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Minnesota Department of Public Safety <br />Alcohol and Gambling Enforcement Division <br />445 Minnesota Street, Suite 1600, St. Paul, MN 55101 <br />651-201-7507 Fax 651-297-5259 TTY 651-282-6555 <br />APPLICATION AND PERMIT FOR A 1 DAY <br />TEMPORARY CONSUMPTION AND DISPLAY PERMIT <br />(City or county may not issue more than 10 permits in any one year) <br />Sheet of <br />Club <br />Name of organization Date organized Tax exempt number <br />Address City Zip CodeState <br />Name of person making application Business phone Home phone <br />Date(s) of event <br />Charitable Religious Other non-profit <br />Type of organization <br />Organization officer's name City State Zip <br />Location where permit will be used. If an outdoor area, describe. <br />City or County approving the license <br />APPROVAL <br />APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO ALCOHOL AND GAMBLING ENFORCEMENT <br />Date Approved <br />Fee Amount Permit Date <br />Date Fee Paid <br />CLERKS NOTICE: Submit this form to Alcohol and Gambling Enforcement Division 30 days prior to event. <br /> <br />ONE SUBMISSION PER EMAIL, APPLICATION ONLY. <br />PLEASE PROVIDE A VALID E-MAIL ADDRESS FOR THE CITY/COUNTY AS ALL TEMPORARY <br />PERMIT APPROVALS WILL BE SENT BACK VIA EMAIL. E-MAIL THE APPLICATION SIGNED BY <br />CITY/COUNTY TO AGE.TEMPORARYAPPLICATION@STATE.MN.US <br />City or County Email Address <br />City or County phone number <br />Signature City Clerk or County Official Approved Director Alcohol and Gambling Enforcement <br />Please Print Name of City Clerk or County Official <br />St. John's Church of Little Canada June 30, 1851 8918317 <br />380 Little Canada Rd Little Canada 55117MN <br />Sue Reinart 651-288-3267 <br />July 21, 2021 <br />X Fr. Thomas Balluff Little Canada MN 55117 <br />Add New Officer