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,~iosM;a;~, <br /> Minnesota Department of Public Safety Qd; <br /> /ALCOHOL AND GAMBLING ENFORCEMENT DIVISION <br /> ~~,r ca`~~ 444 Cedar Street Suite F33;'''~'f.'Paul MN 55101-5133 t ' <br /> ~yOf MIHyE~d ~ .T <br /> (GS 24 t -7507 Fax (GS I) 297-S2S9 T'fY (65 t) 2S2-GSSS ~ :?~h*~• <br /> W W W.DPS.STAT6.MN.US <br /> APPLICATION AND PERMIT <br /> FORA 1 TO 4 DAY TEMPORARY ON-SALE LIQUOR LICENSE <br /> <br /> _ "TYPE OR PRINT INFORMATION <br /> NAMF, OF ORGANIZATION DATE ORGANIZBll TAX EXEMPT NUMBER <br /> 51-'Soho's Cl.uv~G. ~~~~le ~anadw- /~5'~/ ~5 a 33 3 Q <br /> STRF,ET ADDRL'SS CITY S'fA"fliL[P CODE <br /> 3S'0 ~;><//e C~aow~~fa l~oao/ ~;F~~c ~ahadr. NIIJ 5 S'/J~ <br /> NAME OP PERSON MAKING APPLICATION BUSINESS PI-PONE CCQurcL` Id6hhizPl{ONE ~D/n'c•fi -Tony <br /> JS'~cn's ~ Ik ~ - Tvn Nuns (tort)- y~y-a 7o k' (~,sl) a aro- 37c// (c~lc <br /> ~rti r <br /> DATES LIQUOR W ILL, BC SOLD r-,I,.t• 3/z ~ zv`o -y 'T'YPE OP ORGANIZATION <br /> ORGAN/IZAI7lON// Ot~'/FICGR/'~S NAME ADDRESS n / j 1/y~ ) <br /> ,JD1~31 Ze7~Ic.L~ /"rc~SJc(c r7'I•` J'o~5"/ /~Rr/gin ~1-uel ~4 GQ ~1CIiS ~~eiSt~'}, ~'("v <br /> ORGANIZA'T'ION OPP[CBR'S NAME ADDRF,SS <br /> ,l <br /> ~ m ~ti lrcS~ "T`~<~ S't~ rC r' 07 ~1 7 J (~fla. .S~ree~ lY1 Iewoadl /'1') N <br /> ORGANIZATION OPPICF,R'S NAMCs ADDRESS ! <br /> ~~{--F I~rlce Vi cc ~icS%ctcnl` o27a~ FGP~rrlanSl,'rc~~ ~~1-f/c l/anACPc,~ lyl~ <br /> Location license wi(! be used. (fan outdoor area, describe ~ <br /> ~~vt~ey_~r~arn ~-7> ~ .Sc/ia1( - o?~-Z/ /'?/c /rJc'nc/y~fYYecJ" ~,'~i~/< Lait~l,~G~_ <br /> ' <br /> Will the applicant contract for intoxicating liquor service? If so, give the name and address of the liquor licensee providing the service. <br /> /~o <br /> Will th`e/ applicant carry liquor liabi,l,itry insurance? If sq please provide the carrier's name and amoun7t of coverage. ~1 <br /> Y/5- ~a.1/'/ila~,r /'I ~a.~" S~/~~in Sin rrA~ y~.tac~~ >7~rc~c/iO CCSc rJ, ~a•r^~1~ <br /> WnR' ~ i rl ~ ~ a/7d ~~.5 - <br /> APPROVAL <br /> APPLICATION MUST BE APPROVCD BY C[TY OR COUNTY BEFORE SUBMI'1"I'MG TO ALCOIiOL & GAMBLING <br /> ENT'ORCGMENT <br /> CITY/COUNTY DATE APPROVED <br /> CITY FEE AMOUNT LICENSE DATES <br /> DATE FEE PAID <br /> SIGNA9'UIiL' CITY GLGttK OR COUNTY OF[>[CIAL API'IiOVRD UIRGC'1'Oli ALCOHOI• AND GAMDLING hNPOIiCEMEN'f , <br /> NOTE: Submit this form to the city m• county 30 days prior to event. Rorward applicatimt signed by city and/or county to the address <br /> above. [f the application is approved the Alcohol and Gambling Iinforcement Division will return this application to be used fls the License for the event <br /> ('5-09079 (OS/OG) <br /> 2 <br /> <br />