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Fj <br />DATE (S) OF GAMB, LING <br />,ACTIVITY <br />DOLLAR AMOUNT OF TOTAL PRIZES TO BE AWARDED 0. o V <br />NAME OF PERSONAPPLYING FOR <br />SIGNATURE OF APPLICANT <br />DATE OF APPLICATION <br />LICENSE <br />0 p <br />5 / - ) <br />LICENSE FEE $ 5 o 0 0 <br />'WITHIN TEN (1,0) DAYS OF FILING ANY REPORTS WITH THE CHARITABLE <br />GAMBLING CONTROL BOARDli THE ORGANIZATION SHALL FILE A COPY OF <br />SUCH REPORTS WITH THE CITY OF ROSEVILLE, AS REQUIRED BY SECTION <br />125m060 OF' THE CITY' CODEO <br />