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r- Minnesota Department of Public Safety <br />�r ,�" Alcohol and Gambling Enforcement Division <br />.. -. ° ; 4/1/1 Cedar St —Suite 133 <br />m jq z' St. Paul, MN 55101 -5133 <br />i Fty, <br />• Hz issati <br />(651)296 -6439 TDD (651)282 -6555 <br />APPLICATION AND PERMIT <br />FOR A TEMPORARY ON -SALE LIQUOR LICENSE <br />TYPE OR PRINT INFORMATION <br />aF, a, <br />�� <br />1OFMMNi+e4/ <br />NAME OF ORGANIZATION <br />Saint John's Church of Little Canada <br />DATE ORGANIZED <br />1851 <br />TAX EXEMPT NUMBER <br />ES 23330 <br />STREET ADDRESS <br />380 Little Canada Road <br />CITY <br />St. Paul <br />STATE <br />Minnesota <br />ZIP CODE <br />55117 <br />NAME OF PERSON MAKING APPLICATION <br />Robert J. Fitzpatrick <br />BUSINESS PHONE <br />(651) 484 -9708 <br />HOME PHONE <br />(AS1) LR /. -2708 <br />DATES LIQUOR WILL BE SOLD <br />Sunday, October 8, 2000 <br />TYPE OF ORGANIZATION <br />❑CLUB ❑CHARITABLE ERELIGIOUS EOTHER NONPROFIT <br />ORGANIZATION OFFICER'S NAME <br />Rev. Robert J. Fitzpatrick <br />ADDRESS <br />380 Little Canada Road <br />ORGANIZATION OFFICER'S NAME <br />ADDRESS <br />ORGANIZATION OFFICER'S NAME <br />ADDRESS <br />Location where license will be used. If an outdoor area, describe <br />School grounds <br />Will the applicant contract for intoxicating liquor services? If so, give the name and address of the liquor licensee providing the service. <br />no <br />Will the applicant carry liquor liability insurance? If so the carrier's name and amount of coverage. <br />( NOTE: Insurance is not mandatory.) yes Catholic Mutual Ins. /Archdiocese of St. Paul /Mpls. <br />APPROVAL <br />APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO ALCOHOL & GAMBLING ENFORCEMENT <br />CITY /COUNTY DATE APPROVED <br />CITY FEE AMOUNT LICENSE DATES <br />DATE FEE PAID <br />SIGNATURE CITY CLERK OR COUNTY OFFICIAL APPROVED Alcohol & Gambling Enforcement Director <br />Note: Do not separate these two parts, send both parts to the address above and the original signed by this division <br />will be returned as the license. Submit to the city or County at least 30 days before the event. <br />PS-09079 (6/98) <br />Page 88 <br />