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LG214 Minnesota Lawful Gambling Premise Permit Application - Part 2 ing Pr.:ent t es Ii%. jormathm Name of establishment where gambling will be conducted Venetian Inn Street Address (do not use a post office box number) 2814 Rice Street Little Canada MN Is the premises located within city limits? ® yes ❑ no City and County where gambling premises is located OR Township and County where gambling premises is located if outside of city limits City of Little Canada County of Ramsey Name and Address of Legal Owner of Premises City State Venetian Inn, Inc. 2814 Rice Street Little Canada MN 55117 Zp Code Does the organization own the building where the gambling will be conducted? ❑ YES ❑ NO NOTE: Organizations may not pay themselves rent they own the building or have a holding company. A letter must be sub - mitted showing rent payments as zero from gambling funds if the organization's holding company owns the premises. The letter must be signed by the chief executive officer.) If NO, attach the following: Rent: * a copy of the lease with terms for one year. * a copy of a sketch of the floor plan with dimensions, showing what portion is being leased. A lease and sketch are not required for Class D appiicantions. For gambling with bingo $ For gambling without bingo $ 600.00 Total square footage leased Total square footage leased 40 sq. ft. Address of storage space of gambling equipment Address City 2814 Rice Street Little Canada $+till InforxllatiotF ',. (each permitted gambling premises must have a separate checking account) Bank Name Bank Account Number State MN Zip code 55117 First Bank - Little Canada Bank Address 2850 Rice Street 051 - 1514329 City State Little Canada MN Zip Code 55113 Name, address, and title of persons authorized to sign checks and make deposits and withdrawals. Name Address ride Stefano Salute 2500 Morrison Street Little Canada MN C.E.O. Z. Lois Blomberg 132 Demont Ave. E. *341 St. Paul MN Gambling Manager Page 21