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Minnesota Charitablie Gambling Control Board LAWFUL GAMBLING EXEMPTIO <br />4 kin N <br />Room N475 Griggs-Midway Building <br />4, <br />FOR BOARD USE ONLY <br />i� Ins'" -.��. �;� � ;� 18,21 University Ave�n�ue <br />S�t. Paul, MN 5151104-33813 <br />(6 1 2)16 42-10 5 5 5 <br />e emption at least 30 days prior to the occasion. <br />CNISTRIUCTIONS: 1. Submit reiq,uest for xi <br />Narne of Premises Where Activity Will Occur <br />Roseville VFW Post 7555 <br />Premises Address City, State Zito County <br />1,1 ,45 Wooldhil"11 Drive Roseville NN 55113 Ramsey <br />Exvenses and <br />Game Yes IN ol Gross Rec . eipts' Cos of PrUes' P r o fi i <br />B• ngo X 3 tf '.�Ac wy <br />e 0! <br />4r- <br />Date(sl of Activity drawing(s) - <br />r I <br />February 20, 1989 <br />Market Val L <br />��`of Priz"e's'": eta w <br />Raffles <br />x <br />Jr. Ar <br />kk J0, <br />_ZM1 S <br />SIR An <br />1h <br />ri <br />". . ftw <br />' V-M <br />% . "w <br />................................................ ... <br />%'w Uri <br />r <br />Padidlewheels <br />x <br />.':ky 511 P! <br />'1� 44iw- <br />14 ". t. <br />via. <br />h� <br />rt . <br />nt,! <br />® <br />Ti�pboards <br />x <br />fir- <br />.1w, • I SVP v. <br />so. 4. <br />"4 <br />91" gap <br />r <br />6 <br />7 -6 F <br />Pu11l-Tabs, <br />I. a -,d • s 1% <br />y. <br />-Wit <br />71 a Y <br />7: <br />x <br />S2,vic- <br />Use of Profit <br />Fund ralsier to offset, expen,sies for ice time and equipment <br />W, 0 <br />Distributor From Whorn Gambling Equipment Acquiked istributar"s License No'_ <br />b' <br />1. 6, IL <br />7w 01 <br />I affirm, all information submitted to the Board is true, accor- I affirm ll financial information submittedlo.,the Boaird i <br />ate, ancl colmplet <br />true, 8C6u"e&6(:,"'aAd coinpleti."_ 'P E <br />C7 <br />L <br />Chief Executive Off iice!r giginaitur,e <br />Date Chief Exiewfivie officer Signature -�,�� � ..�� �, •.,,, ..'' ". rFr- �'F� "v � #� �.�, � . Date <br />F. A 9 1 TLLVIT. Ll 14 -11 eff 9 ZTa �T FE-0 TS 11 r94 F FOT 4 1 A M <br />Siign, i re of r'soin Receiving Aipipli at' in nature of Person Receiving Application <br />silg <br />Titl Date Received Title Date <br />CG-00021,10-01 161871 Whiitie Board Canary — ISlaard returns to Organization to complete shaded areas. <br />Pink — Organization Gold — City or County <br />