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Minnesota Depmment of Public Safety <br /> Alcohol and Gambling Enforcement <br /> 444 Cedar Street. Suite I33 5 <br /> St. Paul, MN 55101-5133 ; <br /> 65 1-296-6979.TTY 65 I-282-6555.Fax 651-297-5259 <br /> RENEWAL OF LIQUOR, WINE, OR CLUB LICENSE <br /> No license will be approved or releascd until the$20 Retailer ID Card fee is received by IN Liquor Control <br /> 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 <br /> license period. City Clerk/County Auditor are d% required by M.S. MOA,4NS. 3 to report any license <br /> cancellation. <br /> ..__ <br /> License Code ON S S License Period Ending 12/31/2002I1)� 2856 <br /> City/County where license approved,R o s e V 1 11 e <br /> Licensee Name Landry ' s Seafood House MN Inc . <br /> Trade Name Joe ' s Crab Shack <br /> Licensed Location address *2704 S n e l l i n g Service Dr E <br /> City, State,Zip Code R o s e v i l l e , M N 5 5 1 1 3 <br /> Business Phone 651/636-5488 <br /> LICENSE FEES: Off Sale . 0' 00 On Sale S 7000.00 Sunda 200.00 <br /> By signing this renewal application,applicant certifies that there has been no change in ownership on the above <br /> named licensee.For changes in ownership,the licensee named above,or for new licensees,full applications should <br /> be used.See back of this application for further information needed to complete this renewal. <br /> Appticant_'s sienature on this renewal confirms the followini:Failure to report any of the following will result in fines. <br /> I 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 hack 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. 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 /> 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 <br /> liability. <br /> Licensee Signature Date <br /> (Signature certifies all above information to be correct and license has been approved by city/county.) <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 above.) <br /> County Anomey Signature Date <br /> County Board issued licenses only (Signature certifies licensee is eligible for license). <br /> Police/Sheriff Signature _ _ Date 12 - 0 2..., <br /> (Signature certifies licensee or as orates have of been cited during the past five years for any state/local liquor law violations <br /> (criminal/civil) Report violations on hack, then sign here <br /> PS 9093-98 <br />