Laserfiche WebLink
<br />,~ <br /> <br />/~ <br />.~~HILLS <br /> <br />City of Arden Hills <br />1245 West Highway 96 <br />Arden Hills, Minnesota 55112 <br />Phone 651.634.5120 <br />Fak 651.634.5137 <br />www.ci.arden-hills.mn us <br /> <br /> <br />_.~-_.~ <br />I <br />! <br /> <br />License No. <br />Receipt No. <br />Amounl Paid <br />Date Recvd <br />Ins. Cerl <br />Tolal Fee Paid <br /> <br />GAM04. <br /> <br />--< <br /> <br />2004 Premises Permit Application <br /> <br />'.;;;'.'~'Q" ..-. <br />..'. .,.. 'I, ~. <br />. '1 v <br />?~ <br />'.:{'.;-; <br />r,.-:-I' <br />>-i--' , !, I <br /> <br />Information {ul/fields lire r"'fuud} <br /> <br />BUSIIlcss Nallle: <br /> <br />PrnpcrI)' Address: <br /> <br />Nature of Business <br /> <br />Lac:..!] rnrl1;lC!" <br /> <br />Business Phone <br /> <br />ElllJiI Address <br /> <br />. <br /> <br />relicr;}] IJ)ii <br /> <br />In\'(:stigation Fee <br /> <br />'9r: <br /> <br />f; <<.ib~L':"g <br /> <br />1./,f:,r""\i1 (~!1 <br /> <br />ch,+LJ~i <br /> <br />cL,i<t:d <br /> <br />]77C Co/) 11<. (If <br />A-Y'~.'\ HI/(( <br />, <br /> <br />11 AJ <br /> <br />rrilL <br /> <br />J l"'lv <br />Vc '- T-'-' ~ <br /> <br />/ r~{(r'ff:,>' <br />Hv\~,--L.." <br />(72 'I <br /> <br />Business Fax: <br /> <br />{, 'I <br /> <br />C J ( - <br /> <br />WebSlle Address: <br /> <br />'-{(- ('ll S' .?yy <br /> <br />150,00 <br /> <br />2003 [nco01e and Loss Statcmel1l K. <br />ProJeclcd 2004 Receipts/Prizes p(.. <br /> <br />(AI] urgJIlII.<llions pl.:nlllltcd [IJ conduCllawful gambllllg \.Vlthllllhc CII)' ul' /Hdcll j-fills sl),1I1 ct)rl[l'lbu[c ] I)':ii, (lcn pCI'cenl) of theIr <br />nel profits derived from gamblIng iJclivlllCS WithIn the CilY 10 (J spcel:.d fund III bl.:: cldllllJ1ISICred by Ihe City Council for lawful <br />purposes. P;lymellts to the fund shall be calculaJed for quanerly periods ending on lhl' I~\sl lbys or M~\rch, June, Scplcmber and <br />December Qu~-!rterly Illstallmenl piJYIlKnlS shall be submitted together WIth Yel'lrl;Jbk SLJpPoi"llng. dUclIlllClllatlon not later than <br />the twentieth lby urlhe month following the end ofllle qU<lrtcrly period,) <br /> <br />'."" CI7~~~/~ <br />d/~~A~ <br />~~ <br />"~.l""''''' ..1';1";1::. <br />, .,..., '~:::~,::'.~"~::':,"',,I. ',~':"" <br />'"'''''''',-<-1''' <br /> <br />Apthori7.ed SIgnature <br /> <br />" <br /> <br />SAINT <br /> <br />. <br /> <br /> <br />Date ~/'~r <br /> <br />KATHERINE UKRAINIAN ORTHODOX CHURCH <br />POT 0' GOI.D GAMBLING ACCOUNT <br />1600 HWY. 96 <br />ARDEN HILLS, MN 55112 <br /> <br />1640 <br /> <br />'1 <br />r <br />, <br />~ <br /> <br />c" 'J <br /> <br />";;-1-0 y <br /> <br /> <br />$ /';,-0.0 0 <br /> <br />,~ <br />I ,/ql <br /> <br />\;,:-,6.J <br /> <br />----r---;-.-'I <br /> <br />~, <br /> <br />': 0 g . g . 7 . b 0 I : 20... 8 7 II' o. b l, 0 <br />