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� �� � • Minnesota Lawful Gambling
<br />�� C�G200R� Lawful Gambling License Renewal Application
<br />Corrections should be made directly on this application
<br />'• Submit one check for all renewal fces, payable to State of P9in�tespta
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<br />� Organization requir�ements: Current license term: 7/1/2004r.� �{30{�� �
<br />y 1. Pn annual or�anization i��er,se tee of �35o is reqU�red. Renewing license term: 7/1/2006 to 6/30/2008 j
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<br />Authorization: 2069 .�:r � Ch:+ckthisk�cifyaur .
<br />asga�SZation qaa4lfles for :
<br />Organization: �'S�, I nc (651)489-2595 I g��� ;
<br />2027 Rice St, Roseville, MN 55113 County of Ramsey I cfeflnec€ in MN Statute 1
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<br />Treasurer: Anthony C Jordan 4��� ����� , f� ������ �)��� �
<br />3754 Rustic PI, Shoreview, MN 55126 (651)482-9608
<br />�,nn�al Ca�l for �arlC��� ���trli��Cl�ns .� �. J _ � � — � I
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<br />Pr�emises permit requirements �� � �' � �
<br />�. An annual premises permitfee of $150,
<br />2. A separate resolution of approval including the site address from the local unit of govemment,
<br />governmentdoes not sign this renewal application) and
<br />3. A�.G�15 lease agreement for each site your orc�anization does not own_is required. _
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<br />(The local unit of �
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<br />Site num ber ��3 `� = �+�. t��s F,avr �F tY� �b� � b� ���aed � �tiG r�t ba raneM,+e� � : 'Boa�'d'us�d�� ;
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<br />Midway PraBo+t�l :_.._..........,,�
<br />1556 University Ave, St. Paul, MN 55104 Ramsey County
<br />�To�.�ap of tiF applicable) Gambling account # 2009181
<br />Organization owns this site: � Community National Bank
<br />Does your organization conduct bingo at this site? Y�ii ��Q�'+'� G� �� �r �os��e� MN �5113
<br />��� r`'e��1 I�Iti �f ����� ������� �%� ;'��Y�, the attached ffst of the days and beginning and ending hours of your ,
<br />. . . . . . . . . . bingo occasions must be u�ated_and returned. . . . . . . . . . �
<br />�� ��-s,-.•.. - - - .. . . . . . .
<br />Site number ��5 '� ����7� hAx If UiiS Yihr Itins p�� ���r�yL•'r�er,�.l ar t�,ll ��r r�� f���,�_
<br />01 Mexico
<br />1754 Lexinqton Ave, Roseville, MN 55113 Ramsey County
<br />�To�r:is:•ip of (if applicable) Gambling ��lil� � 2009181
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<br />Organization owns this site: � _ Community National Bank
<br />Does your organization conduct bingo at this site? Y,��._ ���� � Ca Rt� G Roseville, MN 55113
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<br />�� ��'� ��SO�1��f1 �f c��1'+��� a����l��? � � � : �IF �re� me a'tath,,ed �Lr rr rF.: ng,�a �,,� Frn��•��.,� an.� o„rr.�., x� �.,�.,.,.T ;
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<br />ni`�+� •�[fri�ts tri�sk L•r. i� i4erJ �Rd r�t�xr�ed.
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<br />Slt@ '� � ��I ' �; ��•t41lS�i41i�i4���n.is�}d�5+IdlbConkrfll�@d�n 5'ti:llra{i��n+�F� : 6Vsirtlilae�r;
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<br />Chalet Lounge
<br />1820 Rice S� Maplewood, MN 55113
<br />�Tvw�•zFcp of (if applicable)
<br />Or anization owns this site� �
<br />Ramsey County
<br />Gambling account # 2009181
<br />Commun�Ly Na�ionat Bank
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<br />Does your organization conduct bingo at �}�i� �I�e� �,� ���� � ea Rd C. Roseville, MN 55113
<br />I� �f7� r�solutior� �f a��'r�val ��p,��? Y�� : �i y�:,, lhle��t[#led II� �f khe �3,'S 31YJ ;�i:�� ar� o��r�a ���,�� s�t s�,�
<br />__ _ . . � _-___ •�' ootaslrx,� �sust �."� ar�l returszetl.
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