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Paid $75.00 <br /> I <br /> Chk# 326 <br /> F E B 2 2 2011 <br /> i <br /> o p`��S to Araoy�09 S E Gr C !A C <br /> TOWN OF LEXINGTO <br /> aw Z SELECTMEN'S OFFICE <br /> 3 <br /> AML 14TM <br /> APPLICATION FOR <br /> ONE-DAY LIQUOR LICENSE <br /> The Board of Selectmen issues one-day liquor licenses to for-profit and non-profit organizations <br /> that serve liquor and charge either a cover charge or for each drink. Please fill in this form <br /> completely and return to the Selectmen's Office along with a check for$25.00 made payable to the <br /> Town of Lexington. <br /> BUSINESS/FUNDRAISING ORGANIZATION: <br /> CONTACT NAME AND NUMBER: ,-� Sf s <br /> ADDRESS FOR MAILING: t� �- `' c C LA-) o 6Q r� r A o f,$b <br /> EMAIL ADDRESS: C <br /> TITLE/PURPOSE OF EVENT: <br /> LOCATION AND ADDRESS: L� -��`� ��.,c`r�� G ►�ct'S �f�e'� <br /> DATE OF FUNCTION: � / o , L 0,2 <br /> TIMES OF FUNCTION: <br /> TYPE OF LIQUOR TO BE SERVED: <br /> DATE AND TIME WHEN LIQUOR DELIVERED: Al <br /> DATE AND TIME WHEN LIQUOR REMOVED: S f 2 r , <br /> ADDITIONAL INFORMATION: <br /> ....._.... <br /> Authorized Sign ure Federal Identification No. or <br /> Social Security Number <br />