
<br />5. Licensee confirms that during the past liceme 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.
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<br />Licensee has attached a liquor liabiUty insurance certificate that corresponds with the license period in city/county
<br />where Ucense is issued. $100,000 in cash or securities or $100,000 surety bond may be submitted in Heu of liquor HabiI-
<br />ity. (3.2% Hquor Hcenses are exempt if sales are less than $25,000 at on sale, or. $50,000 at off sale).
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<br />Li~Si~ature ....~~. . Date 1t7-II-()~
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<br />(Signature certifies all above information to be correct and license has been approved by City/county.)
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<br />CitY Clerk/CountY AUditor Sienature Date
<br />(Signature certifies that renewal of a liquor, Wine or club license has been approved by the citY/county as stated above.)
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<br />(Signature certifies Hcen ee or associates have not b~n cited during the past five years for any stateJloc
<br />(criminaVcivil). Report violations on back, then sign here.
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<br />PS 9093-98
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