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East <br />LG214PPR PRINTED: <br />STATE OF MINNESOTA <br />GAMBLING CONTROL BOARD <br />PREMISES PERMIT RENEWAL APPLICATION <br />FOR BOARD USE ONLY <br />AMT PAID <br />CHECK NO. <br />IDATE <br />-- .LICENSE NUMBER: D- 01878 -008 <br />EFFECTIVE DATE: 04/01/96 EXPIRATION DATE: 03/31/98 <br />NAME OF ORGANIZATION: Lions St Paul North Ramsey 500th Club <br />GAMBLING PREMISES INFORMATION <br />NAME OF ESTABLISHMENT WHERE GAMBLING WILL BE CONDUCTED <br />Venetian Inn <br />2814 Rice St <br />Little Canada 55117 <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 />Venetian Inn <br />2814 Rice St <br />Little Canada MN 55117 <br />NAME OF PROPERTY OWNER (WHEN NOT LESSOR): <br />Pascal Vitale <br />SQUARE FEET PER MONTH: <br />SQUARE FEET PER OCCASION: <br />0 AMOUNT PAID FOR RENT PER MONTH: <br />0 AMOUNT PAID PER OCCASION: <br />BINGO ACTIVITY <br />BINGO IS CONDUCTED ON THIS PREMISES: No IF YES, REFER TO INSTRUCTIONS FOR REQUIRED ATTACHMENT <br />/LA4JcI I 4%/jr" �` STORAGE ADDRESS <br />365 Koehler Rd �/ O tn <br />, ,c1( , 4 14G'/ et <br />Vadnais Hgts MN 55127 /� <br />BANK INFORMATION <br />i`c,/ <br />/00 w< e <br />.w. . 'Tye✓ 557/7- /93/ <br />GAMBLING BANK ACCOUNT NUMBER: [OTCO4l6. <br />& g& -i 4193 °y <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 />(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 118 <br />