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East <br />LG214PPR PRINTED: <br />STATE OF MINNESOTA (FOR BOARD USE ONLY <br />GAMBLING CONTROL BOARD AMT PAID <br />PREMISES PERMIT RENEWAL APPLICATION !CHECK NO. <br />DATE <br />LICENSE NUMBER: B- 00393 -003 <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 />Bradys <br />2500 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 />Bradys Inc <br />2612 Edgerton St <br />Little Canada MN 55113 <br />NAME OF PROPERTY OWNER (WHEN NOT LESSOR): <br />SQUARE FEET PER MONTH: 36 AMOUNT PAID FOR RENT PER MONTH: 600 <br />SQUARE FEET PER OCCASION: 0 AMOUNT PAID PER OCCASION: 0 <br />BINGO ACTIVITY <br />BINGO IS CONDUCTED ON THIS PREMISES: No 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 -Arden Hills <br />1220 W Co Rd E <br />Arden Hills MN 55112 <br />GAMBLING BANK ACCOUNT NUMBER: 2100160&3?58Z0306 <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 Pillsbury 4200 MrManainy Rd Vad -axis Rni.ghts, MAT _5127 ProQ -Lent <br />JoAnn M. Sherman 2442 Rice St. *53, Little Canada, MN 55113 GAMBLING Mgr. <br />J. Sook Kim 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 61 <br />