Agenda - Council - 04/14/1999 - Laserfiche WebLink

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ACKNOWLEDC~MENT GAMBLINg' PRE~{ISES AUTHORIZATION I HEREBY GIVE CONSENT TO LOCAL LAW ENFORCEMENT OFFICERS, THE GAMBLING CONTROL BOARD, OR AGENTS OF THE BOARD, OR THE COMMISSIONER OF REVENU]E OR PUBLIC SAFETY, OR AGENTS OF THE COMMISSION-ERS, TO ENTER THE PREMISES TO ENFORCE THE LAW. BANK RECORDS INFORMATION THE GAM]~LING CONTROL BOARD IS AUTHORIZED TO INSPECT THE BANK RECORDS OF THE GAMBLING ACCOUNT WHENEVER NECESSARY TO FULFILL REQUIREMENTS OF CUPdIENT GAMBLING RULES AND STATUTES. I DECLARE THAT: I HAVE READ THIS APPLICATION AND ALL INFORMATION SUBMITTED TO THE GAMBLING CONTROL BOARD; · ALL INFORMATION IS TRUE, ACCURATE AND COMPLETE;; · ALL OTHER REQUIRED INFORMATION HAS BEEN FULLY DISCLOSED; I AM TI{E CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION; · I ASSUME FULL RESPONSIBILITY FOR THE FAIR AND LAWFUL OPERATION OF ALL GAMBLING ACTIVITIES TO BE CONDUCTED; · I WILL FAMILIARIZE MYSELF WITH THE LAWS OF MIN1FESOTA GOVERNING LAWFUL GAMBLING AND RULES OF THE GAMBLING CONTROL BOARD AND AGREE, IF ISSUED A PREMISES PERMIT, TO ABIDE THOSE LAWS A/QID RULES, INCLUDING AMENDMENTS TO THEM; ANY CHA/~GES IN APPLICATION INFORMATION WILL BE SUBMITTED TO THE GAMBLING CONTROL BOARD AND LOCAL UNIT OF C-OVERNMEhWf WITHIN TEN DAYS OF THE CHANGE; I UNDERSTAND THAT FAILURE TO PROVIDE REQUIRED INFORMATION OR PROVIDING FALSE OR MISLEADING INFORMATION MAY RESULT IN THE DENIAL OR REVOCATION OF THE PREMISES PERMIT. DATE SIGNATURE OF CHIEF EXECUTIVE OFFICER LOCAL GOVE~ ACKNOWLED~M~iTT 1. THE CITY* MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES IS LOCATED WITHIN CITY LIMITS. 2. THE COUNTY** ~ TOWNSHIP** MUST SIGN THIS A/~PLICATION IF THE G~4BLING PREMISES IS LOCATED WITHIN A TOWNSHIP. 3. FOR TOWNSHIPS THAT ARE UNORGANIZED OR UNINCORPOP. ATED, ~THE COUNTY** IS REQUIRED TO ATTACH A LETTER TO THIS APPLICATION INDICATING THE TOWNSHIPS STATUS. 4. THE LOCAL UNIT OF GOVERNMENT (CITY OR COUNTY) MUST PASS A RESOLUTION SPECIFICALLY APPROVING OR DENYING THIS APPLICATION. 5. A COPY OF THE LOCAL UNIT OF GOVER/W'MEAVf'S RESOLUTION APPROVING THIS APPLICATION MUST BE ATTACHED TO THIS APPLICATION. 6. IF THIS APPLICATION IS DENIED BY THE LOCAL UNIT OF GOVERNMENT, IT SHOULD NOT BE SUBMITTED TO T}{E GAMBLING CONTROL BOARD. TOWNSHIP: BY SIGNATURE BELOW, THE TOWNSHIP ACKNOWLEDGES THAT THE ORGANIZATION IS APPLYING FOR A PREMISES PERMIT WITHIN TOWNSHIP LIMITS. CITY* OR COUNT~** TOWNSHIP** ! ! CITY OR CO~ NAME SIGNATIIRE~~OF PERCEIVING APPLICATION TOWNSHIP NAME SIGNATURE OF PERSON RECEIVING APPLICATION ! ! TITLE DATE RECEIVED I TITLE. REFER TO THE ClqECKLIST FOR REQUIRED ATTAf~NTS MAIL TO: GAMBLING CONTROL BOARD 1711 W CO~ ~ B - SUITE 300 S ROS~ILLE, ~ 55113 DATE RECEIVED ! !