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r <br />i I <br />Minnesota Department of Public Salcly <br />Alcohol and (iambliti}' Finforccinent Division <br />444 Cedar St-Siiitc 133 <br />St. Paul. MN 55101-5133 <br />(651 )2%-6439 Tl )D (651 )2H2-6555 <br />APPLICATION AND PERMIT <br />FOR A I KMPORARV ON-SALE LIQUOR LICENSE <br />TYI’n OR PRINT INFORMATION <br />NAMF OF OROANI/AtlON <br />/€c/COTAvZ <br />.sTRi;irrAi)i)Rii.s.s ' . ^^*kr^/iTo»j0j ^co <br />NAMF.OF.PHR.SON MAKINaAPPI.ICATION <br />U/i'nis LigOoB wiu. hf: solo <br />INO <br />Ml <br />l)k WIL <br />ON OnOROAN^'I I()mJl l-l(:F;R <br />ORtlANIZATRJN OM K I-R-S NAME <br />DA I F. OKOANIZFL) <br />^//y/ 7<^/ <br />TAX f;xf ;mit numuhr <br />CITY STAIF ,ZIPCODIi <br />5XA5?' <br />HDSINFLSS PIIONH <br />(9zJh *f7C. /ssr/ <br />iiomf; piionf ; <br />( ) <br />typf : of oroani /aiion <br />L UT3JHI ICHARnAHLF: □RHLIOIOUS I 10TIIF.R NONPRC )FTI <br />NATION OM K I-R-S NAN <br />()R( tANIMI K^.OI-VICIiR’S NAMH <br />SM- <br />AOORHSS <br />/*/7^ /^jk^ AZfOtyjsr^ <br />AOORF^SS^ // ✓ ' '/ <br />Ixicatinn whcic litni.sc will he ii.srd If nn outdoor nren, describe <br />-rr.^9/ ' <br />Will (lie ejiplicnni rnunw i lot inloxicflemg liquor Krivicrj? If so, givfl Uic luuiic mtU udilicis of the Iic|uoi licenwe piovuling (he srrvict <br />7^ <br />Will (he npplirnni enrry liquor li.ihility instiranre'' II.no . thc^mcr’s name nmJ umuiiul ol tovef.u^ <br />(NOTF.: liiMiiiiiii r isnol m.iii.la(niy ) /^P/J/r/'ijt <br />APPROVAI. <br />Airi l( A IK »N^ IS I UK AITKC »VHl IIV (TIV OK < (It WrV DEK( IKK SUBMlTnN(; TO AMOIIOI. S CAMBI.ING l-USK >l(( l-.MI N r <br />ai Y/rOlINTY Ot0>^0 . _ DATI-Al'I-KOVI-.l) <br />(Tl Y I I I-; AMI )lIN I , 0 O ___ LU liNSF. 0ATI-:S _ . _ ____] <br />0ATI-: n:i-PAID ____ ____ <br />sKsNAiimi cn V(11RK cmcuuki y ufhcial AITROVI 1) AIioIniI A Ciaiiihliny' I nltwii'fiirni <br />Null*: Do IM»I M fiufulr llirk.- loo p«il«. wiiil liolli |iiirl\ to Ihr ttdilrrx^ nhinr und Ihr mlgin^t vlgrod tn llii\ diibitin <br />oMI fir trfuf Itrij u) (hr Ikrii^r. Submit lu Ihr liti to ( minit ul Irust UJ dii«% tu lmr Ihr r%rnl <br />rs UMU71 if*mi