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07-27-2005 Council Agenda
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07-27-2005 Council Agenda
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TYPE OR <br />Minnesota Department of Public Safety ` <ri:.•„ 6.� <br />u' 5',. LIQUOR CONTROL DIVISION <br />" _ 444 Cedar St. /Suite 100E 8 <br />St- Paul, MN 55101 -2156 <br />\` la <br />(61_)296 -39 TAD (61 2)282-6555 <br />;wy. 64 <br />$, tom.. <br />APPLICATION AND PERMIT <br />FOR A 1 TO 4 DAY TEMPORARY ON- SA.I:E•LIQUOR. LICENSE <br />(Organization or location limited to 3 permits in a I2 month periods ¶') 222L t/— 1 c `/ 7 . <br />Of <br />PRINT INFORMATION MRItt <br />NAME OF ORGANIZATION DATE ORGANIZED) TAX EXEMPT NUMBER <br />9oQ 3rn j1s Chug ,T'Na-_ P990 <br />STREET AD RESS CITY STATE ZIP CODE <br />2-9 Y 3 cam e. t t1 Can, cL M� S�r7 <br />r <br />NAME OF P RSOt MAKING APPLICATION BUSINESS PHONE HgvE.P,HxONE <br />P` <br />ton ■,Ornctr\ (CoS!)76Coyoy/ (b )`PO -aCCJSS <br />DATES LIQUOR WILL BE SOLD (1 to 4 days) TYPE OF ORGANIZATION <br />AU , j ' -T ) to a 5 9 CLUB 0 CHARITABLE 0 RELIGIOUS OTHER NONPROFIT <br />ORGA ATION OFFICERS NAME ADDRESS <br />3 DI - q,1 Q A f 3 Q A Ai (\Q - nl , L ii- o C4-na.J rnry S"-,C) :7 <br />OR-GANIZATION OFFICER'S NAME ADDRESS <br />iORGANIZATION <br />OFFICER'S NAME ADDRESS <br />Location where Lccnsc will be used. If an outdoor area, doscribc r <br />Rr ✓h¢ -4-ve P,,,-1(.. c-,41—,,,.c-,41—,,,..4\ i <br />
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