Laserfiche WebLink
Minnesota Department of Public Safety <br />ALCOHOL AND GAMBLING ENFORCEMENT DIVISION <br />444 Cedar Street Suite 222, St. Patti MN 55101 -5133 <br />(651) 201 -7500 Fax (651) 297 -5259 TTY (65 t) 282 -6555 <br />W W W . DPS.STATP..MN. LJ5 <br />APPLICATION AND PERMIT <br />FOR A I TO 4 DAY TEMPORARY ON-SALE LIQUOR LICENSE <br />"TYPE OR I'12IN'I' INFORMATION <br />NAME OF ORGANIZATION <br />Little Canada Canadian Days Inc <br />DATE ORGANIZED <br />12/17/1978 <br />TAX EXEMPT NUMBER <br />STREET ADDRESS <br />515 Little Canada Rd E <br />CITY S'L'ATE ZIP <br />Little Canada <br />MN <br />CODE <br />55117 <br />NAME OF PERSON MAKING APPLICATION <br />Susan Nelson <br />BUSINESS PRONE <br />( ) NA <br />NOME PHONE <br />(653)483 -4541 <br />DATES LIQUOR WILL BE SOLD <br />July 29 -31, 2011 <br />TYPE OF ORGANIZATION <br />CL1J13 0 IARFIAI3L.E RELIGIONS OILIER NONPROFIT X <br />ORGANIZATION OFFICER'S NAME <br />Janene Connelly, President <br />ADDRESS <br />3327 Twin Lake Ct, Little Canada, MN 5512 <br />ORGANIZATION OFFICEI2:S NAME <br />Susan Nelson, CEO <br />ADDRESS <br />762 Labore Rd, Little Canada, MN 55117 <br />ORGANIZATION OFFICER'S NAME <br />Lynda Beadoin, Treasurer <br />ADDRESS <br />2442 Rice St #165, Little Canada, MN 5511 <br />Location license will be used. Ilan outdoor area; describe <br />Spooner Park, 350 Eli Rd, Little Canada, MN 55117 <br />Will the applicant contract for intoxicating liquor service? If so, give the name and address of the liquor Ii consec providing the service. <br />No <br />Will the applicant 08rry liquor liability insurance? If so, please provide the carier's name and amount of coverage. <br />APPROVAL <br />APPLICATION MUST BE APPROVED BY CITY OR COUNTY <br />ENFORCEMENT <br />CITY /COUNTY <br />BEFORE SUBMITTING <br />DATE APPROVED <br />LICENSE DATES <br />TO ALCOHOL & GAMBLING <br />CITY FEE AMOUNT <br />DATE FEE PAID <br />SICNA'FIJI1: CITY CLERI( OR COUNTY OFFICIAL. APPROVED DIRECPORALCOLIOL AND GAMBLING ENFORCEMENT <br />NOTIC: Submit this torn to the city or county 30 days prim to event. Forward application signet) )y en), and /or county to the address <br />above. If the application is approved the Alcohol and Gambling Enforcement Division will return (ilia application to he used as the License for the event <br />P5- 09079 (1749) <br />2 <br />