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1993_1011_packet
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1993_1011_packet
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10/13/2011 10:17:47 AM
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ALCKNOWLE <br /> OMOL P15E8 AUTRI ZATION <br /> I HEREBY GIVE CONSENT TO LOCAL LAW ENFORCE NT OFFICERS, THE GAMBLING CONTROL BOARDf OR AGENTS <br /> OF THE BOARDp OR THE COMMISSIONER OF REVEL OR PUBLIC SAFETYo, OR AGENTS OF THE HMISSIONERS, <br /> TO E'ETER THE PREMISES TO ENFORCE THE LAW O � <br /> BA'l11C REDS 11M ION <br /> THE GAMBLING CONTROL Bcum IS AuTHORIEED TO INSPECT THE BANE RECORDS OF THE GAMBLING ACCOUNT <br /> NEVER NECESSARY TO FULFILL REQUIRE NTS OF CURRENT GAMBLING RMAS AND STATUTES. <br /> 'r <br /> I DECLARE TENT t <br /> I HAVE READ TRIS APPLICATION AND ALL INFORMATION SUBMITTED TO THE GAMBLING CONTROL BOARD; <br /> * ALL INFORMATION IS TRUE] ACC MTE AND 00KPLZTZvel <br /> AM OTHER REQUIRED INPORMATION HAS BEEN FULLY DISCLOSED; <br /> I AN THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION; <br /> I ASSUME FULL RESPONSIBILITY FOR THE FAIR AND LAWFUL OPERATION OF ALL GAMBLING <br /> ACTIVITIES TO BE CONDUCTED; <br /> I WILL FMILIARI ZE MYSELF WITH THE LASTS OF KINNBSOTA GOVERNING LAWFUL GAMBLING AND RULES <br /> OF THE GAMBLING CONTROL HOARD AND AGREEr IF ISSUED A PREMISES FERNITj TO ABIDE THOSE LAWS <br /> AND RCS# INCLUDING AMENDMENTS TO THEM; <br /> ANY AGES IN APPLICATION INFORMATION WILL BE SUBMITTED TO THE GAMBLING CONTROL BOARD AND <br /> Z. <br /> LOCAI+ UNIT OF GOVERNMENT WITHIN TEN DAYS OF THE CHANGE; <br /> I UNDERSTAND THAT FAILURE TO PROVIDE REQUIRED INFORMATION OR PROVIDING- FALSE OR•ICISLEADING <br /> INFORMATION MAY RESULT IN THE DENIAL OR REVOCATION OF THE PREMISES PERMITS <br /> .r .. <br /> Sf GNA CRISIS EZE o"lczR DATE • r <br /> LOCAL GOVERNMENT <br /> 1.a TEiE CITY* MUST SIGN THIS APPLICATION Ilr THE GAMBLING PREMISES IS L chTED WITHIN CITY x <br /> LIMITS. <br /> a THE COUNTY** AND TOWNSHIP** MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES IS <br /> LOCATED WITHIN A TOWNSHIP <br /> 3a FOR TOWNSHIPat THAT ARE UNORGANIZED OR UNINCORPORATEDp THE COUNTY** IS REQUIRED TO ATTACH <br /> A LETTER TO THIS APPLICATION INDICATING THE TOWNSHIPS STATUS, <br /> S. THE LOCAL UNIT OF GOVERNMENT (CITY OR COUNTY) MUST PASS A RESOLUTION SPECIFICALLY <br /> APPP"%FING OR DENYING THIS APPLICATION. <br /> so A COPY OF THE twat. UNIT OF GOVERNMENT'S RESOLUTION APPROVING THIS APPLICATION DUST BE <br /> A ACHE'S TO THIS APPLI CATION-# <br /> $# IF THIS APPLICATION IS DENIED BY THE LOCAL UNIT OF GOVERNMENT, IT SHOULD NOT BE SCSI TTED <br /> TO THE GAMBLING CONTROL BOARD& <br /> C <br /> BY SIGNATURE BELOW TOWNSHIP RCENOWUDGZS THAT TSE ORGANIZATION IS APPLYING FOR A ®; <br /> PREMISES PERMIT WITHIN TOWNSHIP LIMITS <br /> . s <br /> r <br /> CITY* OR ** SHIP** <br /> r <br /> CITY OR t NAME T-NSHI P N r <br /> SIG BIOTURE OF PERSON RECEIVING APPLICATION <br /> TITLE DATE RECEDED TITLE DATE REC:EI D <br /> o 0% <br /> --]UiXL Toy <br /> 1711 W COUNT2 RD M — OU TE SOD S . . <br /> W $3113 <br />
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