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� ,. �' ��. <br />Alcnhnl � Gambiiag Erdoresmeni <br />Wame of <br />n xz ie c±fr-sic`F�."i �i��`iYiz � ii:�F~€ c`3� �Ei?i'3�i: �::rtµ� <br />. ...-."__'_'_ _� ___________ __ _ ______ __.'_{ <br />RIcoF�o! and Garnbfing �nforcement Division <br />494 Cedar Street, Suite 222, St Paul, MN 55:i01 <br />65 Z-20'f -7500 Fax 6�1-2'97-5259 lTY b51-282-6555 <br />�4��i�i�#3� �� ��`� �� � � �A.� <br />TO 4 DAY TEMPORAi�Y ON-SALE LIQUOR LICENSE <br />.-r � <br />Date o��i�ed: Tax exempt nnmber <br />i� i 3 �!V Z�9t.FEt� �3-L�✓i158I2 <br />Address �ily State Z-ip Code <br />2T31 Fairview Avenue NoRt� Rosevilie M'innesota 55113 �°� <br />�1arr�e af <br />�s'snr�s�+r.r,� i;�rrre���r-,� <br />� . � �. <br />pateis} of event C. Type of organization •.,, <br />., <br />?J22/'{ 3, 3/8I7 3, 3/22li 3 � Club � Charitable � Reiigious ❑ Other non-profit <br />flrganization othcer'� name <br />Rabert �itzpatrick <br />:.,:�w: <br />City 5tate Zi� <br />� Minnesata � 55i 13 <br />a; <br />L�catior v��re �ermii will �e use�. (f an �u� ;a�r a��a, ;rs�: �. <br />I�i three Parish Community �ish Fry's vvi! be held in �arish gath�ring spac� attached to church/sd�ol buildingm at same address al�ove. <br />If ihe applicant will contratC for intoxitating iiquor service give the name and address af the liquor license pro�iding the service. <br />B�eer and wine an(y. <br />tf the applicani wi�l carry iiquar [iaf�ility insurance pfease �rouide t�ie carrier's name a�# a�aunt of cquerat�e. <br />Cathalic Mutual - SSQOr00Q. <br />APPf�OVAL � <br />a�.icnr�on� w�usi's� npP�ovEa �v [RV ottcouMV s�o� susnnttnn� ro p�corrot ►v�ro c,►unBtn� �rr�ott[enii€xr <br />����:1� <br />-- - ----- �t}F1Ceunry _� Qate Rpprov�d <br />5'Cj_�� <br />City ee mount <br />1�t1 �I 5 <br />Rdxe �ee Pait3 <br />� <br />/ <br />✓ � <br />Stgnatu�e ty Clerk or a�r�� 4ffslaf <br />erm ate . <br />A,h�•��e�i Dir�ctor Alcoh,�+E ane� Gam�lin� Enforcement <br />NOTE: 5ubrr�it �is f�m ta the c�ty or courriy'3�i days pr"wr to e�nt �w�rd �tat�on sic,�t3ed �y ciry andl� county to t�e �cfdress <br />above. If tFte applica�tinn is approved tl�e Afcohol artd Garribiing E►ofarcerne�tt pirrr�ion will retvm this applir�tian to be used as ihe <br />perm'tt far the event . <br />,- <br />�!� <br />/ <br />P3qe T t2T 1 <br />