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<br /> ~ <br /> . .- _____0______ ____ __ _____ ".-- ---- ____._u_ <br /> CG220 Minnesota Lawful Gambling <br /> (Rev. 3.'30) Application for Exemption from For Office Use Only <br /> . <br /> Lawful Gambling License <br /> Fill in rhe unshaded portions of this application for exemption and send it in at leB!it 45 days before your gambling activity for processing. <br /> Name and Address of Organization <br /> Organization Name current/previous license number current/previous exempt number <br /> Fish & Wildlife Le islative Alliance <br /> Street City State Zip rode County <br /> 3800 W. 80th Street, #1500, Mpls., MN 55431 Henne in <br /> Chief executi...e officer Phone Treasurer Phone <br /> Lance Ness ( 612 377-1774 ( ) <br /> Type of Non-profit Organization <br /> Number of years in existence I 5 I Number of active members (must be age 18 and older) I :>~ I <br /> Check the box below which indicates your type of organization <br /> D Fraternal D Religious D Veterans ex Other non-profit <br /> Attach proof of nonprofit status which shows that your organization has been nonprofit for the most recent three years <br /> D IRS designation ~Incorporated with Secretary of State D Affiliate of parent nonprofit organization (charter) <br /> Gambling Site <br /> Name of site where activity will take place <br /> Howard Johnson (McGuires Inn <br /> Street City or Township State Zip co<:Ie County <br /> 1201 West Count Road E' Ramse St. Paul MN 55112 Ra msp.y <br /> , <br /> Date(s) 01 activity - <br /> .; <br /> . September 22, 1990 <br /> Types of Games 11111111'lllll1llllllllllli!ll!tllll'IIJllllillt'~'IIIj,1111111 <br /> GamA <br /> Bingo D :~~~~~~m:m~~m~mt*ili*ff,i~U~~~~H~j~mmm:~ili~~:~~~illtlm\m:~*t:~~mm~~ilitt~t~~iliWmmmm~~nm~~t~~~~M~a~ri:lf11f~~~tm~~~tlW1.*tHi\~\~mmfmg\Hl~ <br /> Raffles D<: d;~:;; > :~;: ;i;;~,:_;~}.;~ ~~ :j~ili~J.mlilit**&*~~~t~;Emf:m~~mi;tmtm :lm;~trHjWlili*t~MHm~~~~~Mlili :lillt~;tilig1tmmmItMilitj~~t~@rM~~j\: <br /> Paddlewheels D :~~~~11;~t.t~illillilitilliliilit*ili*ili*iliffitB*!]ill~:;rt~:lfWl~tilif;]iliEHiliili*~~*t~Mg~*l*~;lmt~flf~ilil;~tlmilit~~i~rt~ili~~~!;l*~jlntljtllii:t~~*~filitt~:~iliM;I*ili*ilim~~m;t*~~i <br /> Tipboards D tii~mmHt.Mf:tg&~~~*t~JMitmilittUf:Wtilit@MJ~MtMtn@%~Wi:~ilitf:mMm@@f~*~;tM~JMmHili%1j~m <br /> ~ull-tabs D :~r1j;ji~1~rrrfr~ij~rt*~~~ilji~tifr;tt~r~f:: lrtt~t~~~~~~i[~ili~1i~~1~t8~~~1~ili~~[f; ~~t*\iJ~!J\i~~~*[tat~~fEfut~~~ri\~*~~~ <br /> How will profit be used: Administrative expenses IJlltllltll;lwJlill:IIIIII/llifillfllllllfl,ljjlll!! <br /> related to operation of membership <br /> development and education. - <br /> Date *tiliillt:MR.nmt!~~~gjlmr.~~If:!i~~!W!t,t~iliK#jtf{ill@t1@t{Mk@r&!NWM@ <br /> Local Government Acknowledgement <br /> I have received a copy of this application. This application will be reviewed by the Gambling Control Division and will become effective 30 <br /> days from the date of receipt by the city or county, unless the local government passes a resolution to specifically prohibit the activity. A copy <br /> of that resolution must be received by the Gambling Control Division within 30 days of the date filled in below. Cities of the first class have 60 <br /> days in which to disallow the activity. <br /> City or County Township <br /> . City or county name Township name <br /> Signature of person receiving application Signature of person receiving application <br /> Title Date received Title Date received <br /> Wti1lf-BoMd Mall to: <br /> PInk-Org-*~ <br /> YIllloort-lIowdr.\Im~bOrgfiulonlo Department of Gaming - Gambling Control Division <br /> _._ _.~.Ilh~"'_ tv1Plil f;tPltinn ~~15 <br />