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<br /> . <br /> Minnesota Lawful Gambling <br /> Bingo Hall License Application (LG300) . Part 2 <br /> . RJ."brBH[~If;~11flili;lili~ljrW4t'iliijffiil~lilit~!lil!i~11;iR\rfilf!ijlii!iilili~wiijlln~TI;;lt;~1~jf,!lilljliliJi!1\11jjjmiilItl11jli:l11tmfll@;illmiliilll;'il111iitililiiiliiiij;:j;jl~;i!lll;l[if:illlil.il <br /> I declare that this application is correct and complete to the best of my knowledge and belief. I will familiarize myself with the <br /> laws of the state of Minnesota and rules of the Board regarding gambling and agree, if licensed. to abide by those laws and <br /> rules, including amendments to them. Changes in the information submitted in this application will be submitted io the Board <br /> and local government unit within ten days after the change occurs. <br /> 9. Signature 01 chiet ecutive office of the lessor Date Name (please print) Title <br /> 9-9'- /f. ' <br /> 10, Name of person completing this form Ti~e Phone <br /> ( ) <br /> <br /> 1. The city' must sign if the bingo hall is located within city limits. <br /> 2. The county" AND township" must sign if the bingo hall is iocated within a township. <br /> 3. The iocal government (city or county) must pass a resolution specificaliy approving or denying the application. <br /> 4. A copy of the resolution approving the application must be attached to the application. <br /> 5. An application which is denied by the locai governing body should not be submitted to the Gambling Control Division. <br /> Township By signature below, the township <br /> acknowledges that the organization is applying for <br /> a bingo halllice'nse within townShip limits. <br /> C~' or Countv" Township" <br /> 11. City or county name 12. Township name <br /> . Signature of person receiving application Signature of person receiving application <br /> Title Date received Title ~ Township official Date received <br /> Name of person delivering application to local government Is township? organized unorganized unincorporated <br /> D D D <br /> f.!l!Ug!illm!~,)liftiii!llr.llm:;iqtl!rg.l{g~~m@1~.ttl11~llif~tt~WWf.i@ll~ilm~~][@t~~M~~!~~ln~l} <br /> . Form LG300, Bingo Hall License Application, Parts 1 and 2 <br /> . Form LG302, Bingo Hall Occasion List <br /> . Form LG315, Bingo Hall Personnel Information (for each person listed in item 4 and 5 on form LG300) <br /> . Form LGS16, Bingo Hall Affidavit, (for each person ilsted in item 4 and 5 on form LG300) <br /> . Check for license fee of $2,500, made payable to "Slate of Minnesota" <br /> ~""l.1lf.E~1_I~q{i~m:.~%!gg~'If.lgi\1I~~1%.f$.!11iljlI11[!1!~~!111~!&;;&i!11\.1~fl111 <br /> Department of Gaming <br /> Gambling Control Division <br /> Rosewood Plaza South, Srd Floor <br /> 1711 W. County Road B <br /> Roseville. MN 55113 <br /> . <br />