Laserfiche WebLink
I' M& Minnesota Department of Public Safety <br />6 Alcohol and Gambling Enforcement Division <br />F � "+ 444 Cedar St —Suite 133 <br />?; St. Paul, MN 55101 -5133 <br />y <br />9 I SS <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 />s s <br />� <br />eFa a <br />*� <br />M <br />0 MtNNF$� <br />NAME OF ORGANIZATION <br />Little Canada Canadian Days <br />DATE ORGANIZED <br />12/17/78 <br />TAX EXEMPT NUMBER <br />N/A <br />STREET ADDRESS <br />515 Little Canada Road <br />CITY <br />Little Canada <br />STATE <br />MN <br />ZIP CODE <br />55117 <br />NAME OF PERSON MAKING APPLICATION <br />Virginia Smith <br />BUSINESS PHONE <br />( ) <br />HOME PHONE <br />(RS1) dRa -1196, <br />DATES LIQUOR WILL BE SOLD <br />A „g „Gt ti a aa4 <br />TYPE OF ORGANIZATION <br />❑RELIGIOUS MOTHER NONPROFIT <br />❑ CLUB ■ CHARITABLE <br />ORGANIZATION OFFICER'S NAME <br />Virginia Smith, President <br />ADDRESS 55117 <br />334 East Little Canada Road, Little Canada, to <br />ORGANIZATION OFFICER'S NAME <br />Carl Nelson, Vice President <br />ADDRESS <br />215 Burke Lane, Little Canada, MN 55117 <br />ORGANIZATION OFFICER'S NAME <br />Sue Nelson, Treasurer <br />ADDRESS <br />215 Burke Lane, Little Canada, MN 55117 <br />Location where license will be used. If an outdoor area, describe <br />Spooner Park. Eli Rnad Tittle Canaria. MN <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.) McNamara Company, 1330 Highway 96, St. Paul, MN 55110 50/100/1C <br />APPROVAL <br />APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO ALCOHOL & GAMBLING ENFORCEMENT <br />CITY /COUNTY T,i tt 1 e Canaria DATE APPROVED <br />CITY FEE AMOUNT Waived 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 (6198) <br />age 137 <br />