Laserfiche WebLink
CITY OF ST. ANTHONY <br /> DEPARTMENT OF LICENSING DATE <br /> ,rlle followincj is applicaL-:i.on for use of 3. 2 beee.r. -in City Parks <br /> PULL NAME OF APPLICANT: 6R—eda� � <br /> P-Dun (MUST <br /> LIVE INRST. ANTHONY) <br /> �IONY OR <br /> ADDRESS: u�-� <br /> AGE:_� <br /> I certi�y that I am a resident of St. Anthony or work in City of St. Anthony. <br /> I am esponsible for conduct of his/her group. <br /> Signatu o pli.cant NAME OF GROUP : V�L <br /> NO in Group: / 9-0 A p <br /> LOCATION : CRIJ TF LL �- C_\\+l/ , <br /> DATE I - C / �5 aS�� 1 L <br /> $50 . 00 Clean-up_'Deposit: TELEPHONE## : <br /> Received By <br />