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<br /> 'I <br />East STATE OF' MINNESOTA jF'OR BOARU USE ONLY I <br /> GAMBLING CONTROL BOARD I ANT PAID II <br /> PREMISES PERMIT RENEWAL APPLICATION I CHECK NO. <br />LG214PPR PRINTED:10/30/95 I DATE ~I <br />LICENSE NUMBER: B-00489-007 EFFECTIVE DATE: 07/01/95 EXPIRATION DATE: 04/30/96 <br />NAME OF ORGANIZATION: Church of St Mary Romanian Orthodox St Paul <br /> GAMBLING PREMISES INFORMATION I <br />NAME OF ESTABLISIIMENT WHERE GAMBLING WILL BE CONDUCTED I <br />n . _ Inn H"/..'VA-'( t.."., <br />1201 W Co Rd E <br />Arden Hills 55112 <br />COUNTY Ramsey IS THE PREMISES LOCATED WITHIN THE CITY LIMITS?: Y I <br /> LESSOR INFORMATION I <br />DOES YOUR ORGANIZATION OWN THIS SITE?: No <br />IF NO, LIST THE LESSOR: <br />Minneapolis Motel Enterprises <br />1201 W Co Rd E I <br />Arden Hills MN 55112 <br />NAME OF PROPERTY OWNER (WHEN NOT LESSOR) : I <br />SQUARE FEET PER MONTH: 56 AMOUNT PAID FOR RENT PER MONTH: 1000 <br />SQUARE FEET PER OCCASION: 0 AMOUNT PAID PER OCCASION: 0 <br /> BINGO ACTIVITY <br />BINGO IS CONDUCTED ON THIS PREMISES: No IF YES, REFER TO INSTRUCTIONS FOR REQUIRED ATTACIIMENT I <br /> STORAGE ADDRESS <br />3776 Connelly I <br />Arden Hills MN 55112 <br /> BANK INFORMATION <br />Firstar Bank I <br />2100 N Snelling Ave <br />Roseville MN 55113 <br />GAMBLING BANK ACCOUNT NUMBER: 372000306 I <br />ON THE LINES PROVIDED BELOW LIST THE NAME, ADDRESS AND TITLE OF AT LEAST TWO PERSONS I <br />AUTHORIZED TO SIGN CHECKS AND MAKE DEPOSITS AND WITHDRAWALS FOR THE GAMBLING ACCOUNT. <br />THE ORGANIZATION'S TREASURER MAY NOT HANDLE GAMBLING FUNDS. <br /> I <br /> N;("'h(""\l~c:: M:=.n0;11 . rRn ?Rlh M~Kinlpl' ~+- 7\TP Mr1" Ml\T 'i'idlR <br /> ,T~moc:: r~rc:.t- i . ~::lmh';nr; M.:::In:='0C>'- q?'i lRt-h Zl.ut:!> 1\1 ~f""In+-h ~t- p:=."l . MT\T 'i'in7'i I <br /> (BE SURE TO COMPLETE THE REVERSE SIDE OF THIS APPLICATION) ~ <br />THIS FORM WILL BE MADE AVAILABLE IN ALTERNATIVE FORMAT (I.E. LARGE PRINT, BRAILLE) UPON REQUEST <br /> I <br />