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Minnesota Departments of Public Safety <br /> -= <br /> Alcohol and Gambling Enforcement <br /> r � <br /> 444 -Su' te Cedar St <br /> St, Paul HN 551011 <br /> 9 (6 1 <br /> (612)296-64-) TDD � +w } <br /> w� <br /> APPLICATION T <br /> i <br /> ON-SALE FOR A I TO 4 DAY TEMPORARY <br /> TYPE OR ITT INFORMATION ���� TAX ti _{,M T N <br /> LT�ER <br /> NAME OF OR�A�ATION DA-IT ORGAN ES 32148 <br /> Church of St. Rose of Lima 1939 <br /> STIRT <br /> A.DD SS CITY STATE ZIP CODF <br /> 2048 -N. Ham line Avenue Roseville 5511 <br /> NAMtr OF PERSON MAKINcir APPLICATION BIT.SfNi Es ;PHONE HOME PHONE <br /> S <br /> usan Galush Rainart, Bus. Adm. 61 645-9389 <br /> DATES T,1 Q1 TOR WILL BE SOLD(I to 4 days) TYPE CAF ORGANUWFIO <br /> September 20, 1998 : CU <br /> ;B CTLARITABII RFLIGIO �_ . <br /> S _s OTHER NONPROF11' <br /> ADDRIFSS <br /> ORGANIZATION OFFICER'S NAW Rev. Walter L. � <br /> o�hacRi 205 N. Ramline Avenue, Roseville, MN 55113 <br /> ORGANIZATION OFFICER'S NAM ADDR S S <br /> ORGANIZATION COIFFIC~ER'S NAME ADDRESS <br /> Location where ficeme w'l be used. If an outdoor area,dcscribc i school cafeteria <br /> Beer will he sold to tent on the parish grounds and Possibly n the se <br /> WEENERP <br /> illthe applicant contract for intoxicating liquor smites? I#'so,gig-e the umne and address of the Liquor Iieense Pro%kiding the scnw-e' <br /> No <br /> will the applicant warty liquor liability inn-wance If so,the carrier:'s name and amount of coverage. <br /> ]NOTE. Insilranee is not mandatory) Tes we are insured through Catholic Mutual Insurance <br /> APPROVAL <br /> C oR CotgV BEFORE SLBVMING TO LIQUOR CONTROL <br /> APPLICATION Ii T APPROVED <br /> - DATE APPROVED <br /> CITY/COUNTY 5D <br /> C IT Y FEE ACTT <br /> LICENSE DATES_ <br /> DATE FEE PAID <br /> �--- <br /> SIGNATIRE CITY Y CrLERK OR C <br /> OIJNT Y OFFICIAL APPROVE D LI I jOR C ONT'RO L DIRECT OR <br /> lNO'TE. Do not separate these two parts,,send both parts to the address above and the original signcd by this division � <br /> ►gill he returned as the Heense. Submit to the City or County at least 3o days before the event. <br /> PS-09079(8/95 <br />