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CITY OF ST. ANTHONY <br /> DEPARTMENT OF LICENSING <br /> The following is application 0 for use of 3. 2 beer in City Parks. <br /> FULL NAME OF APPLICANT: — (MUST WORK IN ST. ANTHONY OR LIVE <br /> IN ST. ANTHONY) // I <br /> ADDRESS: <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 /> lgnature of apple ant NAME OF GROUP �r/L�r�J -y L / �v " �s. ,cc4• <br /> NO <br /> LOCATION <br /> $50. 00 Cleanup Deposit JC" <br /> Received by : <br /> 61 <br />