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I � <br />� <br />MINNESOTA DEPARiMENT OF PU9lIC SAFETY <br />� � � � � <br />Minnesota Department of Public Safety <br />Alcohol and Gambling Enforcement Division <br />444 Cedar Street, Suite 222, St. Paul, MN 55101 <br />651-201-7500 Fax 651-297-5259 TfY 651-282-6555 <br />APPLICATION AND PERMIT FOR A 1 DAY <br />TO 4 DAY TEMPORARY ON-SALE LIQUOR LICENSE <br />Name of organization Date organized Tax exempt number <br />Saint Rose of Lima Jan 1, 1939 ES-32148 <br />Address City State Zip Code <br />2048 Hamline Ave. N Roseville Minnesota 55113 <br />Name of person making application Business phone Home phone <br />Susan Reinart 651-357-1204 <br />Date(s) of event <br />July 26, 2014 <br />Organization officer's name <br />�( �Fr. Robert Fitzpatrick, Pastor <br />Add New Officer <br />Type of organization <br />� Club � Charitable � Religious � Other non-profit <br />City State Zip <br />Roseville Minnesota 55113 <br />Location where permit will be used. If an outdoor area, describe. <br />We will have beer and wine available in a large tent setup in our parking lot for the 75th Anniversary Celebration of our Parish. We will have a <br />Mass followed by a dinner, music and rafFle. <br />If the applicant will contratt for intoxicating liquor service give the name and address of the liquor license providing the service. <br />No <br />If the applicant will carry liquor liability insurance please provide the carrier's name and amount of coverage. <br />We have insurance coverage through our insurer, Catholic Mutual Insurance <br />APPROVAL <br />APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO ALCOHOL AND GAMBLING ENFORCEMENT <br />C��'C `l of ���V 1 LL.-E <br />� City/County Date Approved <br />� <br />City Fee Amount <br />�i �3o�2d t�i <br />Date Fee Paid <br />Signature City Clerk or County Official <br />Permit Date <br />Approved DirectorAlcohol and Gambling Enforcement <br />NOTE: Submit this form to the city or county 30 days prior to event. Forward application signed by city and/or county 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 />Page 1 of 1 <br />