Laserfiche WebLink
PS- 0907901(6/85) <br />PHONE <br />TYPE <br />MINNESOTA DEPARTMENT OF PUBLIC SAFETY <br />612-296-6159 LIQUOR CONTROL DIVISION <br />333 SIBLEY • ST. PAUL, MN 55101 <br />APPLICATION AND PERMIT <br />FOR A 1 to 3 DAY TEMPORARY ON-SALE LIQUOR LICENSE <br />OR PRINT INFORMATION <br />NAME OF ORGANIZATION <br />Little Canada Recreation Association <br />DATE ORGANIZED <br />1958 <br />NO. OF MEMBERS <br />60 <br />TAX EXEMPT NUMBER <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 />Jerry Boca <br />BUSINESS PHONE <br />(612) 290 -3783 <br />HOME PHONE <br />(612) 484-2716 <br />DATES LIQUOR WILL BE SOLD? (1 TO 3 DAYS) <br />4 -13 -91 <br />DOES ORGANIZATION HAVE A CHARTER <br />XX]Yes 0 N <br />GENERAL PURPOSE OF ORGANIZATION <br />Youth Sports <br />ORGANIZATION OFFICER'S NAME <br />Steve Morelan /President <br />ADDRESS <br />109 Bluwood; Little Canada, MN 55117 <br />ORGANIZATION OFFICER'S NAME <br />Jim Cronick /Secretary <br />ADDRESS' <br />869 E. Cnty Rd. D; Vadnais Hts, MN <br />ORGANIZATION OFFICER'S NAME <br />Linda Fahey /Treasurer <br />ADDRESS <br />2926 LaBore Rd; Little Canada, MN 55_ <br />Location where license will be used. If an outdoor area, describe. <br />St. John The Evangelist of Little Canada; 380 Little Canada Rd; Little <br />Canada, MN. 55117 (School Gym) <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 />Yes $500,000 through the Catholic Mutual Relief Society <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 />age <br />09 <br />