89-1096 WNITE - CITV CIERK f
PINK - FINANCE CO�II1C11
CANARV - DEPARTMENT GITY OF S INT PAUL /
BLUE - MAVOR File NO. ` D�� -
Counci esolution 3�2
Presented By �
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #1 208) for a Class A ambling License
by Punt Inc. at 1324 E. Rose, be and the s e is hereby
approved�ecl..
COUNCIL MEMBERS Requested by De artment of:
Yeas Nays
Dimond
i.ong In F or
Goswitz
Recrman � B
Sc6e�be� _ Agai st Y
_see�.
Wilson
JUN 151 9 Form Approved b City Attorney
Adopted by Council: Date . •
Certified Y� - d y oun .il , ta By �'�� �y
.
By
Approve Mavor: Date
�` � j �jy� Approved by Ma oc for Submission to Council
gy — BY
PU�I� J��N ? i 9 9
���1/4��
DEPARTMENT/OFFlCEICOUNqL DATE INITIATED � �� �
Fi nanc,e/�i c�nse REEN SHEET No.
CONTACT PERSON 3 PHONE INITIAU DATE INITIALIDATE
D ARTMENT DIRECTOR �CITY COUNCIL
Chri sti ne Rozek 298-5056 ��� ATfORNEY �CITY CLERK
MUST BE ON OOUNGL AOENDA BY(DA7� ROU71N0 B DOET DIRECTOR �FlN.Q MOT.SBRVICES DIR.
6-15-89 YOR(OR ASSIST �1 '1 R
TOTAL M OF 81GNATURE PAGEB (CLIP ALL LO AT NS FOR 81QNATUR�
acroN�cwes,�o:Approval of an appl i cati on for a ta e C1 ass A Gambl i ng Li cense.
Notification Date: 6-2-89 Hearing Date 6-15-89
RECOAAMENDATIONS:Approve(N or Rejs�t(R) COUNCIL MI EARCH REPORT OPT
ANALYST PHONE NO.
_PLANNINO COMMISSION _qVIL SERVK;E COMMI3810N
_GB COMMITIEE _
COI�AMENTB:
_STAFF —
_DIBTRICT COURT _
BUPPORTS WNICH COUNCIL OBJECTIVE?
INITIATINQ PROBLEM,IS8UE,OPPOH'NNITY(INho,What,Whsn,Where,Wh�:
Todd Portinga on behalf of Punt In . requests City Cou cil approval of
his application for a State Cla s Gambling License a 1324 E. Rose. The
bingo sessions will be held Thu sd ys between the hour of 7:00 PM and 11:00 PM.
Proceeds from the bingo session w 11 be used to help upport and fund
ARTS ETC. , an arts organization wh ch provides persons with developmental
disabilities the opportunity to ex erience a life with quality through
artistic expression, participat on and education. All fees and applicati�ns
have been submitted.
- ADVANTAOES IF APPROVED: .
If Council approval is given, un Inc. will hold a w ekly bingo session
at 1324 E. Rose.
DISADVANTAf3E8 IF APPROVED:
a3ADVANTA(iE8 IF NOT APPROVED:
Ga����'; ���^�;�ch ��r��er
J�!id 0� �i:;��
TOTAL AMOUNT OF TRANSACTION = COST/REVENUE BU (qRCLE ONE) YES NO
FUNDINQ SOURCE ACTIVITY NUMBER
FlNMICIAL INFORMATION:(EXPWI�
D �
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE C3REEN SHEET INSTRUCTIONAL
MANUAL AVAILABLE IN THE PURCHASINC3 OFFICE(PHONE NO. 298-4225).
ROUTIN(3 ORDER:
Below are proferred routings for the flve moat frequeM rypes of dxuments:
OONTRACTS (assumes suthorized COUNCIL RESOLUTION (Amend, Bdgts./
budget exists) Acc�pt. Grants)
1. Outside Agency 1. Department Director
2. tnitiating Department 2. Budget Director
3. City Attomey 3. City Attorney
4. Mayor 4. MayoNAssistant
5. Finance&Mgmt Svcs. Director 5. City Council
6. Finance AccounNng 6. Chief Accountant, Fin&Mgmt Svcs.
ADMINISTRATIVE ORDER (Budget COUNCIL RESOLUTION (all others)
Revision) and ORDINANCE
1. Activity Maneger 1. Initiating Department Director
2. Department Accountant 2. City Attorney
3. Department Director 3. MayodAssistaM
4. Budget Director 4. City Council
5. City Clerk
6. Chief Accountant, Fin &Mgmt Svcs.
ADMINISTRATIVE ORDERS (all others)
1. Initiating Department
2. City Attorney
3. MayoNAssistant
4. Gty Clerk
TOTAL NUMBER OF SIGNATURE PAGES
Indicate the#of pages on which signatures are required and relf
each of these pages.
