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Gambling License Application <br />Type of Application: ❑Class A fSt asa B ❑Class C ❑Class ID <br />YesCNo 22. Is gambling premises tocated within city limits' <br />y,'Yes CNo 23.. Area!! gambling activities conducted at the premises listed in /1 B of this application? If not, complete a separe•' <br />'apDlicationior each premises lexcept ref(lesl eseseperate license is required for each premises. - <br />a.CYess►10 24.. Does org nusnon own the gambling premises7lf no -attach COPY of the base with terms o. et least one year, and 1 <br />7 <br />c L `rtr� attacha sketch o+ the premises indicating wh�e/trpoNCO Is being leased. A leeset ndkYes+tch K'tire"i3siiJ'+�� t 1 <br />^� �peu D eppkeauore <br />S!3 25.�Amounfpof;Rent. Per 28 Do you plan onbonduetin9 bingo wit thisticensa711 Yes Tays �e dandDvmesof bmgooccTs ions. <br />z <br />lip, Day.x'"'>'y;•yr°}rZ <br />t 4 .L - <br />F Pn <br />._ .. _____.. e..nane rta920been obteinadT <br />'o:'.y3G-GambbngManogerBusinessPhone'I� 37lDetegemblingmanagerbeeame.—' �. 'n �k� qz •..+:, <br />La ^r ;S-memtar of orgenaauon ,t ; - W'enth"//'.Yea"7/ ti <br />LJYesCNo 38 Hesffiehcensoterminauonformbeentiomplcted7AttachwDY• -- . , ,-. r -. <br />• OYes ONo'g. Has mecompansetion schedule boonapproved by the orgamzationi Anaoh CODY• ;-, <br />i:.40.?Ihtthedey end time oithe iepularmeeting of the irgenrzetron:D �sLµs-��3 genkAecount Number ' <br />_44neLe55aryt0yNlaaMuisysK xr.::ii 3.=....:. •- ,�.rr ,s '7� K�'r:: r n';i .,:', <br />"r. OATH <br />Ihereby <br />declaiethat' ; +�` _..: ,.j_j� ubml -+ <br />A: I have read this application and all information submitted to the Board <br />2.` All information submitted is true, accurate and complete; - -: <br />3.- All other required information has been fully disclosed; <br />4: Ianrthechief executive officer of worganization -,_} <br />r- 5.': I assume full responsibility for fair and Fawvgfruelta of Minnesota respectin g ion of all activities o bamblinu end rules'of the Bcerd and agreeif <br />NOTICE <br />Byackn <br />ding Cont <br />a resolut <br />