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CCP 02-14-2000
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CCP 02-14-2000
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<br />STATE OF MINNESOTA <br />GAMBLING CONTROL BOARD <br />RENEWAL APPLICATION FOR <br />BINGO HALL LICENSE - LG300 <br /> <br />. <br /> <br />PRINTED:12/09/99 <br />LICENSE NUMBER: BH013 <br /> <br />NAME OF APPLICANT: Pot O'GoId <br /> <br />OATH <br />I declare that this application is correct and complete to the best of my knowledge and belief. <br /> <br />I will familiarize myself with the laws of the State of Minnesota and Rules of the Board governing <br />gambling and agree, if licensed, to abide by those laws and rules, including amendments to them. <br /> <br />I declare that I am qualified under the terms of Minnesota Rules 7862.0010, Subp 3 to be licensed as <br />a bingo hall and will abide by the restrictions set forth in Minnesota Rules 7862.0010, Subp 4. <br /> <br />I declare that any lease agreements between the bingo hall licensee and lawful gambling <br />organizations will specifically identify any goods or services that the organization is <br />required to purchase from the lessor or a third PartY. vendor, and that all goods and <br />services furnished as part of the lease agreement will be valued at their fair market value. <br /> <br />Changes in the information submitted in this application will be submitted in writing to <br />the Board and local unit of government within ten (10) days after the change occurs. <br /> <br />/IoiJ~ ~ J( ~ ~-I"'~ <br /> <br />Signature of the Chief Executive Officer <br /> <br />. <br /> <br />/ - I X - ~ 000 <br /> <br />Date Signed <br /> <br />Reouired Attachments <br /> <br />.j LG302, Bingo Hall Occasion List; <br />.j LG315, Bingo Hall Personnel Information; <br />.j Loca1 Unit of Government resolution of approval; and <br />.j License Renewal application fee of $2,500. Make Checks payable to "State of Minnesota". <br />(Fees are considered earned and are not prorated or transferable.) <br /> <br />Mail application and attachments to: <br />Gambling Control Board <br />Suite 300 S <br />1711 W. County Road B <br />Roseville, MN 55113 <br /> <br />Allow eight weeks for application processing <br /> <br />This publication will be made available in alternative format (Le. large print, Braille) upon request. <br /> <br />Hearing impaired individuals using a TIY may call the Minnesota Relay Service at 1-800-627-3529. <br /> <br />The infonnation requested on this fonn (including any attachments) will be used by the Gambling Control Board (GCB) to dctcnnine your e <br />qualifications to be involved in lawful gambling activities in Minnesota, and to assist the GCB in conducting a background investigation of you. <br />You have the right to refuse to supply the information requested; however, if you refuse to supply this infonnation. the OeB may not be able to <br />determine your qualifications and, as a consequence, may refuse to issue you a license. If you supply the infonnation requested, the GeB will <br />be able to process your application. <br />
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