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G�,'�r ee�< <br /> /;" '°; G ----- L_ --)— <br /> GAMING SITE AUTHORIZATION <br /> r • <br /> `; Site License Number <br /> -'�la,.;i OFFICE OF ATTORNEY GENERAL <br /> (Attorney General Use Only) <br /> \\'4 �. +/% SFN 17996(02-2011) <br /> ∎NOl'[K O,/ <br /> Christine Volunteer Fire Fighters. Inc. is hereby authorized to conduct games of <br /> (Full,Legal Name of Gaming Organization) <br /> chance under the license granted by the Attorney General of the State of North Dakota at the following <br /> location: Knicker Bocker Liquor Locker the address of which is: <br /> 412 Main Ave. Hickson 58047 Cass <br /> (Street) (City) (Zip Code) (County) <br /> Date(s)Authorized: Beginning 7/1/14 Ending 6/30/15 <br /> Specific location where games of chance will be conducted and played at the site (required): <br /> NE wall in the corner at the Knicker Bocker Liquor Locker facility located at 412 Main Ave Hickson. ND <br /> olayed in the entire bar <br /> Number of twenty-one tables (required) (if zero, enter "0") : 0 <br /> RESTRICTIONS: (to be completed ONLY if restrictions are set by the local governing body) <br /> 1. Days of week of gaming operations 7 <br /> 2. Hours of gaming Monday-Saturday 11 am-2am; Sunday 12 pm-2am <br /> 3. List each specific game type prohibited <br /> Attorney General Date Signature of City/County Auditor Date <br /> nit ChM,M •'"'CY, CNA Gud <br /> PRINT Name/ •fficial Position of person ning above <br /> INSTRUCTIONS: <br /> 1. City/County Auditors - Retain a copy of the Site Authorization for your files. <br /> 2. City/County Auditors- Return the original Site Authorization form to the Organization. <br /> 3. Organizations- Send the original, signed, Site Authorization to the Office of Attorney General with any <br /> other applicable licensing forms for final approval. <br /> RETURN ALL DOCUMENTS TO: <br /> Office of Attorney General <br /> Licensing Section <br /> 600 E Boulevard Ave, Dept. 125 <br /> Bismarck, ND 58505-0040 <br /> Telephone: 701-328-2329 OR 800-326-9240 <br />