5.a) Washington County Historical Society, Temporary On-Sale Liquor License Meeting Date: 3/3/2009
Agenda Item: /F Q
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City Council Agenda Report
City of Scandia
14727 209`h St. North
Scandia, MN 55073 (65l) 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 fund-raising event on
Saturday, June 27, 2009. They hosted a similar event in June,
2008.
• Under Section 22 (H) of Ordinance No. 93, the Historical Society
is eligible £or 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 certificate of insurance has been received.
Recommendation: I recommend that the Council consider approving the license.
� Attachments/ • Application
Materials provided:
Contact(s): Brent Peterson, 651 433-4014
Prepared by: Anne Hurlburt, Administrator
(wash co historical society temp liquor 2009)
Page 1 of 1
02/25/09
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APPLICATION AND PERMIT
FOR A 1 TO 4 DAY TEMPORARY ON-SALE LIQUOR LICENSE
TYPE OR PR1NT INFORMA'1-lON
NAME OF ORGANIZATION DATE ORGAMZED TA EXEMPT NUMBER
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STREET A DRESS C1TY STATE ZIP CODE
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N E OF ERSO AK]NG APPLICATION BUSINESS PHONE HOME PHONE
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DATES LIQUOR WILL BE SOLD ���p�� ��_,0� TYPE OF ORGANIZATION
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ORGANIZATION OFFICER'S NAME ADDRESS
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O GANIZATI N OFFICER'S NAME ADDRESS
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O ANl ATI N OFFICER'S NAME ADDRESS
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Location license will be used. ]f an outdoor area,describe
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Will the ap licant contract for intoxicating liquor service? If so,give the name and address of the liquor licensee providing[he service.
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W�11 e applicant c liquor liability insurance? If lea e pro ide the camer's name and a ount of coverage.
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APROVAL
APPLICATION MUST BE APPROVED BY CTTY OR COUNTY BEFORE SUBMITTING TO ALCOHOL&GAMBLING
ENFORCEMENT
CITY� OUNTY •�"�.' >� :���` '��`�'; ' :'i��� � DATE APPROVED
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CITY FEE AMOUNT ���7O LICENSE DATES
DATE FEE PAID ,� � �� �%�� L �
SICNATURE CITY CLERK OR COUNTY OFFICIAL APPROVED DIRECTOR ALCOHOL AND GAMBLING ENFORCEA9ENT
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
abo��e. If the application is appro�•ed the Aicohol and Gambling Enforcement Divfsion will return thfs application to be used as the License tor the event
PS-09079(OS/06)