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<br />c ";;'.i,,,,-,,;;,,~o-,'O;;i'lC"-- ,"';'''' MfnnesotaLaw....1Gambllng --", .'___ "",
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<br />' ' -----' " ;;~remise Permit Application - Part 2 of 2 .-
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<br />&~k Na~ " ",., " . . Bank Account Number
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<br />Bank ddress CIty tate Zip I
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<br />board or agents of the board, or the commissIoner of .', ,tion of all activ~les to be conducted; " "
<br />revenue or public s~fety, or agent~ of the cornmiss~n'ers'.fwill iamiliarize myself with the laivs of Minnesota":'
<br />may enter the prem,ses to enforce the law. governing lawful gambling and rules of the board and
<br />Bank, Records Information agree, tllicensed. to abide by those laws and rules,
<br />, The bollrd is authorized to inspect the bank records of the including amendmentslo them;
<br />ga~?lingll.ccount whenever n~cessary to fuffill 'oanychanges i~application infClrl)1,ation will be suOO1il!ed
<br />requirements of current gambling rules and law. to the board and local un~ of government w~hln 10 days
<br />. Oa~h.,..., of the change; and '" ",
<br />1 declare that: . .1 understand that failure to provide required information
<br />01 have read this appiication and all iQformation submitted or providing false or misleading information may result in
<br />to the board is true, accurate and romp/ete; the denial or revocation of the license.
<br />oaU other required information has been fully disclosed;
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<br />Signat fe , f xe ulive officer Date
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<br />. * . .... '. 4. Aroovofthelocalunitofoovernment'sresolutionao-
<br />!. T~e cnY',f11~s.Is.lgn ~h's.a~llCa!lO~tl,th~ gambhngprem- orovino thisaoolication must be attached to this aoolicatio~.
<br />Ises IS located wnhln Clty limns ".,'.'.., , "" .<.'..... "'ed' " h' 10' 'I . 'f 'L' . t
<br />..-'. '.,; ,-- -~' '. C',-,' .,'.--." ", "':;":ic," ''';,,-.i.-.--,.' __ ,:-,' ,",'," ;',.". 5.11 th,s apphcatl~.n IS deD' . "bYJ e", ca ,un,t() .go\l.~r.~r:n.n ,
<br />.' .. 2. The COur'lty"*AND,townshlp*!must sign th,s aoohcat,on tl. ",""., ." "'.'" .--!-",' ' __ ..,"'c'. .....,." "~ ,__ "":".-
<br />p.", --," -- -- ;,"~ ".",., , ".,. -- ":'.", ." ", '".. ("Ai!..;' ';.f-\n~h!,~n?__t__~.~Ubmilled,tClt~e~~,~.b'-I~~ Ccint{oIBo~rdi <j-,'__":,,,/,{
<br />"...,-tk,. .,.the,gall1bIIQgPJ~I1)IS~s.ls,lOOated,\Vnhln,~,ow~s!J'p., '(,' ; ":',""'r-~...L...,...",.:.,,....,~_________.____,,-,o1\__'''''.~~..__~__~'&L\O::'..S-:, ,.;,_"._.
<br />,-- ., 3)"The IOc8.1 un~goiiernment (c;tyorcouhty) must p~sa':.r!'] 'To~n~hlp:; By'Sig~':;ure 'oeki,"y the tow.nship~m)wledges
<br />resoluti,'?!) ~p~if'9-lIy~pr'>reving,!r .de~Yir'g,m!s. a,ppl~t!()~:.. tliat llie oq;"-nizaiion is aPPlying' for a premises permit withi." '
<br />,: --, "," __ township limits.
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