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5.f) Temporary On-Sale Liquor License for Scandia Marine Lions (Spring Chicken Dinner) Meeting Date: 3/20/2012 � Agenda Item: L � J � City Council 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 Scandia Marine Lions Club, for a one-day event to be held at the Scandia Fire Hall. Deadline/Timeline: N/A Background: • The Lions Club is planning their second annual Spring Chicken Dinner fund-raising event on Saturday, Apri121, 2012 (4:00 p.m. to 8:00 p.m.) Proceeds will benefit the Lions Scholarship Fund and Fire Department equipment needs. • Under Section 22 (H) of Ordinance No. 93, the Lions Club 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. • The required certificates of insurance and $SO.00 license fee have been received. Recommendation: I recommend that the Council approve the license. Attachments/ • Application Materials provided: Contact(s): Dave Wilson, 651 433-1413 Prepared by: Anne Hurlburt, Administrator (Lions temp liquor april 21 2012) Page 1 of 1 03/14/12 ���� ��� �� Y Minnesota Deparhnent of Public Safety � .. .� }�•� �'. � . �� ALCOHOL AND GAMBLING ENFORCEMENT DIVISION '°`�� - �,���• 444 Cedar Street Suite 133,St.Paul MN 55101-5133 ' �• ' �" (651)201-7507 Fax(651)297-5259 TTY(651)282-6555 ��;:'i�.��,_�'' 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 �,��,�-�;¢r„�� L%o��- ���� �-i�-��l�a =��-��Go:�i� STREET ADDRESS po gnx /5�/ CITY STATE ZIP CODE /�7�2 7 ao�%•`.. g� �/ ���-�o„� �� �s"o 73 NAME OF PERSON MAKING APPLICATION BUSINESS PHONE HOME PHONE �AyLr l�ILJU/1/ `i7j�� �t)7 '�d7 O v W7// T J.S"'���� DATES LIQUOR WILL BE SOLD ��j�.�(��G/,,,Z TYPE OF ORGANIZATION ORGANIZATION OFFICER'S NAME A DRESS ,-v�io - �z�5^:z-''S%• 4- /� GG�/�E-�%' G.�uc-�.� � ,�'i�'v-'�-Da'✓7/ .;�-sY,y,'�,q. /�'/�. 5:5a 73' ORGANIZATION OFFICER'S NAME Annu F.ss __ v �i�Jj'✓'�!��j'——---- ;J�ri/ G�/�j� •T.Q � ����'`�.�"� ��7, 5 J [�'fft����;c? t-l:*';`�, /✓,/U .S��i„� ORGANIZATION OFFICER'S NAME ADDRESS ,��.n.' ��-"-�G ��c=�T/�'�� �r.3 So �'a.�r.�v� ,y�� �/. Sc�/-�v���, �ti �So�3 Location license will be used. If an outdoor area,desc 'be s'��'it/%/.� T/�U� �Si`�T��.� 15`��� SCAar/�iA �i/�'�..¢iG ,ol�. S�.'.¢N�iA . .�ti • j U 7.3 Will the applicant contract for intoxicating liquor service? If so,give the name and address of the liquor licensee providing the service. .�1/cJ Will the applicant carry liquor liability insurance? If so,please provide the carrier's name and amount of coverage. ,jcc'et�iT� 5.71-i�" �Gx�i�%� �/UcU t)D� �%�t�/ �3�.�� -�.�� APROVAL APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO ALCOHOL&GAMBLING ENFORCEMENT CITY/COUNTY .S c a h�i � �W rns h;n c��r� DATE APPROVED CITY FEE AMOUNT � - �� LICENSE DATES DATE FEE PAID � ` �� � �� I a 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 even� Forward application signed by city and/or county to the address above. If the application is approved t6e Alcohol and Gambting Eni'orcement Division will return this applicatfon to be used as the License for the event PS-09079(OS/06)