ACTION REGIUESTED
Deacribe what the project/request seeks to accomplish in either chronologi-
cal order or order of importance,whichever is most appropriate for the
issue. Do not write complete sentences. Begin each item in your list with
a verb.
RECOMMENDATIONS
Complete if the issue in question has been presented before any body, public
or private.
SUPPORTS WHICH COUNCIL OBJECTIVE?
Indicate which Council objective(s)your projecUrequest supports by listing
the key word(s)(HOUSING,RECREATION, NEIC3HBORHOODS, ECONOMIC DEVELOPMENT,
BUDGET, SEWER SEPARATION). (SEE COMP�ETE LIST IN INSTRUCTIONAL MANUAL.)
COUNCIL COMMITTEE/RESEARCH REPORT-OPTIONAL AS REQUESTED BY COUNCIL
INITIATING PROBLEM, ISSUE,OPPORTUNITY
Explain the situation or condftions that created a need for your project
or request.
ADVANTAGES IF APPROVED
_Indicate whether this is simply an annual budget prxedure required by Iaw/
charter or whether there are specific ways in which the Ciry of Saint Paul
and its cltizena will beneflt from this projecUaction.
DISADVANTAGES IF APPROVED
What negative effects or major changes to existing or past processes might
this projecVrequest produce if it is passed(e.g.,traffic delays, noise,
tax increases or assessments)?To Whom?When?For how long?
DISADVANTAGES IF NOT APPROVED
What will be the negative consequences if the promised action is not
approved? Inabiliry to deliver service?Continued high traffic, noise,
accident rate? Loss of revenue?
FINANCIAL IMPACT
Although you must tailor the information you provide here to the issue you •
are addressing, in general you must answer two questions: How much is it
going to cost7 Who is going to pay?
. � li���°��v
DIVISION OF LICENSE ANT� PERMIT ADMINI T TION llATE �/ �/
INTERDF.PARTMENTAL REVIEW GHECKLIST pn P oce sed/Rece ved by
Lic Enf Aud
�
Applicant �O� �p/—`'(�►C�� Home Address IU�S{�Q��n t�-�
Rusines� Name �U/►'C, ..�.V�� Home Phone (l/ 7 ? � 1 a y
Business Address �y � I�OS� Type of License( ) l��,aSS �'
Business Phone y� �j��n � C�'�S�
Public Hearing Date f2 1� S License I.D. 4{ �� ai�O
at 9:00 a.m. in the Counci Ch uibers, ,�/ ,`/
3rd floor City Hall and Courthouse State Tax I.D. 4P `-� 7` 7�3�
llate Notice Sent; Dealer �� +� ,L�^
to Applicant jo�o7�'
Pederal I'�_rearms �� � �
Public He�.;ring �'
DATE INSP CT UN
REVIEW VERFIED (G MP TER) COMMENTS
A proved N t roved
�
Bldg I & D 1
�(,a- ;
Health Divn.
��A �
�
Fire Dept. � �
i ��� I
I �tnt a
Police Dept.
yIa-, � �1�
License Divn.
1 � �t,treS � � �, v�ti.��--{-���
Vtc�-� c` �
(� 2 ' �
� �.
City Attorney �
�P � '
Date Received:
Site Plan ,Z� �
To Council P.ese rch � L �
Lease or Letter Date
from Landlord � Z )
--�---¢- ,�,;. . .—� ---- - - _ ____ --- . � .. _ _._
.�. .
n ' ' r� . ��1 /09�
• ' OR BOARD USE ONLY
MINNESOTA DEPARTMENT OF REVENUE licen Number �
GAMING DIVISION PAID
Mail Station 3315
St. Paul MN 55146-3315 A T
612/297-5300 CH CK#
D E
GAMBLING LICENSE APPLIC I N
INSTRUCTIONS
A. Type or print in ink.
B. Take completed application to local governing body,obt n si nature and date on all copi ,and leave 1 copy.Applicant keeps 1
copy and sends original to the above address with a ch k.
