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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: )F> %li '• /C�/l'��fi"� (MUST WORK IN ST. ANTHONY OR LIVE <br /> IN ST. ANTHONY) <br /> ADDRESS: <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 /> l _ <br /> Signa ure of applicant NAME OF GROUP <br /> L <br /> NO <br /> LOCATION <br /> $50.00 Cleanup Deposit <br /> Received by / I <br /> '•) <br /> 1 <br />