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CITY OF ST. ANTHONY ` t <br /> DEPARTMENT OF LICENSING DATE; L I <br /> The following is application for use of 3. 2 beer. in City Parks. <br /> FULL NAME OF APPLICANT: ��3-row �- a r (MUST WORK IN ST. ANTHONY OR <br /> LIVE IN ST. ANTHONY) <br /> ADDRESS: �J��nl (�' '�Z'� � r, <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 /> Signature o Applicant <br /> NAME OF GROUP: <br /> NO in Group: <br /> LOCATION: (,►t� r <br /> $50.00 Clean-up Deposit: TELEPHONE #: �,z40;?_ <br /> Received By �J , <br />