C. Incomplete applications may be returned.
D. Enclose license fee with application.
�ype of Application:
Class A — Fee S100.00(Bingo, Raffles, Paddlewheels,T bo rds, Pull-tabs)
d Class B — Fee S 50.00(Raffles, Paddlewheels,Tipboar , II-tabs) Mak cnecks Psyawe to:
� Class C — Fee S 50.00(Bingo only) Co missiooer of Revenue
� Class D — Fee S 25.00(Raffles only)
Check one: 1A. Organization has never been licensed.
❑ 1 B. New site—Give base license number �
❑ 1 C. Renewal of existing license—Give co ple license number. � � 0 - 0
❑ 1 D. Change in class of an existing license Gi e complete license number. � - � � 0
❑ Yes No 2. Has organization ever received a Lawfu Ga bling Exemption Permit fro the Board? If yes,give complete
`permit number
❑ Yes o 3. Have Internal Controls been submitted revi usly on a form provided by t e Board? If no,please attach copy.
4. Applicamt(O,ffi�ial, legal name of organization) 5. Bu in, s ddress�of 0 nization;
� �. , � , '� , ' �� . I J',
6. Cit�,S ate.Zip` _ _ , 7. Co�nty ,. 8. Busiri�ss Phone Number
� � y
� • I /^ ,� 1� < <' 1 ' ` ' �' l � �,�f i � ; % +` � f�" /.��
� ' < <.
9. Type of organization: OFraternal OVeterans �R ligi s �Other nonprofit
�Yes ❑ No 10. Is organization incor orated as a non ofit rganizationt If yes,give nu ber assigned to Articles or page and
book number: ttach copy of certificate.
`C�7 Yes � No 11. Are articles filed with the Secretary of Sta T
❑ Yes ��I�lo 12. Is organization exempt from Minnesot or eral income tax7 If yes,pl ase attach letter from IRS or
Department of Revenue declaring exe pti n.
❑ Yes o 13. Has license ever been denied,suspen ed r rewked7 If yes,check all t at a I :
O Denied ❑ Suspended O vo d Give date: -
14. Number of active members 15. Number of ye �s i existence Note: Attach evidence of
�;"' • i � � , �, �, three years existence.
�� .� �
16. Name of Chief Executive Officer(Cannot be f 17. Name of treasurer r person who accounts for other
GamWTrfg Ma�ger) � ;'1 r�evenues f the or anization(Cannot be Gambling Manager)
�/ �/� l � ` �' .
!�')L';' (,� � t � '�� ` _ /lf)G %� t��' � i �� '�' �' �
Title-� Title
��.
��� ->: �1c=�..�''" r:� �S y.� r� r
Business Phone Number Business Phone N mber
,;'�r� , �� � �i - �/�U3 �-��tZ �;� � - ��.t�-3
18. Nar�e of est blishment whe� gambling wifl be co ac 19. Street address(n t P.O. Box Number)
�%/� �;f � � �� .1�� �1 l� �-� � T- � � ��
20. City, State ��i 21. County(where g bling premises is located)
i , �' I ( l ft� , �. j ' r j� !!i ( �( ' Y. f .
CG-0001-03(3/89) White Copy-Board Canary-Applican Pink-lceal Governing BodY
age 1 of 2
�� � �G ��
. , C�1 �^l�
Gambling License Appii ation
T e of A lication: Class A ❑ Class 6 ❑ Class C ❑ Class D
Yes ❑ No 22. Is amblin remises located within cit imit ?
�Yes O No 23. Are all gambling activities conducted at t e p emises listed in i#18 of this pplicationT If not,complete a separate
a lication for each remises(exce t raf les) s a se arate license is re ui ed for each remises.
❑ Yes No 24. Dces organization own the gambling pre is ?If no,attach copy of the I ase with terms of at least one year,
and attach a sketch of the premises ind ati g what portion is being leas d.A lease and sketch are not required
for Class D a lications.
