Laserfiche WebLink
M^mesota Oeptrtmaoi o( Pubfic SaieiyLIQUOR CONTROL DIVISION <br />190 5th St. E.. SI. Paul. MN 55101 <br />(612) 296-6430 TDD (612) 297-2100 <br />I . <br />K®APPLICATION AND PERMIT <br />fora 1 to 3 DAY TEMPORARY ON-SALE LIQUOR LICENSE <br />rm OP WWWTINPOAMATIQN <br />NAMC 0* OPGANIZATtON <br />Sm-lt' Ctu.b ^ AlutivSciTi.^ <br />0AT£ O«GANl2f0 <br />Kl <br />NO. OP members <br />Auv <br />TAX *X£M?T NUMBEP <br />4\ - H()^ 2b^ <br />STPcrrAooPESS ^ • <br />% uIt*. P*"'-'*-I 2*4*^*^ Cl;a.,iC| t.t.cU <br />C ity Zif^COOg <br />4“ <br />NAMi OF PERSON MAKING APPLICATION <br />Pd Rtf' PtaH) <br />DATES LIQUOR WtU 6E SOLO’ <1 TO 3 DAYS! <br />S\p k:.H <br />OPQANI2ATION OPPICEB'S NAME <br />pCtutiX U\ , Pf/^ifL «v(: <br />OBOANIZATION OPPICEft^S name ^ . <br />StViitTu PfCOiCU^t <br />;ANI7AnON OPPtCEft S NAME <br />HOME PHONE <br />(i,2) muBUSINESS PHONE <br />, (6i2> 523 2. _______________ <br />DOES OBCANizATION HAVE A CHARTER GENERAL PURPOSE OF ORGANIZATIO? <br />^ yt% □ Nc .^(i4vrc4 HwmaI c*^0i»oI z*» <br />ACOBESS ^ <br />address , ^ , <br />U2iy 5 Dr. A>I aJ <br />OBO- <br />1/ u4r< c'f K-'tx fK plAft. <br />ADDRESS .. <br />Lirlivtff^ Ay6 ~>l- tT(A.IL/' ^'^ILS <br />Locition wbAfB Uc«ft*B w3l bB ut#d. It «n outdoor *fea. describe. <br />L: tv n„. A ^ 2240 <br />/ |Ci|t.hcn j <br />Will th* <br />the stfvicf <br />4«r 1^- ent contract for intoxict.ng l-cuor se. v.ces? II so. give the nan^e .nd address of the Uouor licensee orov-d-ng <br />K)o <br />WiH the eoolicant carry liQuOr liability insurance? II so. tne earner s name and amount of coverage. <br />(Note:Insurance is not mandatoryl <br />Mo <br />APPflOVAl. <br />CITY OF <2^1gjOOO <br />CITY FEE AMOUNT <br />DATE FEE PAO <br />SIGNATURE CITY CLERK <br />DATE approved <br />LICENSE DATES <br />APPROVED LIQUOR CONTROL DIRECTOR <br />TOTAL P.Ol <br />I'3 <br />i