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<br />..;....,.,.;,-~.:.....- -~~," ......:...-.~_...............--..:........:..~~........;.. <br /> <br />.-.. . <br /> <br />..................:.. <br /> <br />Jf <br /> <br />East <br /> <br />STATB OF MINNIlSOTA <br />GAMBLING CONTROL BOARD <br />PREMISBS PBRMIT RKNKWAL APPLICATION <br /> <br />IFOR BOARD OSE <br />IAMT PAID <br />I CHECK NO. <br />I DATE <br /> <br />; <br /> <br />ONLyl <br />I <br />I <br />I <br /> <br />LG214PPR PRINTED: <br /> <br />LICENSE NUMBER: B-00102-002 <br /> <br />EFFECTIVE DATE: 02/01/97 <br /> <br />EXPIRATION DATE: 01/31/99 <br /> <br />NAME OF ORGANIZATION: American Legion Post 513 New Brighton <br /> <br />GAMBLING PREMISES INFORMATION <br /> <br />NAME OF ESTABLISHMENT WHERE GAMBLING WILL BE CONDUCTED <br />Am Legion Post 513 <br />400 old Hwy 8 <br />New Brighton 55112 <br /> <br />COUNTY Ramsey <br /> <br />IS THE PREMISES LOCATED WITHIN THE CITY LIMITS?: Y <br /> <br />LESSOR INFORMATION <br /> <br />DOES YOUR ORGANIZATION OWN THIS SITE?: Yes <br />IF NO, LIST THE LESSOR: <br /> <br />NAME OF PROPERTY OWNER (WHEN NOT LESSOR) : <br /> <br />o <br /> <br />AMOUNT PAID FOR RENT PER MONTH: <br />AMOUNT PAID PER OCCASION: <br /> <br />o <br />o <br /> <br />SQUARE FEET PER MONTH: <br />SQUARE FEET PER OCCASION: <br /> <br />o <br /> <br />BINGO ACTIVITY <br />BINGO IS CONDUCTED ON THIS PREMISES: No IF YES, REFER TO INSTRUCTIONS FOR REQUIRED ATTACHMENT <br /> <br />STORAGE ADDRESS <br /> <br />251 5th St NW <br />New Brighton MN 55112 <br /> <br />BANK INFORMATION <br /> <br />Firstar <br />Stinson Blvd << Lowry Ave <br />St Anthony MN 55418 <br /> <br />GAMBLING BANK ACCOUNT NUMBER: 0038148 <br /> <br />ON THE LINES PROVIDED BELOW LIST THE NAME, ADDRESS AND TITLE OF AT LEAST TWO PERSONS <br />AUTHORIZED TO SIGN CHECKS AND MAKE DEPOSITS AND WITHDRAWALS FOR THE GAMBLING ACCOUNT. <br />THE ORGANIZATION'S TREASURER MAY NOT HANDLE GAMBLING FUNDS. <br /> <br />~arvin Moe 1274 Imperial Lane New Briqhton, Mn 55112 Gamblina Manoer <br /> <br />)ouglas Anderson 13041 Filmore St. Blaine, Mn 55434 CEO <br /> <br />lerbert Higgins 4307 McLeod St. N.E. Mpl$., Mn 55421 Inventory Control <br /> <br />(BE SURE TO COMPLETE THE REVERSE SIDE OF THIS APPLICATION) <br /> <br />THIS FORM WILL BE MADE AVAILABLE IN ALTERNATIVE FORMAT (I.E. LARGE PRINT, BRAILLE) UPON REQUEST <br />