25. Amount of Rertt Per 26. Do you plan on conductin bi o with this license?If yes,gi days and times of bingo occasions.
Month o�Bingo Occasio _ �aY ,�� Ti e Day Time Day Time
/ I. : C ..
s � r/ J i , i 1 -
� Yes ❑ No 27. Has the 510,000 fidelit bond re uired y M nnesota Statutes 349.20 be n obtained?
28.. Insuran e C�npany Name�not agency namey ; ;, , 29. Bond Number. -
� � ,1 / / �'K.�i� . ;� . - .� � "J �._ �
30. Lessor Name • 31. ddr ss 32., City, State,Zip -� �
i , �_ _ � . �,- `�` ;�, , ,. ; ; ,,
33rf�m�ling�nager Name 34. dr ss - ... � 35. City,State,Zip ,
-:� � � � �}! d. s . ; � ,f� ;.` � �. •����=�-! �.
;" r ' ; v l -�.i j 'v�
36. Gambling Manager Busi�ess Ph�e 37. Date ga blin manager became
i: , - • J� i member f or anization: onth . Year
� Yes ❑ No 38. Has the license termination form been om leted?Attach co
❑ Yes 0 No 39. Has the com ensation schedule been r ed b the or anization?Att ch co
40. List the da and time of the re ular meetin of the or ani ation. Day Time
41. Bank Name 42. Bank dd ss 43. Bank Account Number
GAMBLI G S TE AUTHORIZATION
By my signature below, local law enforcement officers o� ge ts of the Board are hereby a thorized to enter upon the site at any
time gambling is being conducted to observe the gamblin a to enforce;the law for any u authorized game or practice.
BANK R O DS AUTHbRIZATION
By my signature below,the Board is hereby authorized t ins ct the bank records of the g mbling bank account whenever
necessary to fulfill requirements of current gambling rul s a law.
I hereby declare that: OATH
1. I have read this application and all information sub itte to the Board;
2. All information submitted is true, accurate and com lete
3. All other required information has been fully disclos d;
4. I am the chief executive officer of the organization;
5. I assume full responsibility for the fair and lawful o rat n of all activities to be cond cted;
6. I will familiarize myself with the laws of the State o Mi esota respecting gambling nd rules of the Board and agree, if
: licensed,to abide by those laws and rules, includin am ndments thereto;
7. Membershi list of the or anization will be availabl wit in seven da aft u sted b the board.
44. Off; ial, Legal�Name o�rga. 'zation 4 �g �ure�m� igned by Chief:E�iecu�Officer)
� '� ! ; 1 -� ,;..�- ��1 � • X � , .� �,
Title of S� er ' Date / ;� � �
��,.: ,c: (� , , '1" . ;f� . � :' / /
ACKNOWLEDGEMENT F TICE BY LO AL GOVE ING B DY
I hereby acknowledge receipt of a copy of this applicatio . B acknowledging reoeipt, I ad it having been served with notice that this
' application will be reviewed by the Charitable Gambling Con rol Board and if approved by he board,will become effective 60 days
from the date of receipt(noted below►unless a resolutio of he local gaverning body is pa sed which specifically disallaws such
activi and a co of that resolution is received b the hari able Gambli Control Boar within 60 da s of the below noted date.
46. Name of City or County(Local Governing Body) If site is located withi a township, item 47 must be completed,
ti � in addition to the cou ty signature. If township is not organized,
� �' �� lCl,�-��� coun must si n.
Signature of per receiving application 47. Name of Towns ip
_s ,
, j��� � t ,
Xt,c.].,i.�_•-f� ,../ Li!%:..��_r .. . . . .__ . . . � .
