Agenda - Council - 06/14/1994 - Laserfiche WebLink

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.......... .......... ; Premise Perm t llcatlon Part 2 of 2 -:.~ .~.~. ~,~..~ .,~F~:"~-~,-.,,~,~. '-. ~ .,~i ~ ~. -..~ ~,~:~,,-~"~.:.-. ~l'~-~.,~. ~-. , .9~.*-- ~. '~ -~",'.~"; .... Y.i,.?~ :-~:i~%~'~L.~?;'~i~".~' ~?"~ · ::~- :~'~ ~~1 '~ ;~ ~ .~,- ~,-~ -:-,~ '~:- ' '~ ~'~:. .... ,~'~ '.~ ." : ~ ~1 ~:~'~ ~ ~"- ~ '~'~ .......... · ....... ~,~- ~ ~a .... ~< :f .... : : ': ' : .' " ' :" ': ' "~'~:"-'~" '"'"'"'~ ~ .-:.::,~,~=--~- ,~ 'a~ ' ~.a<:~,~a:~., ,..-~ ..... . ~t...: ............ ::::::::::::::::::::::::::: ............. ~ ............... ..:.~:~:.:.~ ...................... · ' .... I hereby ~nsent that ~c~ law enfo~meni offi~rs, the -'- - · : board or agents of the board, or the commissioner of .. ' ' ~ ' revenue or public safety, or agents of the commissioners may enter the premises to enforce the law.-. ';:, -~ :~ ~:. ' ' . .... .' .': l~auk Records L~fformation ; :-: · ::~?, ~,~:.'The board is authorized to inspeci the bank records of the'_ .... ': . :.~ gambling account whenever necessary to fulfill ,. ~ . :~:- requirements of current gambling rules and law.' [ declare that: :: .I have read this application and all information submitted .. to thet)oa~d is~rue, accurate and complete; . .all other required information has been fully disclosed; · l am the chief executive officer of the organization;' :-. '. · l assume full responsibility for the fair and lawful opera-' · I will familiarize myself with the law.~ of Minnesota'..::-~- ~ 'governing lawful gambling and rules of the board and '?, :; agree, if licensed, to abide by those [aws and rules;" . ? including amendments to them; ' ' · any changes in application information will be submitted to the board and k)cel unit of government within 10 days · I understand that failure to provide required information or providing false or misleading information ma)~ result in the denial or revocation of the ticense. - · . - · . Signature o.,~hief executive ~fficer /I ' Date 1. The city 'must sign this application if the gambling prem- ises is located within city limits. 2. The county '*AND township*' must sign this application if the gambling premises is located within a township. .3. The local unit government (c~y or county) must pass a resolution specifically approving or denying this application, 4. A cooy of the local unit ofoovernment's resolution orovin~ this aoolicatioq must be attached to this aoolication. 5. If this application is denied by the local unit of government, should not be submitted to the Gamb)ing Control Board. Township: By signature below, the township acknowledges that the organization is applying for a premises permit within township Emits. 'Township** - city or County Name . ~- ;.~/f~p . . - I / Signature of person receiving application TiUe Date Received Mail to: Gambling Control Board Rosewood Plaza South, 3rd Floor 1711 W. County Road B Rosaville, MN 55113 LG214(Part 2) (RevT.r'~ 1)