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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 /> DULL NAME OF APPLICANT: ^f�l� /1.1k'n 1 ,/���.� _(MUST <br /> LIVE IN STINAST. ANTHONY OR <br /> ADDRESS: -32Q/ <br /> AGE: <br /> I certiffy 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 /> DATES;,-.'-,: July 21 & 22 19.9(l (Friday & Sat)_ <br /> .: a e e e e c e e e e e�c• e " <br /> Signature of i.cant NAME OF GROUP: St. Anthony Villagefest <br /> NO in -Group: X)o _ �3 00 <br /> LOCATION: Central Park <br /> DATE': ()S <br /> $50. 00 Clean-,u Deposit. <br /> Received By <br />