Laserfiche WebLink
CITY OF ST kNTHONY <br /> DEPARTMENT OF LICENSING <br /> Date: <br /> The following is an application for use of 3.2 beer i City Parks. <br /> FULL NAME OF APPLICANT: 2 ?A— <br /> (Must work in St. Anthony or live in St. Anthony) <br /> ADDRESS: C7 U <br /> AGE: 7'� <br /> I certify that I am a resident of St. Anthony or work in the City. <br /> I amresponsiblefor conduct of his/her group. <br /> • Signature of Applicant <br /> NAME OF GROUP: V4-Ov <br /> # IN GROUP: 7 s <br /> LOCATION: <br /> DATE: f4j:t HOURS: /— 6 <br /> TELEPHONE#: 7,f-/ — 7 <br /> $50.00 CLEAN-UP 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 />