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<br />I - <br /> <br />License Number: 3800 <br />License Expiration: 9/30/2008 <br /> <br />Premises permit requirements: <br />1. An premises permit fee of $150 paid annually, <br />2. A separate resolution of approval, which includes the site address, from the local government (city or county) is <br />required. The local government does not sign this license renewal application. <br /> <br />Site # 001 <br />Blacksmith Lounge <br />17205 N Forest Blvd, <br /> <br />Check this box if this site has been discontinued or will not be renewed. <br /> <br />Gambling account # 3011821 <br />Mainstreet Bank <br />1650 5 Lake St, Forest Lake, MN 55025 <br />Organization owns this site: N (If no, A lG215 leas}'\greement is required.) <br />The local resolution of approval is attached? Y IQ!) (If no, fax the resolution from the city or county to us prior to expiration) <br />Does your organization conduct bingo at this site? Y jI~If yes, include the days and hours) <br /> <br />Hugo, MN 55038 <br /> <br />Washington County <br /> <br />Site # 008 <br />Trio Inn <br />7082 Centerville Rd, Centerville, MN 55038 <br /> <br />Check this box <br /> <br /> <br />Anoka County <br /> <br />Gambling account # 3011821 <br />Mainstreet Bank <br />1650 SLake St, Forest Lake, MN 55025 <br /> <br />Organization owns this site: N (If no, A lG215 lease agreement is required.) <br />The local resolution of approval is attached? Y I@ (If no, fax the resolution from the city or county to us prior to expiration) <br />Does your organization conduct bingo at this site? Y ,@If yes, include the days and hours) <br /> <br />Site # 012 <br />Wiseguys Pizza & Pub <br />7095 20th Ave 5, Centerville, MN 55038 <br /> <br />Check this box if this site has been discontinued or will not be renewed. <br /> <br />Anoka County <br /> <br />Gambling account #3011821 <br />Mainstreet Bank <br />1650 SLake St, Forest Lake, MN 55025 <br /> <br />Organization owns this site: N (If no, A lG215 lease agreement is required.) <br />The local resolution of approval is attached? Y I@ (If no, fax the resolution from the city or county to us prior to expiration) <br />Does your organization conduct bingo at this site? Y I€!)If yes, include the days and hours) <br /> <br />Site # 015 <br />Sagers Bar N Grill <br />7098 Centerville Rd, Centerville, MN 55038 <br /> <br />Check this box if this site has been discontinued or will not be renewed. <br /> <br />Anoka County <br /> <br />Gambling account # 3011821 <br />Mainstreet Bank <br />1650 SLake St, Forest Lake, MN 55025 <br /> <br />Organization owns this site: N (If no, A lG215 lease agreement is required.) <br />The local resolution of approval is attached? Y I@ (If no, fax the resolution from the city or county to us prior to expiration) <br />Does your organization conduct bingo at this site~If yes, include the days and hours) <br />_~.~~__~_. _._..__ _~__~ .~___.___ ____________~_______ -"~f~~_~-- .t.__~~-- <br /> <br />;J) <br />