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License No. <br />APPLICATION FOR RAFFLE LICENSE - $10.00 fee Date Received <br />Date Expires <br />Final Drawing Date <br />CITY OF ORONO <br />1335 BROWN ROAD SOUTH <br />BOX 66 <br />CRYSTAL BAY, MN 55323 <br />Organization: Cr..^-, 90cwrr i rsleaa <br />Address: BLS zcs- . Lcn'e [.Ic7 <br />Representative: ric,u Pl .4.4,C./ - <br />Affiliation with Organization C.+/Li [-.' nip <br />Address: LX., -:. O,dc N( :CAD <br />Date(s) of the Drawing TM N j, cSI.— <br />Phone '/76 /Ec/ <br />Phone '/7c- /E: / <br />lr"_ I <br />Location of Drawing Cdpn.• H1.4H SC'K e' cn:r T[-it/µ. <br />Purpose of Raffle 77cND AGfdA <br />/ n(,e e-Y /iert7eni <br />List Prizes to be Raffled and their value (fair market retail value) <br />Specify which of the prizes noted above were donated <br />/�/•'I <br />Security (minimum amount $10,000.00) in the form of Bond _ <br />Insnrance !.'e.,.• /4J • - Jn.s A'A'k'7L <br />Copy of security to be submitted with con.pleted application. <br />THE ORONO POLICE CHIEF SHALL HAVE ONE HUNDRED EIGHTY DAYS (180) IN WHICH TO <br />INVESTIGATE AND MAKE A RECOMMENDATION PURSUANT TO ORONO MUNICIPAL CODE SECTION <br />5.23, SUBDIVISION 3(D). <br />------------------------------------------------_____--------------------- <br />The undersigned hereby agrees to the conditions quoted in Section 5.23 <br />Subdivision S of the Orono Municipal Code attached to this application and any <br />additional requirements the City staff may have. <br />Signature of Applicant: . ""�— 1---�_ I_ -___----Date_- <br />------------------------'_:____ <br />FOR CITY USE ONLY: After review of application, staff recommends the following: <br />_Ll-� Approval of application Denial of application <br />Signature of City Official: <br />Date: <br />Signature of Police Chief: _____________Date_--/ '� <br />