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08-28-2019 Workshop & Council packet
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08-28-2019 Workshop & Council packet
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MINNESOTA LAWFUL GAMBLING 6/15 Page 1 of 2 <br />LG214 Premises Permit Application Annual Fee $150 {NON-REFUNDABLE) <br />I REQIUIIRIED ATTACHM1ENTS TO' LG2ll41 1.If the premises is leased, attach a copy of your lease. Use LG215 Mail the application and required attachments to:Lease for Lawful Gambling Activity. Minnesota Gambling Control Board2. $150 annual premises pe1·mit fee, for each permit (non-refundable). 1711 West County Road B, Suite 300 South Make check payable to "State of Minnesota." Roseville, MN 55113 <br />Questions? Call 651-539-1900 and ask for Licensing. <br />ORGANJiZATJiON INFORMAli1i01N <br />Organization Name: Little Canada Recreation Association License Number: 34510 <br />Chief Executive Officer (CEO) Jon Joriman Daytime Phone: 651-324-1414 <br />Gambling Manager: Katie McGinnity Daytime Phone: 651-775-5993 <br />GAMBLING PREMISES INFORM IATION <br />Current name of site where gambling will be conducted: TNT Billiards <br />List any previous names for this location: <br />Street address where premises is located: 80 Little Canada Rd. Little Canada, MN 5117 5u}�(Do not use a P.O. box number or mailing address.) <br />City: OR Township:County: Zip Code: <br />Little Canada Ramsey 55117 Does your organization own the building where the gambling will be conducted? <br />Oves EJNo If no, attach LG215 Lease for Lawful Gambling Activity. <br />A lease is not required if only a raffle will be conducted. <br />Is any other organization conducting gambling at this site? Oves 0No □Don't know <br />Note: Bar bingo can only be conducted at a site where another form of lawful gambling is being conducted by the applying organi-zation or another permitted organization. Electronic games can only be conducted at a site where paper pull-tabs are played. <br />Has your organization previously conducted gambling at this site? Oves 0No □Don't know <br />GAMBUNG BANK ACCOU'lff INfORMlAl"ION; MUST BE [IN INIIINNESOTA <br />Bank Name: US Bank Bank Account Number: <br />Bank Street Address: 2850 Rice St. City: Little Canada State: MN Zip Code: 55113 <br />AUL TEMPORARY AND PIERMANIIENrli OFF-SITE Sl"ORAGIE S'PACIES Address (Do not use a P .0. box number): City: State: Zip Code: <br />2900 Rice St Little Canada MN 55113 -- <br />440 Little Canada Rd Little Canada MN 55117 -- <br />MN --
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