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L0214 <br />MinnesotaLawfnt Gambling <br />Premise Permit Application Part 1 <br />raa?zso rafoaii� `r ` ;.� <br />.... Aa"4u..x�oa..S:`'l"�.. <br />Laps Name at Organtzanon <br />Cr.410w:,..10 /o..tL'A cgs ;; Inc.. <br />Business Address at Organizacon - Street or P. O Box (Do not use address of gambling manager) <br />P.O. t?ex 131),s3 <br />FOR BOARD USE ONLY <br />FEE <br />CHECY <br />INITIALS <br />DATE <br />X t ��\ <br />Coda <br />OSGIf% I•rw\hSt� P <br />5SIJI33 <br />Name of chief executive officer (cannot be gambling manager) <br />Address of ctief executive ot&ar - Streeter P.C. Box <br />Fla," 'i Dcif t.i'ooJ <br />Title <br />County Business phone number <br />i2i�r.sc� (61).) 636.2e6o <br />Business phone number <br />(61).) C32-O 1 SC <br />last's cf Preadie Permit <br />'" ® Class A — Bingo, Raffles, Paddlewheels. l ipboards, Puikabs <br />❑ Cass B — Raffles, Paddlewhaais, Tipboards, Pull -tabs <br />❑ Class C— Bingo only <br />❑ Class D— Raffles only <br />Bingo Occasions <br />If class A or C. fill in days and beginning and ending hours of bingo occasions: <br />No more than seven. bingo occasions may be conducted by an organization per week. <br />Day Be in ning/Ending Houn <br />Roria-c, me Scr+6O u t:E /or.6 <br />Wg's° <br />Sec <br />7 to 9t. <br />ke to vm <br />to 4 Pin <br />et w tt Pm <br />—i to q PM <br />°< tt MYn. <br />Ia cl, c•-.'t A . <br />Day Beginning/Ending Hours Day Begusalag /Ending Hours <br />4aY P&c.. )E t. <br />Ttti1 <br />Ft; <br />--1 Ise <br />°t to <br />IIPAN. <br />..• n ore-1/40 1 Pit, <br />q MM <br />11 PM <br />Ow N. <br />et t.o <br />Won, -lc <br />—7 {o <br />Sal 4 to I <br />-7 o 9 Tor <br />Suv, �i to R t rw'. <br />'❑ <br />New premise —Fin in base organization premise permit number <br />Renewal of exiling premise permit — Fill in comclele premise permit number A 'OI' $ S 0o 3 <br />Previously expired premiss permit — Flit in =mole premise permit number <br />The class of premise permit <br />must be reflected by class of <br />the organization license <br />Bingo Occasions <br />If class A or C. fill in days and beginning and ending hours of bingo occasions: <br />No more than seven. bingo occasions may be conducted by an organization per week. <br />Day Be in ning/Ending Houn <br />Roria-c, me Scr+6O u t:E /or.6 <br />Wg's° <br />Sec <br />7 to 9t. <br />ke to vm <br />to 4 Pin <br />et w tt Pm <br />—i to q PM <br />°< tt MYn. <br />Ia cl, c•-.'t A . <br />Day Beginning/Ending Hours Day Begusalag /Ending Hours <br />4aY P&c.. )E t. <br />Ttti1 <br />Ft; <br />--1 Ise <br />°t to <br />IIPAN. <br />..• n ore-1/40 1 Pit, <br />q MM <br />11 PM <br />Ow N. <br />et t.o <br />Won, -lc <br />—7 {o <br />Sal 4 to I <br />-7 o 9 Tor <br />Suv, �i to R t rw'. <br />'❑ <br />New premise —Fin in base organization premise permit number <br />Renewal of exiling premise permit — Fill in comclele premise permit number A 'OI' $ S 0o 3 <br />Previously expired premiss permit — Flit in =mole premise permit number <br />