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1c. Chan Fire Dept. Temp beer lic CITY OF CHANIIASSEN 690 COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317 (612) 937-1900 • FAX (612) 937-5739 ktior , A'',-"1"- £M 1)c A_ MEMORANDUM F ` TO: Don Ashworth, City Manager FROM: Karen Engelhardt, Office Manager ' DATE: June 4, 1991 SUBJ: Temporary On-Sale Non-Intoxicating Liquor License Request, Chanhassen Fire Department, June 15, 1991 1 Attached please find an application from the Chanhassen Fire ' Department for an on-sale non-intoxicating beer license for June 15, 1991. They are sponsoring their annual fund raising dance at the main fire station in conjunction with Public Safety Days. As of this date, I have not received a copy of the Fire Department's liquor liability insurance. ' Recommendation I recommend that the City Council approve the one day on-sale non- intoxicating beer license for the Chanhassen Fire Department for June 15, 1991, contingent upon receipt of liquor liability insurance. I also recommend that a fee of $1. 00 be established. r r r r r r f w. 11 11. If this is a transfer application, give name, address, or persons partnership or corporation holding license for the past year. r 12. Who owns the tavern fixtures? 13. What vending or mechanical amusement device company has or will _ have machines on the licensed premise? 1 14. Are you a Minnesota resident? _vYes No ' from to If not, where resident: Dates of Residency ' 15. Have you ever been convicted of violating Federal, State or Local liquor laws and/or regulations? Yes —No If yes, explain fully on seperate sheet of paper. ' 16. Applicant, and his associates in this application, will strictly comply with all the Laws of the State of Minnesota governing the taxation and the sale of non-intoxicating malt liquor; ' and rules, regulations and ordinances, promulgated by the City of Chanhassen; and I hereby certify that I read the foregoing questions and that the answers to said questions are true of my own knowledge. ,\) IC ti ' - Sign- _ o A.pl ant Subscribed and sworn to`,before me this �,��( day of 2.clIr„.,&„._., ' 19 Q, — ) Nary Jublic i My commission expires -/& -9/. 1 KAPEN J.ENCrLueDOT NOTAFY PV4UD•r' �=OTA ' My commis'nn e� t:-t 1.7 I f #- II APPLICATION FOR NON-INTOXICATING LIQUOR LICENSE "ON" AND "OFF" SALE CITY OF CHANHASSEN II HENNEPIN AND CARVER COUNTIES STATE OF MINNESOTA This form was prepared for purposes of background investigation for either or both "On" and "Off" Sale Non-intoxicating Liquor . License applications. It does not supercede any laws,' rules or regulations of the Division of Liquor Control regarding the issuance of liquor licenses. Failure to provide or falsification of infor- ' mation requested may result in denial of the application. •4 :N,-00:■ _%,<,u. 47'- 3 - `i/ Trade Name Date of Application II C'-- ls //9/ -.2A.A.J...i. X-` c'k ...470-1A-e...........) Licensing Period I 1. Type of Application: Off-Sale Non-Intoxicating X On Sale Non-Intoxicating - �� A New Renewal Transfer 2. 1 1 Name of Applicant Phone 3. ,C6'.(,) (4). SO ' C.1/..4.Q-/. 3/'14• :3 . Home Address City State 4. 4-4/ Cam. , . ,.6 ,,� i?, , mot= 1 Date of Birth Place o Birth n Q. II 5. 11�✓z•�:.t:-Q,Q.Q-tti.J _./i',i�w �:��.U��., 76 /, �cLi,�..�,c iL Address of Business Location ' 6. II Legal Description 7. List owners of building or premise to be licensed: I 8. II x/ 44. gl.A.0k i • Corporate or Partners ip Title v . • II9. -7(,/c ,4,..t,i4, ,--A., • Corporate or Partnership Address 10. List all partners, officers or directors, if corporation: I Name Address Date of Birth(1P,_:7„a4.^e,vc , YRr-'e L Ar-e ta•t--kM, /S'i -4d c,, , eI4 ,,,,...,_.,..,...„...„.., . P.-7,4 a.4-41,t Z:Pe..W1,1. , II I