Title: • Date re¢eived�60 day p riod Signature of person ceiving application
begins from thi d�te�„
,�d ,{;�: .�y; C . _..,��� �,.� ' ' ! X
' 48. Name of person delivering application to Loc91 G tni Body Title
CG-0001-03 (3/89) White Copy-Board Canary-Applica t Pink-local Governing Body
Page2of2
. - Ci:? o S int Paui /J, r��,_��C��
. • Depar:aenc oc ?inan e nd �anagemeac Ser�i es �� d
, ' � Divisia� o= L:cens a d Pe:ait �egist_at: rs
IYFORMATTON REOUIQED �•+IT�I �P°L=CaTiON ?OR _. I?' TO CONDUCi C'3A.R.I �BL''. G�1.'�3L:VG G�t' ?V
� SaINT ?�UL
1. Fu11 aad co�aplece name oi arganizac' �� ich is applying for licease
� '{"' r �
n � L�'
2. Address vhere games vill be held � " ��Se �i/P- �� Sfi- /'�f� �y1 ��1
- ;lu ' er Screec Cicy Zip
3. Name oF �anager sigrciag chis aoplica ic vno wi�? coaducc, o erace and zsanage
�
�/ , t-�
Gambl*�g Games C��(•C ���r��� Dac af airta � ` � / '� ��
(a) Length of t:me manager has beea e er o� appl;caac ora nizac�oa ��,_`=�
4. Address of ;ianager ��'T� r' ��_ ��• S ' L S �v�
Yumbec Sc:eec C cj Zip
5. Day, dates, and 'nours chis applicac�cn is :or (:f�� V �� ^�! �
6. Is the applicant or organizacion or an`zed under t:�e Iavs a� che Stace oi :�!d? i,�L�
� �--
7. Date of incorporac��n
8. Dace whea registered vich che Staca ei :'a:.nesoca ' /� ��
9. Hev long has arganizacion beea ia e is aacs? GY ��'I'!OI'I f!2 �
-� -
10. How Iong has organizacion beea ia ys eaca f.a �t. 2au�•". �;� ry►onth
11. Whac is the purpose of che o:gaaiz t'_o ? -�D � U ��L � rv��e �i�-
C I'�(,{�2•y?�i e " � /? ' -� � �i l/� S 'C �r50 5 ���� �
�;.� e12 SG! % / � S
I2. Of•`ice s of applicanc organ��ac:on
Name /'� � � l�� Ya�e � �
Address — � �/'G > Address � �-�� ��.lZ}c ,{,uv r�j���� /�� l�
L ^ � (P ;,�r ti v a• ��3��+
Title �li''SiG��Gt,7 DOB � / S L==-=��;�1 �(,i �.f 70B jo � .3� "5�--
Name �� l�' � Vame
Address - �t �"� �t �'�;1 • �ddress
f / �
'ritle - "� '�Z� DOB '� '=�=z �a�
13. Give names oc oc=icers, ar amr oc: e' �e=sar.s Jao :a:: �o: sa:-'r:c_s =� _:e ar3az:::at:oss•
Vame � Yame
Address {dd=-=3
Titla ---=
(,::�ac:: se?z ac �:a�- . - :::�:--_.. _ '_=:•
. ������
14. ?,�:ac:�ed he:aco :s a lisc of names a d dd:esses ci alZ me ' ers ot che organizat=on.
15. In wnose csstody vill organization`s re ords be kepc?
. Name ��' . t.i ( ;'�l � ', �lddress ;��� �+ %,'��� %�':;�,� �1 .
� f• :�c;'c;�f_ ,/'N,,� ..;�';.'�
I6. Persons whc v11I. be conducciag. assi ci g in conduccfng, or operacing'che games: '
��e __�/��,r��'�_._�1�C� �/ C vl Dace oi Birth ��o?f����
�,ddress .�� �� — G.�,.�.T,C.CSS (.t ' � ��'� Cr G� �
Name oc Spousa i _ ,��' �'' j� Dace oE 91:th �
Daces vhen suc'.^. oerson vi�1 conducc, as isc, or operace y ,;
l�'���r � �`�� rc
"�l
Name � ''� lLi��'�`� y!► ��,G� Da.e o= Birth '� / ? 7
�
� /' 1' � �i) �� / /�r YJ ` �� %�� � // l 1 • �1 ._j G'�/i�
�ddress i �
�-
Nane o: Spouse _ �/�J'� �1,� t"1 ' Dace ot Bi:th Ci;`�.?�� ���
�� p hu�sa'�t� s
Dates :aen SL'C:I nerson •.�iII conctcc, ss 's�, or o era[e
ct ..,? �l ��l �. rcLc �/ O
I7. FFave ;►ou :eae aad �o ?ac� c�arau¢a1.� u ce stand che orov:sio of a:l lavs, ordiaances,
..
