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lees <br />UNo 26. Does the organization lease the entire premises? If nol, attach a sketch of 27. Amount of Monthly_Dent <br />thile prelmisies indicating what portiion is being leased.A lease and sketch $ <br />is not required for Class Di applications. <br />EiYesib(No 28. Do you plan on coinduciting blinigo with this license? If yiesi, give days and times of bingo occasions-, <br />Days rar"es <br />K,4.Yes0N10 29., Has, the $101,000 fidelity bond required by Minnesota �Statutes 349.20 been obtained? Attach copy of bon(i . <br />�71 E <br />Biy my signature blielow, l�oca�l law erif orceiment off icers or agents of the Bloa�rd are hereby authorized to enter upon the site, <br />at any ti me,, ga�mblling 'is, being cond ucteld,, to observe the gam bling and to enf orce the law f or any unauthorized game or <br />pracIice-iii <br />BANK, RECORDS AUTHORIZATION <br />BY my signiature belowl, thei Board is, �her,ebly authorized to inspect the blank records of the General Gambling Bank Account <br />ile n eve, r n e cless a ry to f u I f 111 rile qu i rilem ents of' cil u rre nt ga m b I I ng rulel s a n d I a w. <br />I <br />ACKNOWLEDGEMENT OF NOTICE BY LOCAL GOVERNING BODY <br />hierieby acknowleidge, rieliceipt of a colply of this application. By acknowledging receiptil I admit having been served with <br />riolticie, that thisi application will ble reviiewied by the Charitable Gambling Control Board and if approved by the board, wir. <br />eleclomile effective 30 d�ays f riolm the date, of receipt ■ (noted below)l, unlessi a resolution of the local governing body 'is passel <br />which sipecifically disallows such activity and a copy of that resolution is riecleiv,ed by the Charitable Gambling Contro' <br />BloarlIII days of the below noted date. <br />42,. Name of City or County (Local Governing Biodly) <br />k's,.I�nM DF i?cSrWlt-LE� <br />L <br />Signature, of Ipelrs 4n receiving application <br />x V <br />Title Dalte received 1(30 day period <br />begins from this date) <br />M, <br />?L <br />-,,4,. Name of Person delivering application to (Local, Governing Body <br />If site is liocated within a township, item 43 must be completed, in <br />addition to the county signature. <br />43. Narne of Township <br />Signature of person receiving application <br />Q <br />CG-0001-02 l'8' 86li White Copy-Boiard Canary-Appilicant Pink-Local Governing Body <br />