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74. <br />W214 <br />■ sir ifuL Ga=LbUng <br />Plre e Permait Applic an -a Part 2 <br />MY Wid C"OuntY whom g, n promin,sue kmmd OR T p and, County, whwe gambSng prom I z of a r <br />44s is c=1 ou ide ty writs <br />KO S"' e" 9 C 14 <br />IL: <br />g. two* <br />O C'c bF r1% <br />F <7 14 Ll L <br />q=mmmmmmmmmmmmmmmmmmm� 1 11 <br />Dom ft *vani=*m a*n I bukiM wtm the gamfing *d to condumid? YSS NO <br />NOTE.- Organi=Ilnz may nit pay theimselves rent it they own the building or have a holding company. A [attar must be sub- <br />rifted showing rent payments as z= from, gambling funds, d this arganiz=jon"s holding company owns the premisa& The <br />letter must be 3ligned by this chiW ex mr.) <br />Rent: <br />I =py of, the, l6ase with teffns for one year. <br />a copy ofa ske=4 of the floor plan wdhi dimensuldnis., showing what portion Is being !eased. <br />A lease, and sketchil are not required for Class 0 appiA4'antlons. <br />g21fflbfing with blonGO <br />.10 <br />0 jo 9 P M, a W <br />7tir gambling wifthoutbirgo, <br />AddIress of =rage spa cit gamoling equipment <br />Total square footage leased "MMMMMVM'J <br />