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PS- 09079. 0118/85) MINNESOTA DEPARTMENT <br />PHONE 612-296-6159 LIQUOR <br />333 SIBLEY <br />y' 'ri• <br />/ APPLICATION <br />OF PUBLIC SAFETY <br />CONTROL DIVISION <br />• ST. PAUL, MN 55101 <br />AND PERMIT <br />ON -SALE LIQUOR LICENSE <br />F FOR A 1 to 3 DAY TEMPORARY <br />TYPE OR PRINT INFORMATION <br />NAME OF ORGANIZATION <br />Little Canada Recreation Association, Inc. <br />DATE ORGANIZED <br />12 -17 -62 <br />NO. OF MEMBERS, <br />72 <br />TAX EXEMPT NUMBER <br />9426 <br />STREET ADDRESS <br />515 East Little Canada Road <br />CITY <br />Little Canada <br />BUSINESS PHONE <br />1612 1450 -5096 <br />HOME PHONE <br />1612 )481 <br />STATE <br />MN <br />-1727 <br />ZIP CODE <br />55117 <br />NAME OF PERSON MAKING APPLICATION <br />M. Steven Morelan <br />DATES LIQUOR WILL BE SOLD? (1 TO 3 DAYS) <br />September 6 -8, 1991 <br />DOES ORGANIZATION HAVE A CHARTER <br />❑Yes ❑NO <br />% <br />GENERAL PURPOSE OF ORGANIZATION <br />Promote youth arriviti eq. <br />ORGANIZATION OFFICER'S NAME <br />M. Steven Morelan, President <br />ADDRESS <br />109 E. Bluwood Ave., Little Canada 55117 <br />ORGANIZATION OFFICER'S NAME <br />Jim Cronick, Secretary <br />ADDRESS <br />869 E. County Rd. D, Vadnais Heights 55109 <br />ORGANIZATION OFFICER'S NAME <br />Linda Fahey, Treasurer <br />ADDRESS <br />2926 LaBore Rd., Little Canada 55109 <br />Location where license will be used. If an outdoor area, describe. <br />Pioneer Park, Little Canada <br />Will the applicant contract for intoxicating liquor services? If so, give the name and address of the Liquor licensee providing <br />the services. <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) <br />Liquor TAahi1ity Assigned Risk Plan 50 /10N /10 <br />wi <br />APPROVAL <br />CITY OF <br />DATE APPROVED <br />CITY FEE AMOUNT <br />LICENSE DATES <br />DATE FEE PAID <br />APPROVED LIQUOR CONTROL DIRECTOR <br />SIGNATURE CITY CLERK <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 Clerk at least 30 days before the event. <br />Page 38 <br />