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JLIL 07 '92 12:36 WRTEROUS SALES /ADMIN 612 - 4505090 <br />P. 2/2 <br />PS 090790118/85) MINNESOTA DEPARTMENT OF PUBLIC SAFET Y <br />PHONE 672.2966159 LIQUOR CONTROL DIVISION <br />333 SIBLEY • ST. PAUL, MN 55101 <br />APPLICATION AND PERMIT <br />., • db 4; FOR A 1 to 3 DAY TEMPORARY ON-SALE LIQUOR LICENSE <br />I <br />TYPE OR PRINT INFORMATION <br />NAME OF ORGANIZATION <br />Little Canada Recreation Association <br />DATE ORGANIZED <br />12 -17 -62 <br />NO. OF MEMBERS <br />79 <br />TAX EXEMPT NUMBER <br />29426 <br />STREET ADDRESS <br />515 East Little Canada Road <br />CITY <br />Little Canada <br />STATE <br />MN <br />ZIP CODE <br />55117 <br />NAME OF PERSON MAKING APPLICATION <br />M. Steven Morelan <br />BUSINESS PHONE ' HOME PHONE <br />(612)450 -5096 .(612)483 -3727 <br />DATES LIQUOR WILL BE SOLD? 11 TO 3 DAYS) <br />August 7 -9, 1992 <br />DOES ORGANIZATION HAVE A CHARTER <br />k7 Yes 0 N <br />GENERAL PURPOSE OF ORGANIZATION <br />Pr3mote youth activit <br />ORGANIZATION OFFICER'S NAME <br />M. Steven Morelan, President <br />ADDRESS <br />109 E. Bluwood Av. ,'Little Canada 5511 <br />ORGANIZATION OFFICER'S NAME <br />Jim Cronick, Secretary <br />ADDRESS I <br />869 E. Co. Rd. D, Vidnais Hghts 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. 0 an outdoor area, describe. <br />Spooner Park, Little Canada <br />Will the applicant contract for intoxicating liquor services? If so, give the name and address of the Liqu: r licensee providing <br />the services. <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 />MN Liquor Liability Assigned Risk Plan 50/100/10 <br />APPROVAL <br />CITY OF <br />DATE APPROVED <br />CITY FEE AMOUNT <br />LICENSE DATES <br />DATE FEE PAID <br />- ...... <br />APPROVED LIQUOR CONTROL DIRECTOR <br />11. <br />SIGNATURE CITY CLERK <br />Page <br />NOTE: Do not separate these two parts, send both parts to the address above and the original signied by this divisior <br />will be returned as the license. Submit to the City Clerk at least 30 days before the event. ' <br />7 <br />