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LG214 <br />(11/14/90) <br />Minnesota Lawful Gambling <br />Premise Permit Application - Part 1 <br />gOri zatiOni; r arrr rn <br />Legal Name of Organization <br />SF JosPrh'g Society fnr Charity, Inn <br />Business Address of Organization - Street or P. 0 Box (Do not use address of gambling manager) <br />2940 Rice Street <br />City State Zip Code <br />Little Canada MN 55113 <br />Name of chief executive officer (cannot be gambling manager) Title <br />Stefano Salute C.E.O. <br />Address of chief executive officer - Street or P.C. Box <br />2500 Morrison Street <br />City <br />Little Canada MN 55117 <br />FOR BOARD USE ONLY <br />FEE <br />CHECK <br />INITIALS <br />DATE <br />County <br />Ramsey <br />Business phone number <br />(612) 482 -1057 <br />Business phone number <br />(612) 482 -1057 <br />State <br />Zip Code <br />County <br />Ramsey <br />Class of Premise Permit Fee <br />❑ Class A — Bingo, Raffles, Paddlewheels, Tipboards, Pull -tabs $200 <br />El Class B— Raffles, Paddlewheels, Tipboards, Pull -tabs $125 <br />❑ Class C — Bingo only $100 <br />❑ Class D — Raffles only $75 <br />The class of premise permit <br />must be reflected by class of <br />the organization license. <br />Bingo Occasions <br />If class A or C, fill 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 />Status of Premise Permit - check one: <br />to <br />to <br />to <br />to <br />❑ New premise — Fill in base organization premise permit number <br />Et Renewal of existing premise permit — Fill in complete premise permit number B- 00465 -002 <br />❑ Previously expired premise permit — Fill in complete premise permit number <br />Page 20 <br />Bingo Occasions <br />If class A or C, fill 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 />Status of Premise Permit - check one: <br />to <br />to <br />to <br />to <br />❑ New premise — Fill in base organization premise permit number <br />Et Renewal of existing premise permit — Fill in complete premise permit number B- 00465 -002 <br />❑ Previously expired premise permit — Fill in complete premise permit number <br />Page 20 <br />