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

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ACKNOWLEDG'M~'NT ~A/~BLING PREMISES AUTHORIZkTION I HEREBY GIVE CONSENT TO LOCA~L LAW ENFORCEMENT OFFICERS, THE GAMBLING CONTROL BOARD, OR AGENTS OF THE BOA/~D, OR THE COMMISSIONER OF REVENI/E OR PUBLIC SAFETY, OR AGENTS OF THE COMMISSIONERS, TO ENTER THE PREMISES TO ENFORCE THE LAW. BANK RECORDS INFORF~ATION THE GAMBLING CONTROL BOARD IS AUTHORIZED TO INSPECT THE BANK RECORDS OF THE GAMBLING ACCOUNT WHENEVER NECESSARY TO FULFILL REQUIREMENTS OF CURRENT GAMBLING RULES AND STATUTES. I DECLARE THAT.. I HAVE ~ THIS A!~PLICATION AND ALL INFORMATION SUBMITTED TO THE GAMBLING CONTROL BOARD; · ALL IArFORMATION IS TRUE, ACCURATE AND COMPLETE;; · ALL OTHER REQUIRED INFORMATION HAS BEEN FULLY DISCLOSED; I AM THE 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 MINlqESOTA GOVERNING LAWFUL GAMBLING AND RULES OF THE GAMBLING CONTROL BOARD AND AGREE, IF ISSUED A PREMISES PERMIT, TO ABIDE THOSE LAWS AND RULES, INCLUDING AMENDMENTS TO THEM; ~ CHANGES IN APPLICATION INFORMATION WILL BE SUBMITTED TO THE GAMBLING CONTROL BOARD AND LOCAL UNIT OF GOVERNMENT 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. SIGNATURE OF CHIEF EXECUTIVE OFFICER DATE LOCAL GOVERNMENT ACKNOWLED~ 1. THE CITY* MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES IS LOCATED WITHIN CITY LIMITS. 2. THE COUNTY** AiQD TOWNSHIP** MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES IS LOCATED WITHIN A TOWNSHIP. 3. FOR TOWNSHIPS THAT ARE UNORGANIZED OR UNINCORPORATED, THE COUNTY** IS REQUIRED TO ATTACH A LETTER TO THIS APPLICATION INDICATING THE TOWNSHIPS STATUS. 4. THE LOCAL UNIT OF GOVERb'MENT (CITY OR COU1TI"~) ~g3ST PASS A RESOLUTION SPECIFICALLY APPROVING OR DENYING THIS APPLICATION. 5. A COPY OF ~ LOCAL UNIT OF GOVERNMENT'S RESOLUTION APPROVING THIS APPLICATION MUST BE ATTACH"ED TO THIS APPLICATION.' 6. IF THIS APPLICATION IS DENIED BY THE LOCAL UNIT OF GOVERNMENT, IT SHO~ NOT BE SUBMITTED TO THE GAMBLING CONTROL BOARD. TOWNSHIP: BY SIGNATURE BELOW, THE TOWNSHIP ACKNOWLEDGES THAT THE ORGANIZATION IS APPLYING FOR A PREMISES PERMIT WITHIN TOWNSHIP LIMITS. CITY* OR COUNTY** TOWNSHIP** CITY OR COUlFI~Y NAME TITLE DATE-- ~ ~CEI~D TOWNSHIP NAME SIGNATURE' OF PERSON RECEIVING APPLICATION TITLE DATE RECEIVED REFER TO THE. CHECKLIST FOR REQUIRED ATTACH/6ENTS MAIL TO: GA/~BLiN~ CONTROL BOARD 1711 W COUNTY RD B - SUITE 300 S ROSEVILLE, MI~ 55113 I ! I I