Request for Liquor License Application

2. Note:
   The total cost of fees will be determined at a later step. This form submission begins the application process.

   The total cost of fees will be determined at a later step. This form submission begins the application process.

4. Name*

5. Email Address*

6. Date*
   Date

8. Address*

10. Phone Number*

11. City*

12. State*

13. Zip Code*

15. Person Responsible for License*

16. Approximate Date License is Needed*

18. Address/Location of premise to be licensed*

20. Nature of Application*

    1. Natural Person (Individual)
    2. Partnership

    1. Corporation
    2. LLC or Association

22. Type of License*

    1. On-Sale Intoxicating License
    2. On-Sale 3.2 Malt Liquor
    3. Wine On-Sale
    4. Temporary On-Sale 3.2% Malt Liquor
    5. Sunday On-Sale License
    6. Temporary On-Sale Intoxicating
    7. Brew Pub License
    8. Cocktail Room License
    9. Brewer Taproom License

24. THE MINNESOTA DATA PRACTICES ACT requires that we inform you of your rights about the private data we are requesting on this form. Private data is available to you, but not to the public. Your e-mail address is private information. We are requesting this data to register a bee apiary on your property. You are not legally required to provide the data; however, refusing to supply the data may cause your registration to not be processed. In addition, this data can be shared by Edina City Staff. Your signature on this application indicates you understand these rights. Your residence address and telephone number will be considered public data unless you request this information to be private and provide an alternative address and telephone number. Please choose accept below to indicate that you have read this notice.*

    1. I agree.

26. Alternate Address

27. Alternate Phone

Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field