Laserfiche WebLink
• CITY OF ST ANTHONY <br /> DEPARTMENT OF LICENSING <br /> Date: q3 <br /> The following is an application for use of 3.2 beer in City Parks. <br /> FULL NAME OF APPLICANT: M ecNF46L k05A1266 <br /> (Must work in St. Anthony or live in St. Anthony) <br /> ADDRESS: 6 / 7 3 `�"� A V"_ <br /> AGE: 3 <br /> I certify that I am a resident of St. Anthony or work in the City. <br /> I am responsible for conduct of his/her group. <br /> • Signature of Applicant <br /> NAME OF GROUP: q/ll5. YS <br /> # IN GROUP: S V <br /> LOCATION: A L/i /l j CIAI <br /> DATE: �//(7 23 HOURS: �f 7 <br /> TELEPHONE#: 4W — lo3 2- <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: <br /> RETURNED: <br />