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1111 . <br />Minniesou G NG haritable Gambling Control Board LAWFUL GAMBLI EXEMPTION <br />II N�4�75 Griggs-Midway Building <br />FOR BOARD USE ONLY <br />18,,21 University Avenue <br />St. Paul, MN 55104-3383 <br />(612 642-,0555 <br />114S1'RUCTIONS: 1. Submit request for exemption at least 30 days pr,ior to the occasion <br />Naime of Premises, Where Activity Will Occur <br />Cientral Park <br />�Premiises Address <br />Al <br />Lexington & Rounty Road C <br />Games Yes No <br />Bin o, <br />Roseville, YIN 55113 Sept. 26, 1987 <br />Gross Receipts 7 Value, of Prizes -Expense s�IIIIAIIIIIIII� Profit <br />. • <br />I affirm all financial information submi'tted to the Board is <br />all 8 <br />true,, accurate,, and complete. <br />�1� ■ <br />• <br />pill <br />U11 <br />I W. .. <br />algiriaTTire UT rers <br />City or, County) <br />ioln <br />Township Ih� arnie (M� ust be notified when County is the approving body) <br />itle Date Received <br />I itle, <br />CG-00020-01 (4/861 White — Board ICelrtialry — Board returns to Organization lo keep <br />Pink, — Organization Gold — City or County <br />711MM <br />