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Central STATE OF MINNESOTA IFOR BOARD USE ONLY] <br /> GAMBLING CONTROL BOARD IAMT PAID <br /> PREMISES PERMIT RENEWAL APPLICATION ICHECK NO. <br /> LG214PPR PRINTED: IDATE <br /> LICENSE NUMBER: C-02957-001 EFFECTIVE DATE: 06/01/96 EXPIRATION DATE: 05/31/98 <br /> NAME OF ORGANIZATION: American Legion Post 49 Aux Pequot Lakes <br /> GAMBLING PREMISES INFORMATION <br /> NAME OF ESTABLISHMENT WHERE GAMBLING WILL BE CONDUCTED <br /> Am Legion Post 49 <br /> 125 Main St E <br /> Pequot Lakes 56472 <br /> COUNTY Crow Wing IS THE PREMISES LOCATED WITHIN THE CITY LIMITS?: Y <br /> LESSOR INFORMATION <br /> DOES YOUR ORGANIZATION OWN THIS SITE?: No <br /> IF NO, LIST THE LESSOR: <br /> Am Legion Post 49 <br /> 125 E Main <br /> Pequot Lakes MN 56472 <br /> NAME OF PROPERTY OWNER (WHEN NOT LESSOR) : <br /> SQUARE FEET PER MONTH: 0 AMOUNT PAID FOR RENT PER MONTH: <br /> SQUARE FEET PER OCCASION. 4500 AMOUNT PAID PER OCCASION: (>c <br /> BINGO ACTIVITY <br /> BINGO IS CONDUCTED ON THIS PREMISES: Yes IF YES, REFER TO INSTRUCTIONS FOR REQUIRED ATTACHMENT <br /> STORAGE ADDRESS <br /> 125 E Main St <br /> Pequot Lakes MN 56472 <br /> v2 WE j BANK INFORMATION <br /> Nol., Natranal Bank <br /> Box 398 <br /> Pequot Lakes MN 56472 <br /> GAMBLING BANK ACCOUNT NUMBER: 101005399 <br /> ON THE LINES PROVIDED BELOW LIST THE NAME, ADDRESS AND TITLE OF AT LEAST TWO PERSONS <br /> AUTHORIZED TO SIGN CHECKS AND MAKE DEPOSITS AND WITHDRAWALS FOR THE GAMBLING ACCOUNT. <br /> THE ORGANIZATION'S TREASURER MAY NOT 77-7777 777_ING FU NDS. <br /> S _ /� ■ . //#46.0,#46.0, �C//J '/i , 4 i s-- 4/7z <br /> (BE SURE TO COMPLETE THE REVERSE SIDE OF THIS APPLICATION) <br /> THIS FORM WILL BE MADE AVAILABLE IN ALTERNATIVE FORMAT (I.E. LARGE PRINT, BRAILLE) UPON REQUEST <br />