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Page 2 of 2 <br /> Application for Exempt Permit - LG220 3198 <br /> Organization N <br /> ame Roseville Volunteer Fire Department Auxi liar Inc. <br /> Local Unit of Government Acknowledgment(Required by Statute) <br /> alt �Yth - the g m Hng V11813tIses is located In a�ahip, both <br /> t i .Y. ; - <br /> '# iq: n#t mhfp must al�gn thas application. <br /> :•..,ciaxx .M1-r.......•a..,a,i+.u:. .w•�iz:RCad:.r.. r• <br /> e this li #ion On behalf of the county, I acknowledge this application <br /> �n behalf of the city, I a�I�r1�Vl�ledg pP options for the county'. <br /> lions for the city: and three op <br /> and three � � . <br /> 1. Approve the application: Bar taking no action, the <br /> 1. Approve the application. By taic�ng no attic n, county allows the Board to issue a permit after 30 <br /> the city allows the Board to issue a permit after Waive the above-noted waiting period: The county <br /> s for�first class city. �. Vlfa� �#� <br /> 0 days (6o day allows the Board to issue a permit before 30 days. <br /> 2. waive the above-noted waiting period: The Docurnentabon attached. <br /> city allows the Board to issue a permit before 3. Deny the application by passing a resolution with <br /> 30 days(60 days for a first class city). Docu- 30 days. <br /> mentation attached. Print name of counter: <br /> 3. Deny the application by passing a resolution <br /> within 30 days (60 days for a frst.class oily). (Signature of county personnel receiving application) <br /> Print ame of city: <br /> � ��, .� �` Title <br /> Date <br /> (signature of city personnel receiving application) On behalf of the township, 1 acknowledge that the <br /> organization is applying for exempted gambling activity <br /> Tile within the township limits. <br /> Date_.? ! <br /> A township has no statutory authority to approve or deny <br /> an application (Minn. Stat. sec. 349.213, subd. 2). <br /> Print name of township: <br /> (signature-of township official acknowledging application) <br /> Title <br /> D ate. <br /> Chief Executive Vicar @a signature <br /> rName mabor+ provided in this application is complete and accurate to the best of my knowledge. <br /> p <br /> hi cutive officers signature <br /> ease print)- Date <br /> Mail P pl cation and Attachment(s) <br /> At least 45 days prior to your scheduled activity date send: <br /> the completed application; <br /> . a spy of your proof of nonprofit status, and �� Nl <br /> state of �n nesota r <br /> a b application fee (make check payable to Application fees are not prorated, <br /> , <br /> pp <br /> refundable, or transferable. <br /> Send to: Gambling control Board <br /> V11 west County Road B, suite 300 South <br /> Roseville, MN 55113 <br /> If your app <br /> iication has not been acknowledged by the local unit of government, do not send the application to the <br /> Gambling Control Board. <br />