Agenda - Council - 05/26/1998 - Laserfiche WebLink

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~Y 19 '9I~ I8:~IF~I MAPY T IMC ~irm~.so~a ~1, Cam,bllng P.$/~ L~nk.Na.~e. ' _ . - ~ank Aca~um Numbe¢ ~ A~, ~ -" ~" ' ~i~- ~ m~ - .. . La~., U~'.~'-~ --' l~ P~~ ~ ....~_ ~ ~.~ G~~ ~[t~ ~o~~ -! am IMm Chi~ ex~t o~r ~ the organ~al~n; I hereby ~.nt ~h~ ~.law enforcement ~mrs, the -1 assume ful fes~n~bili~ for the ~ir and la~ul b~rd or ~gent5 of th. board, or the commissioner of lion of all act~v~es t~ be conducted; revenue er public s~.~/, or agenls of the c,~mmL~sioner~. ~ ~ecorSs The ~rd i~ lmhoti~ed to inspe~ the blnk re~rds of the gambling ~unt w~enever nece~a~ tO tequlrlments gl Cu~ent gambling ~l.s and I~. I decl~e · I writ (Imfliartz, a myself with the la. wi al Minnesota governing Lawful gambling and rules of the board and agree, if licensed, to abide by t~e laws a~ tu~s. bcludtng amendmen~ ~o them: · a~y.~s~es in a~l~at~n ;ntormN~n will be subm~ed ~o Ih, ~atd ~d b~l un~ of government ~hin 10 days of the change; and · [ un,arsenal tMl failure Io provide required informat~n .I have read this aplpiicatlon and all Infosmafion subm~ted or provlding false or misleading information may result to the ~srd is ~rue,ja~u~. a~ ~m~ote; the denial or invention of the I~onse. · all other required~' formation ha~ been fully disclose; 1. The cky 'must s~gn this II~lic~tbn if the gambling prem- ises is located w~h/n city limits. 2. The county "'Al the gambling pram 3. The ~ocal un~ g resolution specifica Cl..~ty~. or Cou Cky o~ Count'~ Name iD township" musl sign this appficalJon see ts located w~hin a township. overnment (c~y or ~un~) mUSt Signature of per$~n ~ec~h4ng al;~ca6cln C. aunly Reid B ~,ovlna ~;~_aD~!;_c..atioo_ must be. al~ache..d_~ this aoollcatio_n. should not ~ subm~ to Ihs Gambling ~ntml Board. Township: By sTgnatgre below, the township acknowledges lhat Ihs organizer;on is al:~lylng for a premises permil wilhin ~wnsh~ Ilmks. ~To~ShIp" _ T~nlhip ~igq~rt of perl~ ~&lng TIlde I I I I I! I I