Laserfiche WebLink
<br />. <br /> <br />~\ <br />.\ <br />Min es' ta Lawful Gambling <br />Bin 0) all License Renewal Application - LG300 <br /> <br />Fee <br /> <br />. <br /> <br />Oleck # <br /> <br />Bingo Hall Information <br /> <br />License number: BH013 <br />Name of bingo hall: <br />DBA, if applicable: <br />Street address: <br />City, state or province, postal code: <br />Phone number (with area code): <br />Mailing address <br />(if different than above): <br /> <br />Type of Business <br />(sole proprietorship, partnership, corporation, limited liability company, firm): 50le Proprietorship <br /> <br />Minnesota Tax Identification Number: 1123411 <br /> <br />Effective date: 6/1/2001 <br /> <br />Expiration date: 5/31/2002 <br /> <br />Pot O'Gold <br /> <br />3776 Connelly <br />Arden Hills, MN 55112 <br /> <br />(651) 631-1724 Fax number (with area code): <br /> <br />Local Unit of Government Acknowledgment <br />If the gambling premises is within dty limits, the city <br />must sign this application: <br />On behalf of the city, I acknowledge that this application will <br />be forwarded to the appropriate city officials, the city must <br />pass a resolution specifically approving or denying this <br />appication, and a copy of the resolution will be forwarded to <br />. the appying organization. <br /> <br />Name of city: Arden Hills <br /> <br /> <br />1i~pe~~ffi~cation) <br /> <br />Ifthe gambling premises is located in a township, <br />both the county a nd township must sign this <br />application: <br />For the tnwnshiD: On behalf of the township, I <br />acknowledge, t1y this signature, awareness of this application <br />and that the township has no authority to deny or approve an <br />appication. <br /> <br />Name of township: <br /> <br />(Signature of township offidal acknowledging application) <br /> <br />Title <br /> <br />Date---1---1_ <br /> <br />TitleW j1LfJ#3vJl(J1L <br />DateD2./~ l:J j <br /> <br />For the county: On behalf of the county, I acknowledge <br />that this application will be forwarded to the appropriate <br />county offidals, the county must pass a resolution <br />specifically approving or denying this appication, and a copy <br />of the resolution will be forwarded to the applying <br />n"{1:=!oni7.-:ltinn. <br /> <br />POT 0' GOLD <br />~n6 CONNEllY AVE <br />ARDEN HillS, MN 5511 2 <br />(612)78;l-1 !!40 <br /> <br />'4864 <br /> <br />~~;ft!~.CJi~~~~ ~ <br /> <br />.'~.. .--"-,,'," ...--_.... <br />DATEO- -.l,,t(' -0 1 <br /> <br />15-511'91ll <br /> <br />$: (OJ) 210 <br />',_ ..1. '_,_ <br /> <br />- <br /> <br />. _-..0,-"'; <br />~OLLARS..I!.J.~..... <br /> <br /> <br />Fod~, <br /> <br />C~NTIlALBANK ' <br />.2210 FROf)fI"AGE ROAD WEST <br />STILlWATER.MN 55082 <br /> <br />""001.,'8(;1.,'11" I:Ol:j1.'lQSUI,I: <br /> <br />~~~.~d~OJ)-LAL <br /> <br />2'~1If 32 3"'111" <br /> <br />AI' <br /> <br />application. Your name ana aooress Win De pU[JI1[; mlUrrild~1U11 WIIl;:II lcu;;:I....... <br />by the Board. JIll the other informallon that you provide will be private data <br />