Laserfiche WebLink
i <br /> CITY OF ST. ANTHONY <br /> DEPARTMENT OF LICENSING DATE <br /> The following is al)Plication for use of 3. 2 beca: i.n Ci.ty Parks. <br /> PULL NAME OF APPLICANT• ,� y �1 T /Y1 MUST WORK IN ST. ANTHONY OR <br /> T— --� - LIVE 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 /> AiElamesponsibble for conduct of his/her group.o �/Iplican t NAME OF GROUP: <br /> NO in Group: <br /> LOCATION: G <br /> DATE'I <br /> e <br /> $50 . 00 Clean-up-Deposit: TELEPHONE## : S0 05- 111 <br /> � l <br /> Received By 1-21 VVk <br /> 1 <br />