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State of Minnesota For Board Use Only <br /> Gambling Control Board <br /> Premises Permit Renewal Application Amt. Pd <br /> Check# <br /> ,G214PPR Printed: 11/2/2001 <br /> License Number:A-02957-001 Effective Date: 6/1/2000 Expiration Date:5/31/2002 <br /> Name of Organization: American Legion Post 49 Aux Pequot Lakes <br /> Gambling Premises Information <br /> Name of the establishment where gambling will be conducted <br /> American Legion Post Note: Our records show the premises <br /> 4435 Main St is located within the city limits <br /> Pequot Lakes, MN 56472 <br /> County: Crow Wing <br /> Lessor Information <br /> Name of the property owner(If different): Square footage leased per month: <br /> Rent paid per month: <br /> Square footage leased per bingo occasion: <br /> Rent paid per bingo occasion: <br /> Bingo Activity <br /> Our records indicate that Bingo is conducted on these premises. Please refer to the instructions for required at <br /> Storage Information <br /> 125 E Main St <br /> Pequot Lakes, MN 56472 <br /> Bank Information <br /> Norwest Gambling Bank <br /> Box 398 Account Number: 101005399 <br /> Pequot Lakes,MN 56472 <br /> On the lines provided below list the name, address and title of at least two persons authorized to sign checks and make deposits and <br /> withdrawals for the gambling account. The organization's treasurer may not handle gambling funds. <br /> Name Address City, State, Zip Code Title <br /> Sharon Higgins 29700 Lakeshore Dr Breezy Point,MN 56472 <br /> Beverly Williams 31132 Co Rd 121 Pequot Lakes,MN 56472 <br /> (Be sure to complete the reverse side of this application) <br /> This form will be made available in alternative format(ie.large print,braille)upon request. Page 1 of 2 (Continued on Back) <br />