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�`OVS MoRfilNO <br /> op <br /> 0 .1 _; TOWN OF LEXINGTON <br /> $ wrn SELECTMEN'S OFFICE <br /> APRIL I9TH <br /> LExIN°T°� 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$25.00 made payable to the <br /> Town of Lexington. <br /> BUSINESS/FUNDRAISING ORGANIZATION: <br /> CONTACT NAME AND NUMBER: <br /> ADDRESS FOR MAILING: _ c; 3 3L/�"�Q ��f <br /> EMAIL ADDRESS: '$'ct, / <br /> TITLE/PURPOSE OF EVENT: `ylJ�� s-�,.- <br /> LOCATION AND ADDRESS: <br /> DATE OF FUNCTION: 14 V 7 , <br /> TIMES OF FUNCTION: 7: Oo7r►2 <br /> TYPE OF LIQUOR TO BE SERVED: Q,2�' <br /> DATE AND TIME WHEN LIQUOR DELIVERED: _-5,' DD,�ry�. <br /> DATE AND TIME WIN LIQUOR REMOVED: %/ : D� �ti•.� <br /> ADDITIONAL INFORMATION: <br /> Y16-orized Si nature Federal Identification No. or <br /> Social Security Number <br />