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MinnesotaLawful Gambling <br />LG214 Prem ises Perm it Application <br />(see RequiredAttachmentson Page 2) <br />FORBOARD USE ONLY <br />Check # $ <br />Organizationinformation <br />Organization name f,,�� ,r -�-.�,� Organization license number <br />fM1_�.f. .� �.' � i. •�� L�.• � r r r�v ��•"�:_ l�f /� 1�.�r �a'�� J�� � � [}—�i��hf � y }, " _ � :� 1 �� <br />Name of chief executive officer (CEO) � Daytime� p�ne number <br />� � �; i';�1 ��f'�� ,- � � � f�f '� r:�� —_ _.�,,,�, _ <br />Gambling premises information <br />; Name of establishment where gambling will be conducted Street address (do not use a P,p, box number) <br />� � ,�;,,,� -•-`".��.- `_� . ' CLc :+�'y ��r.'��1) � <br />�i� �r kor�r���IR county Zip code <br />,�: ' ` ; Z= 1i/ t �: G ��v, ���;�� 5 c`�`�. -- <br />Does your organization own the building where the gambling will be conducted? <br />�Yes �Vo I f no, attach LG215 Lease for Lawful Gambling Activity <br />Gambling bank account information <br />Bank name <br />Bank account number <br />6/03 <br />1 of 2 <br />��• , .1�;;�1vJ�_ -�.•fYr •• •—�� / _— — <br />Bankstreet address �� City � 5 SWte/Tip code <br />�� ' •� � � � �-�, ..� C f''{��= u �- — - - . �, <br />Address(es) of off-site storage space of gambling equipment related to this site <br />� (Do not use a P.O. box number) <br />Address City State/Zip code <br />�- _ f ,• ` � `?' , ��, ,"._..., '',,"� ��:-,= r_ � <br />Bingo occasions (including bar bingo) { <br />Enter day and beginning/ending hours of bingo occasions (indicate AM. or P.M� Pn occasion must be at least 1-1/2 <br />hours, not to exceed 4 hours. No more than 10 bingo occasions may be conducted per week <br />" r�G-� <br />, `' �� .• %'4 <br />� �OffY�FlOFFnr11C14H0 U q �1Y <br />� � . �- — � —_: . __ <br />� <br />� <br />�} <br />� <br />� <br />� <br />� <br />C� <br />�� � ��- <br />� <br />Noon hour bingo <br />Noon hour bingo must be conducted between 11:00 a.m. and ��4 p.m. on a leased premises which must have a <br />license for the sale of intoxicating beverages on the premises under chapter 340A. Check the day(s) that noon hour <br />bingo will be conducted. <br />I—Sunday Monday Tuesday Wednesday Thursday Friday Saturday <br />� <br />� <br />�-- — —� -- - — •v --- <br />