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1992_0928_packet
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1992_0928_packet
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10/28/2011 11:24:01 AM
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M 9 Vi <br />innesota Lawful Gxambltng <br />Bingo H License Application (LG300) a. Part 2 <br />. . . . . . . . . . ... .. <br />Ill Inn <br />I declarel that this application is coffectl and complete to the best of my kinowlOdge and belief. I will f mifia yseff with the <br />laws of the state of Minnesota and rules of the Board' regarding gambling and agree, if licensed, to abide by those laws and <br />t* n submitted' in this pli <br />apcation will be submitted to the Board <br />rules, including menft h i <br />ients to tlem. Changes n the infOn-na to <br />and ADicalgovemment unit within ton, days after thile change =urs'. <br />9. Signat W <br />ure of ell! exu <br />ecfi ve offloer I the, lessor Date Name (please pdnt) its <br />ROBE�RT ROSENTHAL PRESIDENT <br />10. Name of person complefing this form Tide - Plihone . <br />ON <br />",:fir.," <br />, <br />;nmmmm <br />gi gg W <br />- - WIN <br />1. The city* must sign It the bingol hall is located' • within chy limits. <br />2. "1 county''*" AND, township) **1 must sign N the bingo hall is located Within a township. <br />3. The local government (Clity or county) must pass a resolution specifically approving or denying the application. <br />4. A copy of the resolution approving the application, must be attached to the application. <br />S. An application which is denied by the liocal governing body shoul�d not be submitted to the Gambling Control Division. <br />Cit r Cou <br />11. City or county name <br />R"AMAL4 <br />EVILLE <br />Sigma " q) person reoeiving app,licadon <br />9 <br />TiVe <br />I rxo? <br />�Nam at Person del <br />Date receiv,W <br />applioadon to 6&-go4rnrnent <br />TownshIp By signature below, the township <br />acknowledges ftt the organizabon is applying for <br />a bingo hall license within township limits. <br />TownsIhIp" <br />1, 2. Township narne <br />Signature of person receiving application <br />Tito - Township official Date received <br />Is township? organized unorganized uninoorporated <br />R <br />b <br />M <br />W <br />All hq <br />Form LG300, 181ingo Hall Licensel Application,, Parts I and 2 <br />Form, LG3102, Bingo, Hal! Occasion List <br />al I <br />Form'LG315I, Bingo Hall Parsonnel Informaton (for each person listed In Item. 4 and 5 on form LG300) <br />Form LG31 161, B,iingo Hall) Affildaviii, for each plarson fisted in hem 4 and 5 on form LG300) <br />• Check Ifoir license fee of $2,5100, made playable to, "State of M[nnesolta" <br />Departmant of Gaming <br />Gamblinig Controll Division <br />�Rolsewood Plaza South, 3rd Floor <br />1711 W. County, �RoIad BI <br />RoseVille, MN 55,1131 <br />
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