5.e) Temporary On-Sale Liquor License for Washington County Historical Society (Beer Tasting) Meeting Date: 3/20/2012
Agenda Item: �
�� �--
City Councii Agenda Report
City of Scandia
14727 209�' St. North
Scandia, MN 55073 (651) 433-2274
Action Requested: Approve a Temporary On-Sale Liquor License for the Washington
County Historical Society, for a one-day event to be held at the Hay
Lake School Museum complex.
Deadline/Timeline: N/A
Background: • The Historical Society is planning a Beer Tasting fund-raising
event on Saturday, June 23, 2012. They have hosted similar
events every year since 2008.
• Under Section 22 (H) of Ordinance No. 93,the Historical Society
is eligible for a temporary license in connection with a social event
sponsored by a club, charitable, religious or other nonprofit
corporation that has existed for at least three years.
Recommendation: I recommend that the Council approve the license contingent upon
submission of the required certificate of insurance.
Attachments/ • Application
Materials provided:
ContaCt(s): Brent Peterson, 651 433-4014
Prepared by: Anne Hurlburt, Administrator
(Wash Co Historical Sociery Temp Liquor Beer Tasting 2012)
Page 1 of 1
03/13/12
�a �•:
""��,,`�,w ,��.<..��;��
� <� Minnesota Deparhnent of Public Safety �
ALCOHOL AND GAMBLING ENFORCEMENT DIVISION �� . �
�.•,f, �s�� 444 Cedar Street Suite 133,St.Paul MN 55101-5133 �•
��0�''�"-"`� (651)201-7507 Fax(651)297-5259 T'TY(651)282-6555 ��:"�*��.. . ^<
WWW.DPS.STATE.MN.US
APPLICATION AND PERMIT
FOR A 1 TO 4 DAY TEMPORARY ON-SALE LIQUOR LICENSE
TYPE OR PRINT INFORMATION
NAME OF ORGANIZATION DATE ORGANIZED TAX EXEMPT NUMBER
I�✓�s��y � h �� !�s'�. � l q3� ES -24 0 8S
STREET ADDRESS CITY STATE ZIP CODE
�,d Z rl. �i t� S�; P�f !,67 �a'�'�!��'"' ry/yV SSD$�Z
NAME OF PERSON MAKING APPLICATION BUSINESS PHONE HOME PHONE
�--�'���''�if-�� �ld�i) y-39- 5�9'�� cbsy) �3 3 -4-O��
DATES LIQUOR WILL BE SOLD }�uy` z3 ZO�Z TYPE OF ORGANIZATION
v
ORGANIZATION OFFICER'S NAME ADDRESS �Q 130�G I b 7
��Y�C� L�S - $pa� �+�'' ��i��w�� � S�8"Z.
ORGANIZATION OFFIC R'S NAME � ADDRESS ��Z �• rya,��, $,J--•
�-'1�. .�t��'- ��� ✓�i►-u� �};t I��tr � s�o fsz
ORGANIZATION OFFICER'S NAME ADDRESS
Location license will be used. If an outdoor area,describe
olt.� l��,z. .Sc,�..mU� n��{,��, 1�m�1t� - c�ks.�- �i S }` D�� Cor�+(,�-- 0�d�►►�c�,
Tra.i 1 ►�o►� A►-✓d O)� h�v��-i�-,�. T,�.t �
Will the applicant contract for intoxicating liquor service? If so,give the name and address of the liquor licensee providing the service.
Will the applicant carry liquor liability insurance? If so,please provide the carrier's name and amount of coverage.
.�.GL K� S�dl-'�'G GZAlJ"t-�
APROVAL
APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO ALCOHOL&GAMBLING
ENFORCEMENT
CITY/COLTNTY SC.Gt Y1 G�r'ct /�/�(S�1 i n�--t�y� DATE APPROVED
CITY FEE AMOLTNT $,�D• �� LICENSE DATES
DATE FEE PAID �' v� ` �� I �d�-
SIGNATURE CITY CLERK OR COUNTY OFFICIAL APPROVED DIRECTOR ALCOHOL AND GAMBLING ENFORCEMENT
NOTE:Submit this form to the city or county 30 days prior to event. Forward appiicallon signed by city and/or county to the address
above. If the application is approved the Alcohol and Gambling Enforcement Division will return this application to be used as the License for tLe event
PS-09079(OS/06)