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OM MW MM"i'mi, <br />WIN MI <br />N�' )e;< <br />46 <br />loop" Ar <br />P <br />ITT <br />:X*gx <br />g _0 17J <br />".. " , , " .�"Y'�"�`r'- "'}�"" "''.r� °�".rr:',1�.tie^iw.7'; .'�ti�:';r:�a+d,rr'.�; n'�'w����RRi=I ".+..,n ,� a i x ,,,mom •,�.,.d.,�m �, �' ;° � <br />r 'a v% 1 A-_ C 1,72 <br />Oer <br />4W ASS,. 10 <br />. MONOW <br />64,1]f- %OF- %A <br />10w nr ftntnow him <br />k.e 1 10 V rl C_I.>C; W", <br />MftAftIM4# MAMIMI rmon&oina annIesW& <br />Me "0 <br />aw 0 VO ffl- SOM cu a n�il Tor requaw WN <br />#M.104 1 Ift COMMA MM" <br />Mi W, County RmOl 9 <br />MAWUMMS fl N M-1-t-I <br />4 am ft chief execuW9 officer of the organization; <br />4 amme ful res;ponsIbW lor, to fair, and lawful opera-, <br />Aon of oil actIvNes Io be canduded; <br />*1 wil famikirfte, myoff *ft ft Ilaws of Nnnewta <br />P - M 'Now lawful gambling and rules, of ft board mW <br />agree, I Ilicensed, to, aWe ` those hm mid rules. <br />Ing mendmords to them <br />n k ion l <br />qM" W90M Q ideffio *1 subrril <br />-*am r4mnnes in *rmat vn be fted <br />ft board armd local unk of govemment, within 10 days <br />,of the, chanpi; wW <br />*11 urxWvhwrW that failure to pmide required information <br />or PmWO false or misleading information may result In <br />Mg <br />41 <br />the <br />den iall or revocation the Iceirm. <br />71" IC2 <br />ExWV - R_ -5 THWIUIIU" dup: <br />Ibis Mljgdan mount be aftiMbed to Jbig g2Wj " n, <br />I., III MIS ikWiciffion Is denied by the bcW unk of goverrimer <br />i shoOld not be submflied to the, Gambling Control Board. <br />41 <br />rawn sgriature below,, this townsho &MI-no-T-W-f6dges <br />he the aManiMion is appPAng for a premises pemit within <br />�Mrw* <br />TOMIAIP" <br />Tamishin, <br />M I tIMM bd�wvw <br />J=14(F <br />%WrMI <br />