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(~`"";~~~1 APPLICATION FOR A LOCAL PERMIT OR CHARITY LOCAL PERMIT H1~-~~ C~rn~l ~I ) <br />~~ ;'i~~~ ''f''~J~ OFFICE OF ATTORNEY GENERAL <br />'~".~ ~ t ~„ SFN 9338 (07-2003) <br />- • Application for: (~ Local Permit "^ Charity Local Permit (one event peryear) <br />Name of Non-profit Organization Date(s) of Activity <br />Red River Valle Fair Association <br />May 2009 <br />{o September 2009 <br />Person Responsible for the Gaming Operation, Including Disbursement of Net Income Title Business Phone Number <br />Bryan K Schulz Gen Manager 701-282-2200 <br />Business Address City State Zip Cade <br />1805 West Main Ave West Fargo ND 58078 <br />Mailing Address (it different) City State Zip Code <br />PO Box 797 West Fargo ND 58078 <br />Name of Site Where Games} will be Conducted Site Address <br />Red River Valley Speedway 1805 West Main Ave <br />City State Zip Code County <br />West Fargo ND 58078 Cass <br />Check the Game(s) to be Conducted: 'Poker, Twenty-one, and Paddlewheels may be Conducted only by a Charity Local Permit. <br />^ Bingo ^ Raffle Calendar Raffle ^ Sports Pool ^ Poker • ^ Twenty-one • ^ Paddlewheels <br />DESCRIPTION AND RETAIL VALUE OF PRIZES TO BE AWARDED <br />Game Type Description of Prize Retail Value of <br />Prize <br />1/2 of the money taken Each raffle varies <br />li0i50 Raffle in will be iven awe <br />how much is <br />Intended uses of gaming proceeds• Money collected will go back to offset driver payoffs. <br />Does the organization presently have a state gaming liasnse? ®No ^ Yes - It'"(es," the organlzation Is not eligible for a local pertnil or charily local <br />permit and should call the Office atAttomey General at 1-800-326-9240. <br />Has the organization received a charity local permlt from this or another dty or county for the fiscal year Juy 1 through June 30? ®No ^ Yes - If "Yes " <br />the organization does not qualify for a local permit or charity local permit. <br />Has the organization received a local permit from this or an t er G r county for the fiscal year July 1 through June 307 ^ No ®Yes - If "Yes;' <br />indicate the total value of all prizes p'eviously awarded: s ~~~~. This amount is part of the total prfze limit of $12,000 per year. <br />Signet i•gantz do ' Top ecuiive Offidal Date Title Business Phone Number <br />,. 'F 4/15/2009 General Manager 701-282-2200 <br />L------•~j ~ <br />;- <br />