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wii + <br />DATE (S) OF GAMBLING <br />- e 6 s <br />NAME OF PERSON APPLYING FOR LICENSE <br />SIGNATURE OF APPLICANT <br />DATE OF APPLICATION :iH2A <br />L g <br />CONTROL LICENSE FEE 5,o 001 <br />WITHIN TEM �(1,10)i DAYS OF FILING ANY REPORTS WITH THE CHARITABLE <br />GAMBLING <br />OF <br />SUCH REPORTS WITH THE CITY OF ROSEVILLE,, AS REQUIRED BY SECTION <br />125.060 OF THE CITY CODES <br />MARCH 1 19 <br />