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M in.n.eso to mil.Cranib ling <br /> BI"ngo H I.II License Application (LG300) - Part <br /> .ti <br /> .. . , s corre�and comp fete ��the hest c�rn krtowlad�a ar�d l�eflef. ��ri11 far�iliari,�e rrtyself witf�the <br /> i declare that this a{�pl�cat�on� � <br /> laws of the state of Minnesola and roles of the Board regarding gambling and agree,if licensed, f o'abli e by those aws and <br /> .rules including amandrnenfs to them. Ch anges in the informa ticn s ubm tf ed in this appli6aflon will b e s ubmitf ed to tha Board <br /> -and local government unit whhin fen days aff er th a charge occurs. <br /> 9. Signature of chi I exe oudve officer of th e I as sor Date dame (please print) Title <br /> OBERT W, KRITTA <br /> Name of n completing this faun Tide - Phone <br /> ers <br /> � <br /> � f <br /> ROBERT KR2 TTY PRESIDENT <br /> fill <br /> 1. The city" must sign if the bingo ball is located whhin city limits. <br /> 2. The county'+ AND township*' must sign if the bingo hall is located within a township. <br /> I The local government (city or county)must pass a resolution specifically approving of denying the application. <br /> •4. A copy of the resolution approving the application must be attached to the application. <br /> 5. Areapplication which is denied by the local 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 /> bingo hall license within township limits. <br /> City* r County" <br /> Township" <br /> 11.City or county name 12. Township none <br /> CITY OF ROSEVILLE .� <br /> signa re f person receiving application � Signature of person receiving applic aU on <br /> t <br /> Title Date received Tide}Township official Date received <br /> f <br /> Name of person delivering application to l0 1 g vemment is township? organized unorganized unincorporated <br /> .ROBERT We KRITTA <br /> .d .49 ;.I iti•T?�:;ti l�•. s}- •.tirW.i- '-5.. ''. ar.• a <br /> *Form l_ 300, Bingo Hall License Application, Parts i and <br /> Form LG302, Bingo Hall Occasion List <br /> Form L 315, Bingo Hall Personnel Information (for each person listed in item and on form L 3 � <br /> Form L 316, Bingo Hall Affidavit, (for each person listed i n'rt ern 4 and.5 on form LG300) Jill <br /> r Check for license fee of$2,500, made payable to"State of Minnesota" A�Y.M.N.M.9-I P?..,V <br /> rr7.'�'h ' s *'" ,*:r ,.ti'{,:i}. {tir' •r}}s'r.•: �. • <br /> : .... .-:::-' <br /> --------- <br /> -•--. <br /> department of Gaming <br /> Garbling Control Board <br /> Rosewood Plaza South,3rd Floor <br /> 1711 W. County Road B <br /> Roseville, MN 55113 <br />