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Gambling Control Board <br />Premises Permit Renewal Application <br />LG214PPR Printed: 3/512001. <br />Amc. Pd <br />Check d <br />Date <br />License Number3-00864 -003 <br />Effective Date: 8/1/1999 Expiration Date: 7/31/2001 <br />Name of Organization: Fire Little Canada Vol r^ ^ire Dept. <br />Gambling Premises Information <br />Name of the establishment where gambling will be conducted <br />Hoggsbreath Bar & Restaurant <br />2504 N Rice St <br />Little Canada,MN 55113 <br />County: Ramsey <br />Note: Our records show the premises <br />is located within the city limits <br />Hoggsbreath Enterprises Inc <br />2504 N Rice St <br />Little Canada, MIN 55113 <br />Name of the property owner (If different): <br />Lessor Information <br />Square footage leased per month: <br />Rent paid per month: <br />Square footage leased per bingo occasion: <br />Rent paid per bingo occasion: <br />24 <br />1,000 <br />Bingo Activity <br />Our records indicate that Bingo is not conducted on these premises. <br />Storage Information <br />325 E. Little Canada Rd. <br />Little Canada, Mn. 55117 <br />2504 Rice St. <br />Little Canada, Mn. 55113 <br />Bank Information <br />Firstar Sank of MINNESOTA, N.A. Gambling Bank <br />St. Paul, MN. 55101 <br />ARDEN HILLS OFFICE <br />On the lines provided below list the name, address and title of at least two persons authorized to sign checks and make deposits <br />and withdrawals for the gambling account. The organization's treasurer may not handle gambling funds. <br />Account Number: 173442 771. <br />ess City, State, Zip Code <br />Title <br />Robert G. Johnson <br />2442 <br />Rice St. <br />*178 <br />Little Canada,MN <br />Gambling Manage_ <br />55113 <br />Jim Morelan <br />451 <br />Eli Rd. <br />Little Canada,MN <br />CEO /Fire Chief <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 <br />Page 64 <br />Page 1 of 2 (Continued on Back) <br />