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00IT-A-TH OF MINNESOTA JFOR BOARD USE ONLY <br />GAMBLING CONTROL O' Di JAMT PAID <br />PREMISES PERMIT RENEWAL APPLICATION CHECK NO <br />LG214PPFD PRINTED, DATE <br />... . ......... . .. —",....... .�-�-�.�.�.�.�. "".�.�.�.� . ....................... ...... ............. 111111-111111-'.. . ..... . .............................................. <br />LICENSE NUMBER: B-00,113-001 EFFECTIVE DATE: 03/01/96' EXPIRATION DATE: 02/29/98 <br />........ . . .... ...... 1111111��"""," . ............ .............. . . .... .............. . . .. . ....... ­..'',­ . . .... . .................. . ... ... ... ... ... ............................ <br />NAME OF' ORGANIZATION: American Legion Post 542 Ralneville <br />. ...... . .. . . . . ....... . . . .................. . <br />GAXBLING PREMISES INFORMATION <br />HAME OF' ESTABLISHMENT WHERE GAMBLING WILL BE CONDUCTED <br />Am Legion Polo t 542 <br />70 0 N' Co Rd C <br />Roseville 5 5113 <br />COWTY R,ama ey IS THE PREMISES LOCATED, WITHIN THE' CITY LIMITS.. Y <br />LESSOR INFORMATlIO14 <br />DOES, YOUR, ORGANIZATION OWN THIS SITE) Yen <br />IF NOt LIST THE' LESSOR-. <br />NAME OF PROPERTY OWNER (WHEN NOT' LESSOR).- <br />1 t Star 'Roseville Blank <br />1445 W Co Rd 8 <br />Roseville NN 55113 <br />GAMBLING BANK ACCOUNT NMT3FR: 096016765211095 <br />ON THS LINIg PROVIDED SELON LIST' THE NAME, ADDRESS AND TITLE <br />OF' AT LEAST <br />77WO PERSONS <br />AUTHORIZED, TO SIGN <br />CRECK,S AND MAKE DEPOSIT'S <br />AND WITHDRAWALS <br />FOR THE GAMBLING ACCOUNT. <br />THE ORGANIZATIONIS <br />TREASURER MAY NOT' HAMLE <br />GAMBLING <br />FUNDS, <br />140 ti I Al M�i <br />p <br />(BE SURE TO COMPILETE THE REVERSE SIDR OF THIS APPLICATION) <br />I <br />T TIVE FORMAT' (I.E.i LARGE PRINTo BRAILLE) UPON <br />