Laserfiche WebLink
_ Minnesota Department <br />oti:i1.esry,_ LIQUOR CONTROL <br />`i t `O3e 444 Cedar <br />of Public Safety <br />DIVISION <br />St. /Suite 100L <br />MN 55101 -2156 <br />1 DD (612)282 -6555 <br />AND PERMIT <br />ON -SALE LIQUOR <br />to 3 permits in a t 2 month period <br />LICENSE <br />�e ret*: -- <br />L �� <br />>a St. Paul, <br />(612)296 -6439 <br />ii•i85s:8 <br />��,, <br />APPLICATION <br />FOR A 1 TO 4 DAY i'EMPORARY <br />(Organization or location limited <br />TYPE OR PRINT INFORMATION <br />or <br />lupus <br />NAN[E OF ORGANIZATION <br />L 1 44te C4rtodc, 1Z2C. 4-5SOC , <br />DATE ORGANIZED <br />i2.- /'7 -iv L <br />TAX EXEMPT NUMBER <br />'Z.y`I ZW <br />STREET ADDRESS ,. <br />sr� e. , LItF(eCc0,n<a� AI, <br />CITY <br />z.., line GOen-,sh <br />STAlh <br />"-pi ,t/ <br />ZIP CODE <br />SS /i7 <br />NAME/OF PERSON MAKING APPLICATION <br />Kev,•N i eeAmnJ <br />BUSINESS PHONE <br />( ) <br />HOME PHONE <br />( &57)'f90 ,- 3 /Co_S _ <br />DATES LIQUOR WILL BE SOLD (1 to 4 days) <br />SIN , Zb - 2.-1 i 200 Z.- <br />TYPE OF ORGANIZATION <br />0 CLUB 9 CHARITABLE = RELIGIOUS 0 OTHER NONPROFIT <br />ORGANIZATION OFFICERS NAME <br />Lioda t=ai -ke `! — Ta-es , <br />ADDRESS / <br />G`IZ`1 LG.66ar.e i�r,(, L.c • ., -,,-t7 >a 117 <br />ORGANIZATION OFFICER'S NAME <br />/ <br />ADDRESS <br />ORGANIZATION OFFICER'S NAME <br />ADDRESS <br />Location where license will be used. an outdoor area, describe <br />— LfLI C G.l -f-*1Q Cc.hq,c/4 ,2d . L, C , GS-7 ) 7 <br />/.dv/../ <br />j <br />Will the applicant contract for intoxicating liquor services? If so, give the name and address of the Liquor license providing the service. <br />Al Q <br />Will the applicant cam liquor liability insurance? If so. the carrier' s name and amount of coverage. if <br />(NOTE: Insurance is not mandatory) .S /41.1.../ �! a i it/ t U:-7clePtv/,"ft V76 J S dC 7 G 00 0 <br />APPROVAL <br />APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO LIQUOR CONTROL <br />CITY /COUNTY <br />DATE APPROVED <br />LICENSE DATES <br />CITY FEE AMOUNT <br />DATE FEE PAID <br />SIGNATURE CITY CLERK OR COUNTY OFFICIAL <br />APPROVED LIQUOR CONTROL DIRECTOR <br />NOTE: Do not separate these two pans. send both parts to the <br />will he returned as the license. Submit to the City_ or County <br />address above and the original signed by this division <br />at least 30 days before the event. <br />PS- 09079(8/95) <br />Page 9 <br />