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��NS OF PUg�/ <br />Q� c�T <br />� �� <br />< <br />O� <br />���F OF MINN�S �l <br />Attachment A <br />��� <br />Minnesota Department of Public Safety �� ?.� �M1 }"� <br />ALCOHOL AND GAMBLING ENFORCEMENT DIVISION �� �� <br />444 Cedar Street Suite 133, St. Paul MN 55101-5133 �'� .�. ';� �� <br />(651) 201-7507 FaY (651) 297-5259 TTY (651) 282-6555 °.��. - <br />WWW.DPS.STATE.MN.US <br />APPLICATION AND PERMIT <br />FOR A 1 TO 4 DAY TEMPORARY ON-SALE LIQUOR LICENSE <br />TYPE OR PRINT INFORMATION <br />NAME OF ORGANIZATION <br />Church of Corpus Christi <br />STREET ADDRESS <br />2131 Fairview Avenue North <br />NAME OF PERSON MAKING APPLICATION <br />Mark Motzel <br />TAX EXEMPT NUMBER <br />MN ES 25499 <br />�o� Tr� a� _n�n�s <br />DATES LIQUOR WILL BE SOLD I TYPE OF ORGANIZATION <br />March 6, 2009 „rrrn „rr�„r�,�nrr r <br />ORGANIZATION OFFICER' S NAME <br />Fr. Frank Fried <br />ORGANIZATION OFFICER' S NAME <br />Location license will be used. If an outdoor area, describe <br />ADDRESS <br />same as above <br />ADDRESS <br />ZIP CODE <br />� 55113 <br />HOME PHONE <br />� ) <br />Parish Community Fish Fry - will be held in the parish gathering space <br />attached to church/school building, at same address noted above. <br />Will the applicant contract for intoxicating liquor service? If so, give the name and address of the liquor licensee providing the service. <br />Beer and wine only. <br />Will the applicant carry liquor liability insurance? If so, please provide the carrier's name and amount of coverage. <br />YPS_ Ca�h�lir_ Mu�lial - SPP a��ar_hPd_ <br />APPROVAL <br />APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMTTTING TO ALCOHOL & GAMBLING <br />ENFORCEMENT <br />CITY/COiTNTY <br />CITY FEE AMOUNT <br />DATE FEE PAID <br />SIGNATURE CITY CLERK OR COUNTY OFFICIAL <br />DATE APPROVED <br />LICENSE DATES <br />APPROVED DIRECTOR ALCOHOL 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 License for the event <br />PS-09079 (05/06) <br />