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01/08/031 WED Oi 81:4,81 FAX 612 626, 9624 U OF X GEN COUNSEL,
<br />Check, the actilion that
<br />I
<br />the cl�ity, is takIng on thisi app�l�i'caition.1
<br />The cHY1 approves the appilicaition with nio
<br />waffing perliod.
<br />Check the action that
<br />1101
<br />the, county Is takIII o' on thm applicaticon.
<br />di
<br />This county approves the� apprjration with n�o
<br />WaKing ped'i
<br />loves te apcon wiia 0 e es alawa i waitin g pe�Niodi, andiallows the B'olaird to issue a U
<br />permit after, 30 daiys (60 dallys for a first claim; waftling perii and allows the, Board to Issuile a
<br />Permit aftler 30 daysR
<br />cilt Y)di
<br />0 T'h�ei city, deinil�es, the appillication.
<br />Pdnt na�ma of ci�ty
<br />LThei county denles the applocat,
<br />i loin P
<br />Print name, of county
<br />(Signature of county person nel'rec elvin
<br />9 applicaiticin)
<br />Title
<br />TOWNSHIP: On behalf of' the townuhip, I acknowleldge that
<br />1he organIzatlon IS dippVnig for exempted gann,brol g activity
<br />within the township, limits, [A tovimshilp has no, statutory
<br />authoedy, to, approve or dlany an applicattion (Minn. $tat. sec.
<br />3,4 9.2 11 3', su bid 1, 2).]
<br />P in,
<br />ip' I name of `township,
<br />(SQnature of townsihipi offiCial ackn'awiledging applicaVion)
<br />Title
<br />lei
<br />Chief Elixecutivia Officel's Sligna,tuir►
<br />The inforrinsitil a
<br />on provided in thi's ai,ppi is cornple� "(5wratel to the best qf my knowledgei,,
<br />.....................
<br />Wmi
<br />Ait least 4,5'dlays, pzior to, your scheduladecWh/ date send:
<br />t'hell Completed application,,
<br />a copy of your proof ofnionprofit sta,t�us, and
<br />a $25 application, feile (Maike cheick pla,yable to "State of M'j I ninesotall).
<br />I refundable, or
<br />APPillication fees are not, Prorated, transferable,
<br />Sand tio- Gaitinbill"Ing Control Boardi
<br />1711 WOiSit Countyi Road 131, Suite 30o South
<br />Roseville, MNI $15113
<br />If youri 6PPlication has not,
<br />been acknowledged bylthe
<br />local unit of golveirn,men�t', or
<br />has been denied, do not
<br />uend the 3PPRICaffon to the
<br />Gambruig Control Board,
<br />
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