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CITY OF ST. ANTHONY <br /> DEPARTMENT OF LICENSING <br /> i <br /> The following is application for use of 3. 2 beer in City Parks. <br /> FULL NAME OF APPLICANT: �CC�l)Clr/f?2 � . 't(��i( (MUST WORK IN ST. ANTHONY OR LIVE <br /> IN ST. ANTHONY) <br /> ADDRESS: <br /> AGE 7-- <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 /> Signature of applicant NAME OF GROUP <br /> NO <br /> LOCATION <br /> $50. 00 Cleanup Depo it��� C/ <br /> Received by <br /> G. <br />