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liil>tl>2D0S 02:llt« Frot-CITY OF HSM4I4I1I T-4li FM2/S0I FHSI <br />Dat»KMthr«d <br />siaooFM_42^ <br />City of Orono <br />Application for Gambling Activity <br />a FnniMS Rtsewal <br />Eflircttvc Dales:__ <br />OnC'Day Lawfol CambliBg Exempt <br />' Effective Date: <br />a niBsa <br />a FaMImrbeeli <br />a Pidl-TalM <br />^ Raffle <br />a Tipboards <br />Phone <br />AppUcaat <br />M T( - g7.QA <br />AfiUiatimi witti Orgamzat <br />Addicts <br />Phone _______ • <br />r ^ ^ <br />^ I a AT <br />EstabUshment ^ere Gambliag will be Coaducted <br />Address............ ....... <br />i* <br />PropenyOwner . \ <br />Gambling Manage! ------ <br /># A u T <br />(ffnO (--sat)(tato <br />Phone <br />Kame/Description of Event WJ ? t>r^ — ^----H -a.^R r <br />Day(s) c ‘ Operation <br />Hours of O^ration <br />n 7.O0.3 <br />JLO-^ <br />^****^ Copy of permit application from the Minnesota State Oambling Control Board <br />o Sketch plan of area being leased for gambling activity <br />S 23 of lla Orono Munieipd Code and any sMikNial raquhcnumi Ac City adTimar have. <br />Signature of qtpUcaat: <|:lrc.rv~«£.Date <br />/ <br />2750 Kelhy failmay. P.O. BoKdd,CiyMlBiy. MK 55323 <br />Pbona: 052-249-4000 / Fan; 9S2*249-4dld/aftMt eL<irO0oain.iis