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CITY OF ST. ANTHONY <br /> DEPARTMENT OF LICENSING <br /> The following is - application for use of 3. 2 beer in City Parks. <br /> FULL NAME OF APPLICANT: C.K EfeSO/t) (MUST WORK IN ST. ANTHONY OR LIVE <br /> IN ST. ANTHONY) <br /> ADDRESS: 70 D WD- <br /> OD <br /> AGE <br /> I certify that I am a resident of St. Anthony or work in City of St. Anthony. <br /> I -.am responsible for conduct of his/her group. <br /> Za4l"g-j 4 <br /> I 1 <br /> Signature of applicant NAME OF GROUP <br /> NO �Q O <br /> LOCATION <br /> $50.00 Cleanup Deposit S 0 <br /> Received by <br /> t <br />