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No mo~ ~ ~ b~o ~C~iO~ ~y be conduced by your~ per We~ ': ..... ~: ~' '~': <br /> ....... Day ........ Be~~d~ Ho~...~. ....... Day ......... : ~~Endmg ~o~ .......... :. Day ..... Berg/Ending Ho~ <br /> <br />'" Name of~sm~ishmeni w ~re g~blmg wdl ~ ~d~d __,, ~t Ad~e~ (~ ~t us~st off~ ~x number) .. ~ . <br /> <br /> Is the premiss I~t~wi:bin ~W limits? ~Yes ~ No if no, is ~ship ~ ~ed ~ unorg~ed ~ unin~orated <br /> CiW ~d CounW whe~ ga ~bling ~mises is I~ OR 'To.ship ~d ~un~ w~ g~bling premises is Io~ted if o~ of ci~ limi~ <br /> <br /> Does your organi~on o~ ~ ~e buil~ ~m ~e ~m~mg will ~ ~nduc~d? ~ YES ... ~ ~O <br /> <br /> ~ * a ~py of ~ ~e (~ LG~2) ~ ~s ~r at ~t ~e ye~. ' ..................... <br /> ~ * a ~ of a ske~ of ~ fl~r ~ ~ dim~ons, sho~ng what ~on is ~ing lea~d. <br /> <br /> ~:~:~:~:~:~:~::~:::~;~:~:~:~ ~:[~::~ ~ ~:~ ~- ~- <~-~'~.. · <. -.:~- .-~ · ~-. ~. <..:--. <-.. -~..~. ~:~ --~.~..... ~:- ~ .x. <-:- · ·...:. · .~ ........ :.:<. <<.. ~..~..~. ~.......~ .:.:.~ ~..~ .~ .:.:...:......:. ~... <~.. <~..:.....~ .:.....:..:...:~.....:~..:. ...... ~ ........ ~ ................. :. <br /> <br /> , ,~ ~ , <br /> <br />//7 <br /> <br /> <br />