and regulac:or.s �eve�_�g, cae aperac= n r C�a:.tab_e Gaac:� g ga3�s? (,
18. �lttac::ed here=� ��a ��e :o:-= �nris:�ea �.� �'.te C-�� o: St. Pa• is a riaaacaal Repor:
vhica :���izes a:= :ecsi:cs, e::�enses a d �'s�c�rsemeacs e= ^z aoolicanc or�anizat=on
' as :�ei: as a:: o:gar.:�a�:�as :�a aave -e _:�ed 'suds cor cae �rscec'�.g caLar.dar �aar
:�hic^ .:d5 JeB.^. S:S A�� C:�7?_!ed� 3IIQ 2: ��BC ��! ��� ��. �J'l//C� ���i L
• � tiame
,
�'� ��S��c�U �� !� � ��Y!��l� �1 . `
�c __ss '
/
who is c�:e r� (,� r'� � o: �� aaplicanc Organ=zac:on.
• Vaae �: Qi '
I9. Operaco: or pra�=,es �na-_ ;zames ::�_ �e ie:d:
Name /� jC l� /! (�� n i -- A !�/� � i -� /� L
B�siness tidd=ass � � � � C{ .� �� �� ��v(��
Home :�ddress /`' � .�� o� ��./_- �'�', ��Cr� — �3?�- .�/L i ' ,�i11
20. uneun� o� rer.c �aia �y a�o::;.=nc Jr3�, -_ c:an :or :e^c o: c� ia?Z; saec�:;� aaounc `�S//Y
,� — v
pafd ?er s-hou: ;e==:;.� � � /-�
. � �������
2i, T�r �roceeds oc c::e ;aaes vill be d bu sed after deducc:n prize Iayouc coscs and
� ope:acing expenses cor �he iollovin pu oses and uses:
�, � u � � �- —,�
� ��
�' ; � � d.� - �v� : UPl �yte�� ,
i l i �7'C' s 7� � ! 't!r-�t � Pr?P �% � - �� �
i'U G(G C(r �S� �act�/CS ► , �OG/ t7C�j'XX. . O�'! / L°Ct'C'l_';� G'�'l �
22. Has che �remises vhere che g�nees are co e held been cercified for occupanc� by c e
C�cy oc Sainc °aui?
23. Eias your or3aa:zac:on �ilad :edera= 0 9a0-i° � I� a swe- is yes, �lease accac:►
a cooy v�c:� c::i; apolicac:on. Lc an c:a is no, ex�lain :rhy:
� � ��Uu� n a. �� � c r��re �o
�r"/ cc G�—%
,
Any changQs desi:ec b•r ;ae ap??'_caac :sso =a �on ma� be aade onl wich t�e conser.c o� �;�e
Ci�y Counc?L.
� f �� ,
Or�a�'_zac:on
(� Qf� �� r�;
Date 0 ( ! U � By: --
Ka a3 � :n cn ga oi gane
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c a _ � = �; I :n _ - .. - cz cn
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. � City of S int Paul
. - DepaKme�t of Finan e a d Management Service n,,, �iR_�� ��
License a d rmit Division U''
2 3 Ci y Halt
St. Paul, Min eso 55102-298-5056
APPLICATI N FOR LICENSE
CASH CHECK CLASS NO. Ne enew
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. Oate r 19.s,�L
Code No. Title of License From ! Z 1�To_� '�19�
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Business Address Phone No.
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10 Maii to Address ,�: Phone No.
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1 AlanagerlGwner-H e Address Phone No.
4098 Applicatfon Fee 5 �
Received the Sum of 1 S � . � U k 1. , ' �� �� L
�J��' �v ManayedOwner•Cft ,Slale 3 Zip Cod�
100 Total 1
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Litense Inspector � By: � `, tqna�ure o pp�iea .
Bond•
Compa�y Name Policy No. Expiration Date
Insurance•
Company Neme Policy No. Expiration Oate
Minnesota State Identificatfon No � Social Security No
Vehicle Information:
Serfal Number Plats NumOer
Other:
THIS IS A RECEI T OR APPLICATION
• THIS IS NOT A LICENSE TO OPERATE.Your application for Hcens wil either be granted or rejected ubject to the provisions of the zoNnp
ordinance and completfon of the inspections by the Health, Fire, oni andJo�License Inspactors.
$15.00 CHARGE FOR A L ETURNED CHECKS -
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