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• CITY OF ST ANTHONY <br /> DEPARTMENT OF LICENSING <br /> Date: <br /> The following is an application for u f 3.2 beer in City Parks. <br /> FULL NAME OF APPLICANT:Mr Tayhes <br /> (Must work in St.'r thony or live in St. Antthony <br /> ADDRESS: <br /> AGE: <br /> I certify that I am a resident of St. Anthony or work in the City. <br /> I a pon le con f his/her group. <br /> Ax <br /> • Signatur of A,161icant <br /> NAME OF GROUP: <br /> # IN GROUP: D <br /> LOCATION: <br /> DATE: D HOURS: 'o — 9.'d <br /> TELEPHONE : <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: rY <br /> RETURNED: <br />