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± ' CITY OF ST. ANTHONY <br /> DEPARTMENT OF LICENSING/PERMITS <br /> The following is application for use of liquors, including non-toxicating malt <br /> liquor 0.2 Beer) in City parks. <br /> FULL NAME OF APPLICANT <br /> ADDRESSl'�:'`1� � <br /> AGE <br /> certify that I am a resident of St. Anthony/or work in City of St. Anthony. <br /> 1 am r onsible for conduct of his/her group. <br /> Signature of applicait <br /> NAME OF GROUP <br /> $50.00 0 O <br /> Cleanup Deposit Jt'Q• -��"8y) NO. <br /> PARK LOCATION_ <br /> Received by; <br />