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r-t7-1016 I <br />IMP =111 <br />q t r <br />131 �Falrvlew Avenue North <br />- - --------------------------- <br />Name of person making application <br />Date set ups will be sold <br />3 events - 2/24/1 Z 3/9/12,3/23/12 <br />0� <br />ew- <br />rr' � <br />State Zip <br />Location where permit will. be used. If an outdoor area, describe. <br />All three Parish Community Fish Frys will be held In parish gathering space attached to church/school building, at same address as noted -a� <br />If the applicant will contract fbr Intoxicating liquor service give the name and address of the liquor license providing the service. <br />Beer and wine only. <br />If the applicant will carry liquor liability Insurance please provide the carrieT's name and amount of coverag <br />Catholic Mutual - $500,000 1 <br />APPROVAL <br />APPUCA11ON MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO ALCOHOL AND GAMBLING ENF0'1'C-E11E% 171 <br />Cfty/County <br />( ee Amount <br />Date Approvec <br />Permit Date <br />Signature City Clerk or County Official Approved Director Alcohol and Gambling Enforcement <br />NOTE: Submit this form to the city or county 30 days prior to event. Forward application signed bycity and/or cou nty to the address <br />above. If the application is approved the Alcohol and Gambling Enforcement Division WIll return this application to be used as the <br />permit for the event. <br />