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LG220 Application for Exempt.Permit <br /> <br />Local Unit of Government Acknowledgment <br /> <br />If tile gambling premises is within city limits, the <br />city must sign this application. <br /> <br />On behaif of the city. I acknowledge this application. <br /> <br /> Check the action that <br /> the city is taking on this application, <br /> <br /> The city approves the application with no <br /> waiting period. <br /> <br />DThe city approves the application with a 30 day <br />waiting period, and allows the Board to issue a <br />permit after 30 days (60 days for a first class <br />city). <br /> <br />DThe city denies the application. <br /> <br />(Signature of city personnel receiving application) <br /> <br />Page 2 of 2 <br /> 6/03 <br /> <br /> / <br /> <br />If the gambling premises is located in a township, both <br />the county and township must'sign this application. <br /> <br />On behalf of the county, I acknowledge this application. <br /> <br /> Check the action that <br /> the county is taking on this application. <br /> <br />DThe county approves the application With no <br />waiting period. <br /> <br />DThe county the application with a 30 <br /> approves <br /> day <br /> waiting period, and allows the Board to issue a <br /> permit after 30 days.. <br /> <br />DThe county denies the application. <br /> <br />Pdnt name of county <br /> <br />(Signature of county personnel receiving application) <br />Title <br /> <br />Date / / <br /> <br />TOWNSHIP: On behalf of the township, i acknowledge that <br />the organization is applying for exempted gambling activity <br />within the township limits. [A township has no statutory <br />authority to approve or deny an application (Minn. Stat. sec. <br />349.213, subd. 2).] <br /> <br />Pdnt name of township <br /> <br />(Signature of township official acknowledging application'.) <br />Title <br /> <br />Date / / <br /> <br />Chief..E, xecutive Officer's Signature / . <br /> information provided in this applicati?'n/~.'E/c,,.omple,,[e, &nd agc~ate t~fl:he, best, of my knowledge. <br /> <br />.~afl Application and Attachments <br /> <br />At least 45 days prior to your scheduled activity date send: <br /> ~he completed application, <br /> a copy of your proof of nonprofit sta£us, and <br /> a $50 application fee (make check payable to "State of Minnesota"). <br /> Application fees are not prorated, refundable, or transferable. <br /> <br /> Send to: Gambling Control Board <br /> 1711 1/Vest County Road B, Suite 300 South <br /> Roseville, ~iN 55113 <br /> <br />If your application has not <br />been acknowledged by the <br />local unit of government or <br />has been denied, do not <br />send the application to the <br />Gambling Control Board. <br /> <br /> <br />