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Application <br />Date: -,;R ®/ g <br />{ _I CO(INCII <br />Approval Date: S ��) <br />2401 Mounds View Boulevard * Mound s Yiew MN 55112-1499 Public <br />(763) 717-4000 * Fax (7 3) 717-4019 Publication <br />Hearing Date: j —"R q -,Q J X <br />Date: <br />info cr moundsviewmn.orq * wtiw .mOrmdsview.mn.a <br />+QUOR +LiCgNSE APPLCATION <br />LOCATION OF EVENT: <br />TYPE Or EVENT: <br />PATE OF EVENT: <br />oz Lk- <br />-Mounds <br />Mounds View City Hall ! <br />Festival in the Park <br />August '8, 2018 <br />Q Temporary On-Sale Intoxical 9g Liquor ❑ Temporary On-Sale 3.2% Malt Liquor <br />Event Sponsor/Organization/Licensee Festival in the Park Committee !Phone: ,� 78l -7o5f <br />Contact Person: r m a k- ! I Fax: <br />Address: D <br />City: Mounds View State: MN Zip: 55 J 12 <br />Email: <br />Signature of Licensee: —_ _�,._ -� <br />1;K7i <br />0 • e e ® •' <br />7nt/cttyM/Pc <br />Person Responsible: Paul Brian Spit e� USAUfVlnCejState of Birth: Date of Birth:09/1 /1963 <br />Doing Business As: Ole Piper Inn I <br />Phone: 763-78 -7100 <br />Business Address: (Person Respons blk) 16208 <br />S't. NW Fax: <br />City: Ramsey State: MN <br />Zip: 55303 I <br />Email: pbspitley@comcast.n t <br />Are you a MN resident? <br />o <br />Yves If not, where <br />do you reside: From: to: <br />Have you ever been convicted of viola ins federal, state or local liquor IaxWs or regulations? —]No ❑ Yes <br />If yes, please explain on separate piece f paper. <br />Property OwnerCity of Mounds Viej <br />Address 2401 Mounds View Blvd. <br />Phone: 763-717-4000 <br />City: Mounds View <br />Palo: N <br />Zip: 55112 <br />Fax: 763-717-4 19 <br />Email: info@moundsviewmn.org <br />• a a o 0 o s t• • oan <br />Business Name Addresg/City/state/ . 7-IP Phone Contact Name <br />1. 5 �tr3 ' � 5q <br />2y- ct X yr t > , \,cI m nnco- i'Sl, tyl(Q _ - ' ; - <br />3. 1 S' I -- 3 t)C <br />4—tri rll t ria _z{. o-. <br />o a • • o e o o Mal—c o a • ^• -0 a <br />I pate{ } of License: <br />1. - 1 <br />C. ti �. <br />JI <br />2. <br />I I <br />What is the maximum occupancy fo te premises? ()I,I Pt( - 11 Ill - B' <br />Have you ever had a license revoke ? YFo es If yes, pleas' explain: <br />and my associates in this apli,ation will strictly comply with all the laws of the State of Minnesota <br />governing taxation and the sae f alcohol; rules nd regulations promulgated by the Alcoho and <br />Gambling Enforcement Division Ithe Department f Public Safety; and all ordinances of the <br />it <br />