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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)