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State of Minnesota I For Board Use Only <br /> Gambling Control Board Amt Pd <br /> Premises Permit Renewal Application <br /> Check# <br /> LG214PPR Printed: 3/5/2001 Date <br /> License NumberB-03 162-003 Effective Date: 8/1/1999 Expiration Date:7/31/2001 <br /> Name of Organization: American Business Womens Chapt Lady Slipper <br /> Gambling Premises Information <br /> Name of the establishment where gambling will be conducted <br /> Flahertys Arden Bowl Note:Our records show the premises <br /> 1273 W Co Rd E is located within the city limits <br /> Arden Hills,MN 55112 <br /> County: Ramsey <br /> Lessor Information <br /> Flahertys Arden Bowl Inc <br /> RR 1 Box 18C 1273 W. County Road E <br /> Remer,MN 56672 Arden Hills MN 55112 <br /> Name of the property owner(If different): Square footage leased per month: 28 <br /> Rent paid per month: 1,000 <br /> Square footage leased per bingo occasion: <br /> Rent paid per bingo occasion: <br /> Bingo Activity <br /> Our records indicate that Bingo is not conducted on these premises. <br /> On Site-1273 W Co Rd E Arden Hi <br /> �S�t rage Information <br /> off Site-P Damman, Route 4 Box 86, Pine City MN 55063 <br /> MN Mini Storage, 55 E County Road B, Little Canada MN 55117 <br /> Stewards, 248 N..:Dewey St. , St Paul MN 55104 <br /> Bank Information <br /> Norwest Gambling Bank <br /> 1220 W Co Rd E Account Number: 3528255745 <br /> Arden Hills,MN 55112 <br /> On the lines provided below list the name,address and title of at least two persons authorized to sign checks and make deposits <br /> and withdrawals for the gambling account. The organization's treasurer may not handle gambling funds. <br /> Name Address City, State,Zip Code Title <br /> Mary Goette 839 22nd Ave N South St.Paul,NIN 55075 Employee <br /> Debra Jean Burchett 632�Redwood Ln New Brighton,MN 55112 Employee <br /> Sharon Kay Sibell 5043 Madison NE Minneapolis,MN 55421 Employee <br /> Marlyn J Damman (Be sure to complete the reverse side of this application) <br /> 2700 N Dale Street #208 Roseville MN 55112 GM <br /> This form will be made available in alternative format{ie.large print,braille)upon request. Page 1 of 2 (Continued on Back) <br />