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2014_0106_CCpacket
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r � � <br />� <br />Alcnhol & Gambling EMoresmer� <br />Minnesota Department af Public Safety <br />Alcahol and Gambling Enfarcement Division <br />444 Cedar Street, Suite 222, St. Paul, MN 55101 <br />5S 1-201-7500 Fax 651-297-5259 TTY b51-Z82-6555 <br />APPLICAT�OIV AND PERMIT FOR A 7 DAY <br />TEMPORARY COfVSUMPTIOfV AND DiSPLAY PERM�T <br />(City ar county may not issue mare than 10 permits in any one year} <br />Name of organization Date organized �ax exempt number <br />Friends of the Ramsey County Libraries Jan 1, 1979 41-1597085 <br />Address City State Zip Code <br />4570 N. Victoria Street Shore�iew Minnesota 55126 <br />Name af person making application Business phone Home phone <br />Susan Gehrz 651 486 Z213 651 641 9229 <br />Date(s) of event Type of organization <br />�ebruary 1, 2014 ❑ Club � Charitable ❑ Religious � Other non-profit <br />Organizatian officer's name City <br />State <br />Minnesota <br />Minnesota <br />Minnesota <br />Minnesota <br />55113 <br />55113 <br />55113 <br />55127 <br />Zip <br />Location where permit wilR be used. If an outdoor area, describe. <br />Ramsey County Library in Roseville, Minnesota. Acidress is 2180 North Hamli�e Avenue. 7his wifl be the "Great Gatsby Gala" indoor <br />fundraiser for the Rarnsey County Library. <br />APPROVA� <br />APPLICATION MUST BE APPROVED BY CITY OR CdUNTY BEFORE SUBMITTING TQ ALCpHpL ANp GAMBLWG ENFORCEMENT <br />r <br />City/County Date Approved <br />� �D 2- - [ -- Zb i � <br />City Fee Amount Permit Date <br />� �.-�2 (�- ZO I 3 <br />Date Fee Paid <br />Signature City Clerk or County Official Approved Direttor Alcohol and Gambling Enfortement <br />NOTE: 5ubmit th€s form to the city ar cau�►ty 30 days priar to e�ent. Forward application signed by city and/or countyto the address <br />abave, if the applitation is a�proved the Altohol and Gambling Enforcement Di�isian will return this application to be used as the <br />permit for the event. <br />Sheet 1 of 1 <br />
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