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(,3 <br />FA Md `` I <br />MINNESOTA DEPARTMENT OF PUBLIC SAFETY <br />Name of organization <br />Minnesota Department of Public Safety <br />Alcohol and Gambling Enforcement Division <br />445 Minnesota Street, Suite 222, St. Paul, MN 55101 <br />651-201-7500 Fax 651-297-5259 TTY 651-282-6555 <br />APPLICATION AND PERMIT FOR A 1 DAY <br />TO 4 DAY TEMPORARY ON -SALE LIQUOR LICENSE <br />Minnesota North Star Gay Rodeo Association (NSGRA) <br />Date organized Tax exempt number <br />10-10-2006 20-5597356 <br />Address City State Zip Code <br />PO BOX 581157 Minneapolis Minnesota 55408 <br />Name of person making application Business phone Home phone <br />Colin Smith 612-867-0243 <br />Date(s) of event Type of organization <br />July 28-29, 2018 ❑ Club pX Charitable Religious ❑ Other non-profit <br />Organization officer's name <br />President Colin Smith <br />City State Zip Code <br />Minneapolis Minnesota [55409 <br />Organization officer's name <br />City <br />State <br />Zip Code <br />Secretary Bradley Fletcher <br />Minneapolis <br />Minnesota <br />55401 <br />Organization officer's name <br />City <br />State <br />Zip Code <br />Treasurer James Kelley <br />Augusta <br />Wisconsin <br />54722 <br />Organization officer's name <br />City <br />State <br />Zip Code <br />Rodeo Director Corey Blair <br />Minneapolis <br />Minnesota <br />55411 <br />Location where permit will be used. If an outdoor area, describe. <br />Dead Broke Arena 5676170th St Hugo, MN 55038. This outdoor venue is contained by a tall fence that surounds the arena viewing <br />stands as well as the area surounding the stands for vendors and a dance/eating tent. This secured area is patroled by off duty <br />If the applicant will contract for intoxicating liquor service give the name and address of the liquor license providing the service. <br />We will be selling all beverages by ourselves <br />If the applicant will carry liquor liability insurance please provide the carrier's name and amount of coverage. <br />$1,000,000.00 liquor liability insurance provided though Kaliff Insurance <br />APPROVAL <br />APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO ALCOHOL AND GAMBLING ENFORCEMENT <br />City or Cou ty approving the license Date Approved <br />© <br />Fee Amount Permit Date <br />Date Fee Paid City or County E-mail Address <br />City or County Phone Number <br />Signature City Clerk or County Official Approved Director Alcohol and Gambling Enforcement <br />CLERKS NOTICE: Submit this form to Alcohol and Gambling Enforcement Division 30 days prior to event. <br />ONE SUBMISSION PER EMAIL, APPLICATION ONLY. <br />PLEASE PROVIDE A VALID E-MAIL ADDRESS FOR THE CITY/COUNTY AS ALL TEMPORARY PERMIT APPROVALS WILL BE SENT <br />BACK VIA EMAIL. E-MAIL THE APPLICATION SIGNED BY CITY/COUNTY TO AGE.TEMPORARYAPPLICATION@STATE.MN.US <br />