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1.0214 <br />(9/3/901 <br />Minnesota Lawful Gambling <br />Premise Permit Application - Part 1 <br />y.... M. MNY. 1NH .pN)>M'^ ^!.W!.H!1M..^^....J:�. i.: n:,,�< ^. <br />Qr SII�Za' t FT1.�4ffiat'iO <br />FOR BOARD USE ONL: <br />FEE <br />CHECK <br />INITIALS <br />DATE <br />Legal Name at Orgamzanan <br />Little Canada Charity Plus Tnr <br />Business Address of Crganizaton - Street or P. 0 Box (Do not use address of gambling manager) <br />2940 Rice Street <br />City <br />Little Canada <br />Name of dfief executive officer (cannot be gambling manager) Title <br />Celeste Houle C.E.O. <br />State <br />MN <br />Zip Code County Business phone number <br />55113 Ramsey 612) 482-0733 <br />Business phone number <br />612 482 -0733 <br />( <br />Address of chief executive officer - Street er P. 0. Box <br />1970 Case Street <br />City <br />St. Paul <br />State <br />MN <br />Zip Code County <br />55119 Ramsey <br />Class of Premise Permit <br />❑ Class A— Bingo, Raffles, Paddlewheels, Tipboards, Pull -tabs' <br />® Class 8 — Raffles, Paddlewheels, Tipboards, Pull -tabs <br />❑ Class C— Bingo only <br />❑ Class 0 — Raffles only <br />Bingo Occasions <br />If class A or C. tart in days and beginning and ending hours of bingo occasions: <br />No more than seven bingo occasions may be conducted by an organization per week. <br />Day Beginning/Ending Hours Day Beginning/Ending Hours Day Beginning /Ending Hours <br />to <br />to <br />to <br />to <br />to <br />to <br />to <br />Status of Premise Permit - check one <br />❑ New premise — Fill in base organization premise permit number <br />E Renewal of existing premise permit — Fill in conolete premise permit number}3 -00 393 -003 <br />❑ Previously expired premise permit — Fil in;amolete premise permit number <br />Page 11 <br />The class of premise penult <br />must .be reflected by class of <br />the organization license. <br />Bingo Occasions <br />If class A or C. tart in days and beginning and ending hours of bingo occasions: <br />No more than seven bingo occasions may be conducted by an organization per week. <br />Day Beginning/Ending Hours Day Beginning/Ending Hours Day Beginning /Ending Hours <br />to <br />to <br />to <br />to <br />to <br />to <br />to <br />Status of Premise Permit - check one <br />❑ New premise — Fill in base organization premise permit number <br />E Renewal of existing premise permit — Fill in conolete premise permit number}3 -00 393 -003 <br />❑ Previously expired premise permit — Fil in;amolete premise permit number <br />Page 11 <br />