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<br />t\',J\I~fr P\ .- '/2- <br />. . <br /> <br />~a"st <br /> <br />STATE OF MINNESOTA <br />GAMBLING CONTROL BOARD <br />PREMISES PERMIT RENEWAL APPLICATION <br /> <br />IFOR BOARD USE <br />IAMT PAID <br />ICRECK NO. <br />I DATE <br /> <br />ONLY I <br />I <br />I <br />. <br /> <br />,G214PPR PRINTED: <br /> <br />.ICENSE NUMBER: B-03162-003 <br /> <br />EFFECTIVE DATE: 08/01/97 <br /> <br />EXPIRATION DATE: 07/31/99 <br /> <br />lAME OF ORGANIZATION: American Business Womens Chapt Lady Slipper Rosevi11e <br /> <br />GAMBLING PREMISES INFORMATION <br /> <br />lAME OF ESTABLISHMENT WHERE GAMBLING WILL BE CONDUCTED <br />r1ahertys Arden Bowl <br />L273 W Co Rd E <br />lrden Hills 55112 <br /> <br />:OUNTY Ramsey <br /> <br />IS THE PREMISES LOCATED WITHIN THE CITY LIMITS?: Y <br /> <br />LESSOR INFORMATION <br /> <br />)OES YOUR ORGANIZATION OWN THIS SITE?: No <br />[1' NO, LIST THE LESSOR: <br />r1ahertys Arden Bowl Inc <br />l273 W Co Rd E <br />,cden Hills MN 55112 <br /> <br />~AME OF PROPERTY OWNER (WHEN NOT LESSOR) : <br /> <br />o <br /> <br />AMOUNT PAID FOR RENT PER MONTH: 1000 <br />AMOUNT PAID PER OCCASION: 0 <br /> <br />3QUARE FEET PER MONTH: <br />3QUARE FEET PER OCCASION: <br /> <br />28 <br /> <br />BINGO ACTIVITY <br />BINGO IS CONDUCTED ON THIS PREMISES: No IF YES, REFER TO INSTRUCTIONS FOR REQUIRED ATTACHMENT <br /> <br />1525 Alameda St <br />at paul MN 55117 <br /> <br />& <br /> <br />P Damman <br />Route 4 Box 86 <br />Pine City MN 55063 <br /> <br />STORAGE ADDRESS <br /> <br />BANK INFORMATION <br /> <br />!lorwest Bank Minnesota <br />1220 W Co Rd E <br />~rden Hills MN 55112 <br /> <br />GAMBLING BANK ACCOUNT NUMBER: 3528255745 <br /> <br />ON THE LINES PROVIDED BELOW LIST THE NAME, ADDRESS AND TITLE OF AT LEAST TWO PERSONS <br />AUTHORIZED TO SIGN CHECKS AND MAKE DEPOSITS AND WITHDRAWALS FOR THE GAMBLING ACCOUNT. <br />THE ORGANIZATION'S TREASURER MAY NOT Hl\NDLE GAMBLING FUNDS. <br /> <br />Debra Burchett 632 Redwood Lane New Brighton MN 55112 President <br /> <br />\ . <br /> <br />Marlyn Damman <br /> <br />2700 N Dale #208 Roseville MN 55113 <br /> <br />Gamblinq Manaqer <br /> <br />Sharon Sibell <br /> <br />5043 Madison NE <br /> <br />Mpls. MN 5542} <br /> <br />Asst.. Manaqer <br /> <br />. <br /> <br />(BE SURE TO COMPLETE THE REVERSE SIDE OF THIS APPLICATION) <br /> <br />THIS FORM WILL BE MADE AVAILABLE IN ALTERNATIVE FORMAT (I.E. LARGE PRINT, BRAILLE) UPON REQUEST <br />