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CITY OF ST. ANTHONY <br /> DEPARTMENT OF LICENSING TODAYI-S DATE; <br /> vie following is application for use of 3. 2 beer in City Parks. <br /> �� � i ✓�-' Oc.'L- -ems] (?4UST WORK IN ST. ANTFIONY OR <br /> FULL NAME OF APPLICANT• <br /> LIVE IN ST. ANTHONY) <br /> ADDRESS:ACE:_ 7-S <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 /> ` NAME OF GROUP: j <br /> Signature of Applicant <br /> i <br /> # _n Group: -7 3 <br /> LOCATION: <br /> DATE OF EVENT:'- <br /> $50. 00 <br /> VENT$50. 00 Clean-up Deposit: �� /•�! <br /> Received Dy / ' <br />