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CITY OF RAMSEY - 2004 <br />APPLICATION FOR TEMPORARY SPECIAL EVENTS PERMIT <br /> <br />Return this completed application along with *.$1,500 <br /> City of Ramsey <br /> 15153 Nowthen Boulevard NW <br /> Ramsey, MN 55303 <br /> *($1,000 to be placed in Escrow Account for billable Staff Time) <br /> *(5500 to be placed in Escrow to Guarantee Cleon-Up) <br /> <br />Make check or money order payable to the "City of Ramsey". <br /> <br />2) Manager or Proprietor's FULL Name: ~d~ ~ ~ ~f ~ ~ ~ ~ <br /> Last First Middle Name <br /> <br />3) <br /> <br />4) <br /> <br />5) <br /> <br />6) <br /> <br />Manager's or Proprietor's Date of Birth: <br /> <br />Business Address: <br /> <br />Street, Box, Route City-- State ZIP <br /> <br />Business Phone Number(s): <br /> <br />f ~ <br /> <br />Exact legal description of the premises to be licensed: <br /> <br />7) Owner of the premises: <br /> Last Name First Name Middle Name <br /> <br />8) Address o~ Owner of premises: <br /> Street, Box, Route City State ZIP <br /> <br />9) Owner's Phone Number(s): I ) I ) <br /> <br />10) Applicant's FULL Name: 6/~':"~'~ d?¢z ¢ V <br /> Last NQme First Ne~e Middle Name <br /> <br />11) Applicant's Phone Number(s): <br /> <br />12) Applicant's Date of Birth: <br /> <br />13) Applicant's Place of Birth: __ <br /> <br />14) Applicant's Address: t,,¢ &'~ 0~/~i-' [ ~t,z~ J4~ y <br /> Street, BOx, Route <br /> <br />15) Applicant's Phone Numbers: ( ) <br />16) Applicant's Position With Company: ~¢~ g ~/,'d~¢~ ~ <br /> <br />17) Are you the sole owner of the business? Yes: <br /> <br />18) If partnership, state names and addresses of ail partners. <br /> <br />City State ZIP <br /> <br />No: <br /> <br />( ) <br /> <br /> <br />