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Mtbrit1m#dta Lamp! tt,itbltrt# <br /> Ptetti le pernilt App1lkttlon part 2 of 2 <br /> ff 1i ilkA i i i ra <br /> d <br /> Ban Name Sank Account Number <br /> NORitsfi MANKATO 085163 <br /> hank Address C State Zip Code <br /> SECOI4D i1ICkORY MANKATO MN 56001 <br /> >Y:•<: '.i :�iiili cli cRd i idfrfiiJt io f kiffliii. <br /> P, t <br /> i ...Mail/Milli /ia t W a..: VY Y /M /fY <br /> i yi :'.'<::.yti' <>Ry:.y}�:iyy�::•.� ��an �':III !T <br /> 'ame •Tess I e <br /> ROGER ELLETSON R.3 BOK 44 MAPLE LAKE, MN: 55358 GAMBLING MANAGER <br /> JOHN LEVER 2100 ROE CREST ST. N. MANKATO, MN. 56003 C.E.O. <br /> t�.Gd 0t e3i f. <}Effye'. .c .,L, <br /> 3 y <br /> tt nhlliiig I#e i1.1 0 titi •1 em the chief executive officer or the organization <br /> hereby eonsertt that local law enforcement officers, the •I assume full responsibility for the fair and lawful opera- <br /> board or agents of the board, or the commissioner of lion of all activities to be conducted; <br /> revenue or public safety, or agents'of the commissioner., .1 will familiarize myself %kith the laws of Minnesota <br /> may enter the premises to enforce the la*. governing lawful gambling and rules of the board and <br /> batik f%ecdtde information' agree, if licensed. to abide by those laws and rules. <br /> the board 13 Authorized to Inspect the bank records of the Including amendments to them; <br /> gambling account whenever necessary to fulfill •any changes In application information will be submitted <br /> tt;;clUlr4niant3 81 cUrtent gambling rules and law. to the board and local unit of government within 10 days <br /> delft of the change; and <br /> I declare that: •1 Understand that failure to provide rrequired information <br /> •i have road this application and all information Submitted or providing false or misleading information may result In <br /> to the bard is true, accurate and complete; the denial or revocation oI the license. <br /> •811 other requited information has been fully disclosed; <br /> Signature olAk axe tivo off er Date <br /> "Air .v..: ,�:iNi :.}•Y:• :iY::�:• ,Y:P: Y.;N:i:: <'i /I•:NY %y::.: :ii: <br /> 3 f S <br /> r y. <br /> JY <br /> LV a G j {s pIS -,,g. 5 r z e :i'k' S3 f PYo< 7<:V .w.. :s <br /> 1. The city 'must sign title application II the gambling pl•em- <br /> 4..A catty of the local unit of dovernrperit'! tesolutlon do- <br /> tsi3 (3 located Within d itm118. droving this application mutt att:�bed lo�_eooii�t�p. <br /> ty S. N this 3ppecatioit le donlod by the local unit of government, <br /> 2. The codnt}i"AND township" must sign thie 8pplicitlon II It should not be 3ubmltted to the Gambling Control Board. <br /> the gambling promisee is located within a township. <br /> 3. Th8 local Uhl! gov4rnm8hf (city or coUrity) must pA83 a townehtp: 13y 3lgnaturo below, the township acknowledges <br /> resolution specifically Approving or denying this dppltcatlori. that the organization Is applying fora promises permit within <br /> township limit.. <br /> N' tit County" Township" <br /> ty or C y ty ame Township Name <br /> Ag ia, i .ice -S <br /> Signatur. of •er: •n race 7,2911 don Signature of perlon receiving application <br /> 4 ,(Z---- <br /> Tltfe Date feceived Tide bate Received <br /> a -/C4.,_/-- 1 /1/44 <br /> Molar 6 the inatrudiona for required attachments. <br /> Mail to: Gambling Control Hoard <br /> Rosewood Platt South, 3rd Floor <br /> 1711 W. County flood H <br /> Rouvlllo, MN 53113 1-0214 (Port 2) <br /> (Rev 7/2911) <br /> r <br />