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<br /> ---.....--- <br /> Minnesota Lamful Gambling <br /> Bingo Hall License Application (LG300) - Part 2 <br /> . <br /> I declare that this application is correct and complete to the best 01 my knowledge and beliel. 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 to the Boara' <br /> and local government unit within ten days after the change occurs. <br /> 9. Sig lUre of chiel executive OIfiC2M" ~ Name (please print) Title <br /> ~. 0-- u.J ' ~~ ?;;.1. J..O<J1 -UJAL~L ?RC'i>'1>c><lT <br /> . Nam of person completing this form Title Phone <br /> /""OQ/e. u."IA L OS L- ?"lcs,'j)<--wT ( I, I~ 4lt J" ~ ;)4~ <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 locai government (city or county) must pass a resolution specifically approving or denying the appiication. - <br /> 4. A copy of the resolution approving the appiication must be attached to the application. <br /> 5. An application which is denied by the locai governing body shouid 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 hall license within township limits. <br /> City' or County" I Township" <br /> 11. City or county name 112. Town,h',p name <br /> IJ <br /> . <br /> Signature of person receiving application <br /> Date received Title - Township official Date received <br /> Is township? organized unorganized unincorporated <br /> D D D <br /> tt~!Ffi~~~~t~tllll!rlt'igmfgll;gqqi!1cI1Itl!iQ~~~f1if:ili~~1~\~~\~~~ili~ffifl~t~~~~~t1~ililt~ttM~1]~m\~]~flili~~ili*~i~\~~~t~*ilij!ji.~t\1~)~~~;i.t1~\1~ <br /> . Form LG300, Bingo Hall License Appiication, 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 LG316, Bingo Hall Affidavit, (for each person iisted in item 4 and 5 on form LG300) <br /> . Check for license fee of $2,500, made payable to "State of Minnesota" <br /> <br /> Department of Gaming <br /> Gambling Control Division <br /> Rosewood Plaza South, 3rd Floor <br /> 1711 W. County Road B <br /> Roseviiie, MN 55113 <br /> . <br /> - <br />