Laserfiche WebLink
LG214PPR Printed: 9/5/20()1 <br />License Number�-00330-001 <br />Name of Organization: B-Dale Club <br />State of Minnesota <br />Gambling Control Soard <br />Premises Permit Renewal Application <br />Effective Date: 4/12000 <br />Gambling Premises Information <br />Name of the establishment where gambling will be conducted <br />B Dale 1�Tens Club <br />2100 N Dale St <br />Roseville, MN 55113 <br />County: Ramsey <br />For Board Use O <br />Amt Pd <br />Check # <br />Expiration Date: 3/31/Z002 <br />Note: Our records show the premises <br />is located within the city limits <br />Lessor Information <br />Blri,�O E�Ct1Vl�j' <br />Our records indicate that Bingo is not conducted on these premises. <br />2100 N Dale St <br />Roseville, MN 55113 <br />Western Bank <br />Box 64689 <br />St. Paul, MN 55164 <br />Note: Our records indicate that the <br />organization owns this premises <br />Storage Information <br />Bank Information <br />Gambling Bank <br />Account Number: 4036414 <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 far the gambling account The organization's treasurer may not handle gambling funds. <br />Name Address City, State, Zip Code Tifle <br />Beth Jane Linebarger 1487 St. Albans St St. Paul, MN 55117 ��"� ���+bc� <br />Ac�ene��ofmso 1798 Seiby Ave St. Paul, MN 55104 <br />Z <br />Denny 213 Grandview Ave W Roseville, MN 55113 '� i��s "�"� <br />43 �- <br />(Be sure 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 />