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CG300 <br />(Rev. 1029/89) <br />Foe foe Dato <br />Chk Initial <br />licensers <br />Minnesota Lawful Gambling <br />Bingo Hall License Application - Part i <br />(See instructions for completion of this application) <br />Is this application for a new license, or a renewal? 0 New E Renewal <br />Bingo Hall Information <br />1. Name of bingo hall Bingo Hall Phone Countikwhere hall is located) <br />LITTLE CANADA BINGO HALL 612 ) 483 -1203 qri,ZeUr\ <br />Street address of hall City a Township where hall is located State ' 2ip code <br />2940 Rice Street N. Little Canada, <br />2. Mailing address of bingo hall City <br />2940 Rice Street N. Little Canada <br />MN 551'3 <br />State Zip code <br />MN 55113 <br />3. Is the bingo hall located within city limits? Yesi XI No 1 I <br />If 'No; indicate township in which bingo hall is located <br />Owner(s) Information (Attach additional sheets, if necessary) <br />4. Name of legal owner of bingo hall property <br />Tvtf1VP 1,s Warehouse Trio <br />Business Mailing Address City <br />2940 Rice Street N. Little Canada <br />Phone <br />(1 P 41w4 -29d1 <br />MN State 55113 <br />Sole proprietorship <br />Type of Business <br />Partnership r I Corporation <br />4a. Names of all owners, officers, directors, partners, and managers/supervisors <br />(each person named must fill out a separate Bingo Hall Personnel Information form, C3315) <br />a Thomas Short <br />Richard Manderfeld <br />c. <br />d. <br />0, <br />t. <br />g. <br />h. <br />lessors) Informlatlon (Attach additional sheets if necessary) <br />5. Name of lessor(s) Phone <br />—'"iTh(lo 04? ,.,i kW? O 1 't,c,i^_ (41(3) it? 3c3ci4\ <br />Mailing Address �.. n City ate ip C.ode <br />C4?yn 0 `'\ —41t(t O I /� ,3nnR r•Cio. ) 1111 \l 'SS /I <br />Type of Business <br />Sole proprietorship Partnership <br />x <br />Corporation <br />5a. Names of all owners, officers, directors, partners, and managers/supervisors <br />(each person named must fill out a separate Bingo Hall Personnel Information form, CG315) <br />a. 1 d. g. <br />co, lCli� 0..m Ct� ( (� <br />b. k t � .A10 /� 4k,R Pt' as tr e. h. <br />c. <br />Page 27 <br />