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State of Minnesota <br />Gambling Control Board <br />Premises Permit Renewal Application <br />LG214PPR Printed: 4/26/2001 <br />For Board Use Only <br />Amt. Pd <br />Check # <br />License Number:A- 01474 -003 Effective Date: 9/1/1999 <br />Expiration Date: 8/31/2001 <br />Name of Organization: Lake Owasso Residence SheFeuiew Vol Council <br />Gambling Premises Information <br />Name of the establishment where gambling will be conducted <br />Market Place Ctr <br />2900 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 />Market Place Ctr LLC <br />6440 Flying Cloud Dr #203 <br />Eden Prairie, MN 55344 <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 />t0; <br />238.3 q <br />Bingo Activity <br />Our records indicate that Bingo is not conducted on these premises. <br />vn�a That a- 0.jic_v 3`Io <br />ci900 fe;ee&tmee/ <br />Storage Information ;;,-,4 :,J <br />loam <br />an et. -0 e242#4 e-) <br />416n A; ff- /,e don act- ,C4 <br />US Bank of Little Canada <br />2850 Rice St <br />Little Canada, MN 55113 <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 />Bank Information <br />Gambling Bank <br />Account Number: 105115147321 <br />Name <br />Address <br />City, State, Zip Code <br />Title <br />.P <br />' 11Q SI it; l'ttaCa leaden ?4lfteeanad..mw <br />She seen namnnig4 <br />(,amIlw1/Ilaier-' <br />iStknhLeen <br />untie S'Ybratozit <br />a 3 QYls,aSt <br />464 ;65,4 /ilaVa /en <br />Arne] a. TA0moson <br />02175,e%et St. <br />lase 011ie /II 06% /S <br />wlprn4er <br />This form will be made available in alternative fon <br />(Be sure to complete the reverse side of this application) <br />Page 57 <br />Page 1 of 2 (Continued on Back) <br />