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<br />ast STATE OF MINNESOTA I FOR BOARD USE ONLY I
<br />GAMBLING CONTROL BOARD I ANT PAID I
<br />PREMISES PERMIT RENEWAL APPLICATION I CHECK NO, I
<br />,G2l4PPR PRINTED: I DATE .
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<br />,ICENSE NUMBER: B-00489-007 EFFECTIVE DATE: 05/0l/96 EXPIRATION DATE: 04/30/98
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<br />'.~E OF ORGANIZATION: Church of St Mary Romanian Orthodox St Paul
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<br />GAMBLING PREMISES INFORMATION
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<br />AME OF ESTABLISHMENT WHERE GAMBLING WILL BE CONDUCTED
<br />ioliday Inn
<br />.20l W Co Rd E
<br />~rden Hills 55112
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<br />:OUNTY Ramsey IS THE PREMISES LOCATED WITHIN THE CITY LIMITS?: Y
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<br />LESSOR INFORMATION
<br />,OES YOUR ORGANIZATION OWN THIS SITE?: No
<br />F NO, LIST THE LESSOR:
<br />rinneapolis Motel Enterprises In
<br />.20l W Co Rd E
<br />\rden Hills MN 55112
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<br />,AME OF PROPERTY OWNER (WHEN NOT LESSOR)
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<br />;QUARE FEET PER MONTH: 56 AMOUNT PAID FOR RENT PER MONTH: lOOO .
<br />;QUARE FEET PER OCCASION: 0 .' AMOUNT PAID 'PER OCCASION: ". 0
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<br />',., d. .,t.: _.~BINGO ACTIYITY':,.'__/..;., "",;,,<,__,;;,,<,:~,:~~".i..~~~f:~:< ,..~.:
<br />;INGO IS CONDUCTED ON THIS PREMISES: No IF YES,' REFER 'TO INSTRUCTIONS, FOR,REQUIRED/ATTACHMENT
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<br />. , ' STORAG~ADi;RESS .;"::,,,::~:":':;;.~;:#'X;t: . '.
<br />,776 Connelly . .
<br />,rden Hills.MN 55112 h ',"'" ."" ,; ':f:i', ",
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<br /><osevills MN 55113. ' ":;:\"
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<br />,AMBLING BANK ,ACCOUNT NUMBER: 372000306
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<br />IN THE LINES PROVIDED BELOW LIST. THE NAME, ADDRESS AND'TITLE OF AT LEAST TWO PERSONS
<br />\UTHORIZED TO'SIGN CHECKS.AND MAKE ,DEPOSITS ,AND WITHDRAWALS FOR 'THE GAMBLING ACCOUNT,
<br />. ..
<br />:HE ORGANIZATION'S, ?~EASURER MAY NOT,.HANDLE GAMBLING' FUNDS, .
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<br />" ..,; ',; ". .. " . ,.,. (BE SURE TO COMPLETE,Tilll';Ii.EvERSEs'IDE :OF,THIS:'APPLIcATJ:ON) .
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<br />THIS FORM WILL BE MADE AVAILABLE .IN ALTERNATIVE FORMAT,C(:E JLARGE -PRINT ;"_BRAILLE:)'~upbN REQUEST
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