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0.- <br />Charitable Gambling <br />Control Boar;.: FOR BOAR USE ONLY <br />D <br />Room N-4,7'5 Griggs-Midway Building <br />License Number <br />18,21 University Avenue <br />.1, Minnesota 55104-3383 <br />40r'. <br />St. PaIL; <br />PAID <br />12) 642 <br />0 11 1 <br />f6 -0555 <br />AMI <br />CHECK# <br />DATE <br />GAMBLING LICENSE APPLICATION <br />115., Number of active mernbers, <br />�35 <br />1171. Name of Chief IExecutilive Off icier <br />Gert, D nn ie I ly <br />116., Number of years in existence <br />66 years- 'Momp- - - <br />Note; If less than four yearsr attach <br />evidence of three years <br />existence. <br />MOW. <br />18. Namieof treasurer orpemn who-accounts for other-revenues <br />of the organization. <br />Dell Duff i-nna <br />Title Title <br />Rres i dent -TrE-a'surer <br />Rusiness Phone Number Business Phone Number <br />612 291-8719 612 483-2' <br />387 <br />19. Narne of establishment where gambling will be '120. Street address (not P.O. Bo�-Wumber) <br />conducted <br />Knights of Columbas Hall 2555 North Snelling Avenue <br />21. City, State,, Zip 22. County (where gamblingpTemises is locatedi <br />www Rasev�`11111`1e,,MN 55117 <br />Ramsey <br />C(1-0001,,02 (8/86) White Copy-Board <br />......... .... . fNrdLrLcK::&1 Gov *,mpvirl, <br />I. <br />sx, 'T11% 3k, w I, . . ........ <br />NU I <br />nu <br />M <br />d1i <br />