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State of Minnesota For Board Use Onl <br />Gambling Control Board <br />Premises Permit Renewal Application Amt. Pd <br />Check # <br />LG2l4PPR Printed: 10/182001 <br />License Number: B-001 13-001 Effective Date: 3/1/2000 Expiration Date: 2/28/2002 <br />Name of Organization: American Legion Post 542 Roseville <br />Gamblin� Premises Information <br />Name of the establishment where gambling will be conducted <br />Rosetown American Legion <br />700WCoRdC <br />Roseville, MN 55113 <br />County: Ramsey <br />Note: Our records show the premises <br />is located within tlte city limits <br />Lessor Information <br />Bingo Activity <br />Our records indicate that Bingo is not conducted on these premises. <br />700WCoRdC <br />Roseville, MN 55113 <br />lst Star Roseville Bank <br />1445 W Co Rd B <br />Roseville, MN 55113 <br />Note: Our records indicate that the <br />organization owns this premises <br />Storage Information <br />Bank Information <br />Gambling Bank <br />Account Number: 096016765211095 <br />On the lines provided below list the name, address and title of at least two persons authorized to sign checks and make deposits and <br />withdrawals for the gambling account. The organization's treasurer may not handle gambling funds. <br />Name Address City, State, Zip Code Title <br />Kenneth Roy Edaburn 307 W Main St Belle Plaine, MN 56011 <br />�' GG.m�_Iir_G rnGr � <br />..,�kKrispin 332WCoRdB Roseville, MN 55113 <br />::�cd�N SS� �7`. c�um l� <br />„Iarl�I�isptn, 33�:.8�Rd-B <br />(Be suTe to complete the reverse side of this application) <br />This form will be made available in alternative format (ie. large print, braille) upon request Page 1 of 2(Continued on Back) <br />