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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 (3.2 Beer) in City parks. <br /> , <br /> FULL NAME OF APPL 1 CAN . t <br /> '°� • ADDRESS <br /> AGE <br /> 1 certify that i am a resident of St. Anthony/or work in City of St. Anthony. <br /> 1 am responsible for conduct of his/her group. <br /> Signature of applicant <br /> " !j ; NAME OF GROUP <br /> : . altHER slot <br /> NO. 6,5 OF PAMi LT <br /> $50.00 • <br /> �� ! Cleanup Deposit �O �`Sd <br /> PARK LOCATION �-�- <br /> _'� , Received by;( l� ) PIGN1c- <br /> !; W- <br /> ii�'F <br />