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25. Amount of Rent Per <br />Month or Bingo Occasion <br />$ <br />216. Do you plan on conducting bingo with 'this, license? If yes, give days and times of bingo occasions. <br />Day Time Day Time Day Time <br />77Y'es El No 2 7. Ha s t h e S 10., 00�10 fid e i i ty bon d req u i red by M i n n e so,t a St a t u tel, s 3491.20 bee n obta j ned? <br />28,,, Insurance Company Name (not agielnc,y name) 29. Bond Number <br />,30. Leissor Name 3 1. Address 32. City, State, Zip <br />-1 ryl^ <br />01 (Y& <br />ag-e <br />is <br />M 40" <br />GAMBLING SITE AUTHORIZATION <br />n . wME <br />Date, received (610 day period Signature of person receiving application <br />Ibleglins, from thiis date) q jjqjqD X, <br />48. Name of person delivering appilcation to Local Governing Body IT'itle <br />ATOT <br />White Copy-Board <br />Canary-Applicant <br />Pink-Local Governing Body <br />