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ACKNOWLEDGMENT
<br /> GAMBLING P~LEMISES" AUTHORIZATION
<br /> I HEREBY GIVE CONSENT TO LOCAL LAW ENFORCEMENT OFFICERS, THE GAMBLING CONTROL BOARD, OR AGENTS
<br /> OF THE BOARD, OR THE COMMISSIONER OF R~V~NUE OR PUBLIC SAF~,TY~ OR AGENTS OF THE COMMISSIONERS,
<br /> TO ENTER THE ~R~ISES. To ENFORCe. ~H~ L~ ...... '
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<br /> ~D R~ES ;.b INCL~ING' '~~NTS, TO' THEM;': .h.~'; ? ~';: '? ;.?;t; ~.: ?~' '~ '.'> ::~ .':. '~;:' ~;; ~:~ %' .~;~.~:.':"~?~;~.~.'??~,:;: ,:.::,.~:":;~..: ;~' · . .:.... ' ·
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<br /> .-. LOC~ %NIT' '0F 'Go~'~NT. W~THI~j. TEN ':DAYS'OF. THE. C~E[..".;:.":. '.-::'.:':'.':' .:,.:-?.:. '"'" ':
<br /> · :" i 'uND~RST~D: T~T': pAiLU~: To:: ~ROVfD~ '[ ~Q~I~ j' IN~o~T~ON"0R~,'PROgmDi'~'' F~SE OR:
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<br />SIGNAl'. OF'."~Hi~P EIE~I~' OFFmCE~ .:.'[.]:[~'j','?,?' `.~::.:?j~[~.~.;~.~.~(~j:.~?~::~.:~;~.5~.~.::~[..~[~.:..{F]::t~:;'. ':{["D~:,-;::;;:,..~ [ .'.:,...:.;.,': ..
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<br />1.' ;':T~ 'CmT~*' ~ST,' ~[~N '~HIS: AP~L[d~TION~ IF "'THE ' G~BLINS: P~MISES.~.mS L6CATED WITHIN..-CI~.
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<br />4~'.+~, THE:.LOC~ UNIT,. OF-GO~NT; (CIT~.,',OR.'COUNTY)':' MUST PASS-' ~ ~SOLUTION.: SPECIF~L~.-.'~'~:~,::
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<br />· ::~;-',-~PROVING OR~'DE~ING. THIS -~PLICATION~' '..~.'~ :,:,.'.: ,'~ ::..',-, .. ;'~:~'~".. '.:-* ~.~:-:~.,~: ,,~'.~'~'~": :~,..'--?-':~?~ ~'?,,':'~ ?
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<br />5¥;:~ A COPY' OF' T~B" LOC~" UNIT 'OF GO~RN~BNT ~ S RESOLUTION APPROVING: T~IS APPLICATION. MUST ~E {, ' .
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<br /> i ,.~.:~ . . P~P~P, .TO 'I'~. CB~CK:r.,IST FOR R.~0UIP,.DD ATTACl~,~'NTS ..
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<br /> .... . ;_ MAIL ~ro: ~i~t~mr;~'~° CONT~0L
<br /> .'..'.t./:', :1.7,1.1.I4' C'O~ I:LD B -' SU'TTD 300
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