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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: U �' ��`Ivl LUJOV-ec,��_r (MUST WORK IN ST. ANTHONY OR LIVE <br /> IN ST. ANTHONY) <br /> ADDRESS: S �� C V"C� 'C ..�`. C` l'rCA�� <br /> AGE 4_� <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 /> Signatu of applicant NAME OF GROUP <br /> NO / u-)D <br /> MAW <br /> LOCATION <br /> cv 0 <br /> $50. 00 Cleanup Deposit Q <br /> Received by <br />