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1989_1207_packet
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1989_1207_packet
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11/18/2011 11:29:48 AM
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11/18/2011 11:09:27 AM
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ItATE <br />CITY OF ROSEVILLE - - LICENSE DlIVISIO? <br />APPLICATION FOR RE�N'EWAL OF GAMBLING LICENSA <br />ESTABLISHMENTIORGANIZATION <br />ADDRESS -700 k�-- �i i 0000" <br />GAMBLING SECTIO. <br />Lq <br />ADDRESS �-70 19 io A <br />PHONE NUMBER, So, S. NO., <br />DATE OF B,IRTH <br />GAMBLING XANAGFR INFORMATION*. <br />NAME -1 1, <br />- I I <br />(Last) (M <br />/P (F'i- rst) iddle) <br />ADDRESS lz U0 <br />PHONE NUMBER <br />S, Si, NC <br />DATE, OF BIRTH <br />T�v J - -0 <br />TYPE OF GAMBLING: ff- l "" . Pu,ll T'abs / Raf f le,s/ Tip Boards/ <br />''addle Wheels <br />
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