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M.INNI SO'PA (.,AWFUL GAVII3LING <br />LG230 Application to Conduct Off-site Gambling <br />12./1.2 Page 1 of 2 <br />No Fee <br />Organization <br />Organization <br />Address <br />county <br />Gambling <br />Information <br />name Little Canada Canadian Days, Inc. License number 04219 <br />515 Little Canada Road Oty Little Canada r�N zip code 55117 <br />_ <br />Ramsey <br />manager name Dotty Norgard Daytime phone (651) 587 -6864 <br />Gambling Activity <br />1. <br />2. <br />Four off -site events are allowed each calendar year. Dates for each event, not to exceed 3 days. <br />IMF-_. ii:, i,uI: =) <br />Check the gambling activity that will be conducted. <br />X -tabs X bingo <br />__,raffle _pull ___tipboards __._paddlewheel <br />Gambling Premises <br />3. <br />4. <br />S. <br />6. <br />..._.._. <br />Name of location where gambling activity will he conducted Spooner Park, er Road, urrle Canada <br />County [where gambling activity will be conducted Ramsey <br />Eli R ittle Coach <br />Street address and city [or township) Spooner Park, Eli Road, Little Canada p 55117 <br />Zi code <br />- -----, .. __. ...._ _.... _..__. . <br />Do not use a post office box. <br />e If no street address, write in road designations. Example: 3 miles east of Hwy 63 on County Road 42. <br />cars your organization own the gambling premises? <br />✓�._ Yes If yes, a lease is not required. <br />No U no, the lease agreement below must be completed, and signed by the lessor. <br />Lease Agreement for Off -site Activity A lease agreement is not required for raffles. <br />7. <br />S. <br />9. <br />Rent to be paid for the leased area $0.00 If none, write "0." <br />All obligations and agreements between the organization and the lessor are listed below or attached, <br />Any attachments must be dated and signed by both the lessor and lessee, <br />• This lease and any attachments is the total and only agreement between the lessor and the organization <br />conducting lawful gambling activities. <br />c Other terms, if any <br />. essor's signature Date <br />, <br />Print: lessor's name <br />CONTINUE TO PAGE 2 <br />