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East <br />LG214PPR PRINTED: <br />STATE OF MINNESOTA IFOR BOARD USE ONLY <br />GAMBLING CONTROL BOARD IAMT PAID <br />PREMISES PERMIT RENEWAL APPLICATION ICRECK NO. <br />IDATE <br />LICENSE NUMBER: A- 00393 -006 <br />EFFECTIVE DATE: 05/01/96 EXPIRATION DATE: 04/30/98 <br />NAME OF ORGANIZATION: Charity Plus Little Canada <br />GAMBLING PREMISES INFORMATION <br />NAME OF ESTABLISHMENT WHERE GAMBLING WILL BE CONDUCTED <br />Market Place Center <br />2900 N Rice St <br />Little Canada 55113 <br />COUNTY Ramsey IS THE PREMISES LOCATED WITHIN THE CITY LIMITS ?: Y <br />LESSOR INFORMATION <br />DOES YOUR ORGANIZATION OWN THIS SITE ?: No <br />IF NO, LIST THE LESSOR: <br />Market Place Ctr LLC <br />6440 Flying Cloud Dr #203 <br />Eden Prairie MN 55344 <br />NAME OF PROPERTY OWNER (WHEN NOT LESSOR): <br />SQUARE FEET PER MONTH: 0 AMOUNT PAID FOR RENT PER MONTH: 0 <br />SQUARE FEET PER OCCASION: 11208 AMOUNT PAID PER OCCASION: 238 <br />BINGO ACTIVITY <br />BINGO IS CONDUCTED ON THIS PREMISES: Yes IF YES, REFER TO INSTRUCTIONS FOR REQUIRED ATTACHMENT <br />STORAGE ADDRESS <br />55 E Co Rd B <br />Little Canada MN 55117 <br />BANK INFORMATION <br />Norwest Bank <br />1220 W Co Rd E <br />Arden Hills MN 55112 <br />GAMBLING BANK ACCOUNT NUMBER: 2100144 &5084444 74 & 2100662 <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 />Richard P <br />Of u u -. -u r. <br />H <br />IP <br />JoAnn M. Sherman 2442 N. Rice St. #53, Little Canada, MN 55113 Gambling Mot-. <br />J. Sook Kim <br />4284 Colleen Circle, Arden Hills, MN 55112 Director <br />(BE SURE TO COMPLETE THE REVERSE SIDE OF THIS APPLICATION) <br />THIS FORM WILL BE MADE AVAILABLE IN ALTERNATIVE FORMAT (I.E. LARGE PRINT, BRAILLE) UPON REQUEST <br />Page 52 <br />