Laserfiche WebLink
CITY OF ST ANTHONY <br /> DEPARTMENT OF LICENSING <br /> Date: y-2 7-G. <br /> The following is an application for use of 3.2 beer in City Parks. <br /> FULL NAME OF APPLICANT: 'y is t1_0 e y 7,6 � <br /> (Must work in St. Anthony or live in St. Anthony) <br /> ADDRESS: y0 <br /> AGE: Y07 <br /> I certify that I am a resident of St. Anthony or work in the City. <br /> I am re on able f=uct r group. <br /> Signature of Appli nt <br /> NAME OF GROUP: /4� 0 <br /> # IN GROUP: A S­6 <br /> LOCATION: �►di/��- ��— l 5 ��'� <br /> DATE: - - '7,3 HOURS: <br /> TELEPHONE#: -911-307 <br /> $50.00 CLEAN-UP DEPOSIT: <br /> (You are responsible for Park Clean-up, the deposit will be returned after inspection of the <br /> Park) -- <br /> RECEIVED BY:_ DENNIS M. OR PATRICIA A. FAGERLEE - 18082 <br /> RETURNED: F-264-139-603-425 F-264-676-067-853 . <br /> 3407 CROFT ST., NE. PH. 781-3075 �j� <br /> I MINNEAPOLIS, MN 55418 19 17-13/910 <br /> PAY TO THE ,r <br /> ORDER O -' 6FWge7 $. _ .•fi.—.., <br /> 1 <br /> 1 - DOLLARS <br /> ' ~ Northeast CMolum bia H ghta MN.788-9351. <br /> •W Ba k Coon RaP d$.MN <br /> 784-3533 <br /> MEMO <br /> e:09 1000 L 3 21: S L SE 3 26 71" 8013 2 <br />