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Motms VIEW <br />2401 Mounds View Boulevard ' Mounds View MN 55112-1499 <br />(763) 717-4000Fax (763) 717-4019 <br />infoRmoundsviewmn.arg www.moundsview.mn.oro <br />Application Date - <br />CO U NC I L Approval Date: C.�p - a �e 0 a <br />Public Hearing Date: Lx- - ._). Le - A <br />Publication Date: 06-14-2023 <br />TEMPORARY LIQUOR LICENSE APPLICATION <br />LOCATION OF EVENT: TYPE OF EVENT: DATE OF EVENT: <br />Silver View Park, Mounds View Festival 08/19/2023 <br />S Temporary On -Sale Intoxicating Liquor <br />❑ Temporary On -Sale 3.2% Malt Liquor <br />Event Sponsor/Organization/Licensee: Festival in the Park of Mounds View Phone:763-780-0960 <br />Contact Person: Kathryn Smith Fax: <br />Address: 2401 Mounds view Blvd <br />City: mounds View State: MN Zip: 55112 1 Email: kathyn.k9training@gmail.com <br />Signature of Licensee: Kathrvn Smith <br />Person Responsible: Bruce Westman <br />of Birth: <br />Business Address: 17846 Central Avenue Fax: <br />City: Ham Lake <br />State: MN <br />ZIP: 55304 <br />Email: ginnyw1946@hotmail.com <br />Are you a MN resident? <br />o Yes If not, where do you reside: From: to: <br />Have you ever been convicted of violating federal, state or local liquor laws or regulations? o ❑Yes <br />If yes, please explain on separate piece of paper. <br />PropertyDifferent Than Event Sponsor) <br />Property Owner City of Mounds View <br />Address 2401 Mounds View Blvd. Phone: 763-717-4000 <br />City: Mounds View <br />I State: MN <br />Zip: 55112 Fax: <br />Email: info@moundsviewmn.org <br />List four business references that are familiar <br />Business Narne <br />with you and your business (not required <br />AddresslCity/State/Zip <br />for renewals): <br />Phone <br />Contact Name <br />- Not Need (licensed last year) <br />2. <br />3. <br />4. <br />following,Please list the or have held (not required for <br />renewals): <br />Date(s) of License: <br />1 , Not Need (licensed last year) <br />2. <br />What is the maximum occupancy for the premises? <br />Have you ever had a license revolted? Kjo es If yes, please explain: <br />I and my associates in this application will strictly comply with all the laws of the State of Minnesota <br />governing taxation and the sale of alcohol; rules and regulations promulgated by the Alcohol and <br />Gambling Enforcement Division the Department of Public Safety; and all ordinances of the <br />