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L <br /> CITY OF ST XNTHON'Y <br /> DEPARTMENT OF LICENSING <br /> The following is an application for use of 3.2 beer in City Parks. <br /> FULL NAME OF APPLICANT-Lt 'Zt d�2 LCCA <br /> (Must work in St. A thon�or live in St. Anthony) <br /> AGE: G�a <br /> I certify that I am a resident of St. Anthony or work in the City. <br /> I responsible for nduct of his/her group. <br /> • <br /> Signak&e of Applicant <br /> NAME OF GROUP:2� �a (�44" <br /> div <br /> # IN GROUP: v <br /> LOCATION: <br /> DAT -- -l(gi HOURS: 5'— /90 <br /> TELEPHONE#: 7Ld - LZ71 <br /> $50.00 CLEAN-UP DEPOSIT: <br /> (You are responsible for Park CIean-up, the deposit will be returned after inspection of the <br /> Park) <br /> RECEIVED BY: <br /> RETURNED: <br />