Laserfiche WebLink
• CITY OF ST ANTHONY <br /> DEPARTMENT OF LICENSING <br /> Date:.( <br /> The following is an application for use of 3. _beeriq_City Parks. <br /> FULL NAME OF APPLICANT: Q Jany) <br /> (Must work <br /> 'in/St. A/l ntho 've ' thoy) <br /> ADDRESS: <br /> AGE: <br /> I certify that I am a resident of St. Anthony or work in the City. <br /> I am responsible for conduct of his/her group. <br /> • Signature of Apphc nt <br /> NAME OF GROUP:- <br /> # IN GROUP: <br /> LOCATIO <br /> DATE: 2 .- - HOURS: /"ktl <br /> TELEPHONE#: 6_35-- <br /> $50.00 <br /> 3.-$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- <br /> RETURNED: <br />