Laserfiche WebLink
CITY OF ST. ANTHONY <br /> DEPARTMENT OF LICENSING <br /> The following is application for u,Ase' of 3. 2 beer in city Parks. <br /> FULL NAME OF APPLICANT: V V I L I W YV� r / `y E (Z S (MUST WORK IN ST. ANTHONY OR <br /> LIVE IN ST. ANTHONY) <br /> ADDRESS: 34GO NE +�P1vCS iC& 79,? <br /> AGE: <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 /> NAME OF GROUP: <br /> Signature Applicant <br /> NO in Group: <br /> LOCATION: � - <br /> lel- <br /> $50. 00 Clean-up Deposit: 7er,/�te- <br /> Received BY <br />