Agenda - Council - 05/23/1995 - Laserfiche WebLink

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ACKNOWLEDGMEN~ ~M]~LING PREMISES AUTHORIZATION HEREBY GIVE ~CONSENT TO LOC~ LAW ENFORCE~NT OFFICERS~ ~HE G~BLING CONTROL BO~, OR AGENTS ~ THE BO~, OR THE CO~ISSIONER OF ~NUE OR PUBLIC SAFETY, OR AGENTS OF THE CO~ISSIONERS, ) ENTER THE ~MISES TO ENFORCE THE LAW. ~ ~CO~S ~O~TION HE G~BLING CONTROL BO~ IS AUTHORIZED TO INSPECT THE B~K ~CO~S OF T~ G~BLING ACCOUNT HE~R NECESS~Y TO FULFILL ~QUI~NTS OF CU~NT G~BLING RULES ~D STATUTES. I ~ ~THIS APPLICATION ~D ~L INFO~TION SUBMITTED TO T~ G~BLING CONTROL BO~; ~L INFO~TION IS TRUE, ACC~TE ~D COMPLETE;; ~L OT~R ~QUI~D INFO~TION ~S BEEN F~LY DISCLOSED; I ~ T~ CHIEF E~CUTI~ OFFICER OF THE ORG~IZATION; I ASS~ FULL ~SPONSIBILITY FOR THE FAIR ~D ~WFUL OPE~TION OF ~L G~BLING ACTIVITIES TO BE CONDUCTED; I WILL F~ILI~IZE MYSELF WITH THE LAWS OF MINNESOTA GO~ING ~WFUL G~BLING ~D R~ES OF THE G~BLING CONTROL BO~ ~D AGUE, IF ISSUED A P~MISES PE~IT, TO ABIDE THOSE ~WS ~D RULES, INCLUDING ~ND~NTS TO THEM; ~Y C~GES IN APPLICATION INFO~TION WILL BE SUBMITTED TO T~ G~BLING CONTROL BO~ ~D LOC~ UNIT OF GO~NT WITHIN TEN DAYS OF THE C~GE; I ~DERST~D T~T FAILU~ TO PROVIDE ~QUI~D INFO~TION OR PROVIDING F~SE OR MISLE~ING INFO~TION ~Y ~SULT IN THE DENI~ OR ~VOCATION OF THE P~MISES PE~IT. ;IGNATU~ OF CHIEF ~XECUTIVE OFFICER [. DATE THE CITY* MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES IS LOCATED WITHIN CITY LIMITS. THE COUNTY** AND TOWNSHIP** MUST SIGN THIS 'APPLICATION IF THE GAMBLING PREMISES IS LOCATED ~ITHIN A TOWNSHIP'. FOR TOWN~HIPS THAT ARE UNORGANIZED OR UNINCORPORATED, THE COUNTY** IS REQUIRED TO ATTACH A LETTER'TO THIS APPLICATION INDICATING THE TOWNSHIPS STATUS. THE LOC~ UNIT OF GOVERNMENT (CITY OR COUNTY) MUST PASS A RESOLUTION SPECIFICALLY APPROVING OR DENYING THIS APPLICATION. A COPY O~ THE LOCAL UNIT OF GOVERNMENT'S RESOLUTION APPROVING THIS APPLICATION MUST BE I I i I TO THE G;~24BLING CONTROL BOARD. .~OWNSH IP: '~ ~Y SIGNATURE~BELOW~ THE TOWNSHIP ACKNOWLEDGES THAT THE ORGANIZATION IS APPLYING FOR A ~REMISES PER~IT WITHIN TOWNSHIP LIMITS. :ITY* OR COUNTY** TOWNSHIP** ATTACHED ~TO THIS APPLICATION. IF THIS APPLICATION IS DENIED BY THE LOCAL UNIT OF GOVERNMENT, IT SHOULD NOT BE SUBMITTED -:: "'"" " I' TowNsHIp - :ITYOR COUNTY NAME . I ! I 'ITLE DATE RECEIVED .. TITLE DATE RECEIVED ! I REFER TO THE CHECKLIST FOR REQUIRED ATTACHMENTS MAIL TO: GAMBLING CONTROL BOARD 1711 W COUN~ RD B - SUITE 300 S ROSEVIT,7.~, MN 55113 I I