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'3F LIQUOR <br />Miunesot a Deli Mien t of Pub lie Safety • <br />CONTROL DIVISION <br />€144 Cedar .. Buda 100 L, t. Paul, MN 55101-2156 I ._ <br />` �.. (612)296 -6431 'I-i 6l 212 -655 <br />APPLICATION FOR OFF SALE INTOXICATING LIQUOR LICENSE <br />No license will be Approved or released unto the S20 Retaller ID Card fee is ice � ' <br />�� ed �} ,� �tqrter Control, <br />Workers compensalion insurance camp an %, - N aurae <br />I'cZicy# <br />LICENSE-E'S SALE S & USE TAX III # To a <br />Ply , for sales tax #, call 296 -06181 or 1-800-657-3777 <br />If a corporation, an officer shai1 execute this � licat' <br />lon If a partnership, a finer shall execute this application. <br />Lieensce Name (Individual, Corporation, F arinership) Trade N <br />G ER Be I ONG CHUE ame or 1�13�1 <br />I.icco Se I,ocatiou (Street Address & Block No.) <br />1740 LEXINGTON AVE <br />cily <br />RO EVILLE <br />Name of acre Manager <br />CHUE MOUA <br />License Ptvind <br />From To <br />R AMS E Y MN <br />13u suiess Plione Number <br />NONE <br />Appliennt's iron r~ piimir• <br />Zip Code <br />55113 <br />DOB (Individual Applicant) <br />IF a corporation, state name, date of birth address, <br />title, �� shares h�� d �� ���h �� ��r. �f � ��rirt�rsh� st �� � <br />names,, address and date of birth of each artner. R <br />P mtier Officer (Firm, middle, lash D0I3 16itic Sh arcs City, Zip Address, �it� � State, ��p Codc <br />ER B, X I ONG f_ OWNER 50% <br />Partner Officer ( irsl, middle, last) D0I3 are - �• <br />s Addy cis* �.zt} , state. Zip t;.odc <br />CHUE MOUA J OWNER 5 <br />l� `t Mares Address, Ticcr (FiM middle, la <br />NSA C�iw ( , Mater Z]1) C <br />ode <br />P -vi nor O i t Wirst, ni fiddle, lash DOB Title Shares <br />Address, pity, Mate. Zip ��p ccde <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />If a corporation, date of incorporation * state <br />. m � crated in <br />capital If a sub sidi ary �f any other corp oration, sc state <br />annunt paid fii <br />corporation an • re <br />purpose of <br />. If incorporated tinder the laws of another state, is corporation <br />authorized to do business in the st ate of Minnesota? 0 yes Kj No <br />Dcscrib c reniise <br />p s to which license applies; such as (f wst floor, scwnd floor, basement, cte.) or if cutire bra ildiu . so state. <br />First Floor �} L r <br />Is establishment located near any state university, state hospital, training school reform alo � � <br />� r� �F prison? C1 Yes k No If yes <br />state approximate distance. <br />Nmuc and address of bu ldmg 0 "'ncr: LEXT <br />Mbi —5 FM 2 9 1 <br />H <br />NIGTON RTjhZa TjjjC%-P'0-1:t0X 9q JaA7,Th <br />as owner of building any connection, directly or inditcctly, w- ith applicant? des 0 N <br />Is app licaut or nay of the associates in this application, a rn�tn F . , <br />is to be issued? . �p � � bet ��` the �m��rn� b ody aI` the rnr,zu rcip alr�� ]a ���hteh th is l�ren� <br />. M Yes 0 o If yes. ut whal capaciiy" <br />State whether any persan other than applicants has arky ri rt, title or hiierest in the rumitu e � <br />� r , fixtures �r e�rp�oat for which <br />license is app lied and if so, give name and del ails. <br />Have applicants any intcrest whatsoever, directly or indirect ur an other liquor . <br />❑ Yes Rio if �' � ]� cat � ahLslu�ae]at � the state of Minnesota? <br />yes, lie aanxe and address of es# a'b lishruent . <br />i <br />