05-24-1995 Additions - Laserfiche WebLink

Home Browse Search

ACKNOWLEDGMENT -t' GAMBLING PREMISES AUTHORIZATION "I1 HERESY GIVE CONSENT TO LOCAL LAW ENFORCEMENT OFFICERS, THE GAMBLING CONTROL BOARD, OR AGENTS we OF.THE BOARD, OR THE COMMISSIONER OF REVENUE OR PUBLIC SAFETY, OR AGENTS OF THE COMMISSIONERS,,. "TO, ENTER THE PREMISES TO ENFORCE THE LAW. BANK RECORDS INFORMATION __.. k"THE GAMBLING CONTROL BOARD IS AUTHORIZED TO INSPECT THE BANK RECORDS OF THE GAMBLING ACCOUNT adWHENEVER NECESSARY TO FULFILL REQUIREMENTS OF CURRENT _ GAMBLING RULES AND STATUTES. .... DECLARE THAT: I HAVE READ THIS APPLICATION AND ALL INFORMATION SUBMITTED TO THE GAMBLING CONTROL BOARD; ALL INFORMATION IS TRUE, ACCURATE AND COMPLETE;; ALL OTHER REQUIRED INFORMATION HAS BEEN FULLY DISCLOSED; I AM THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION; I ASSUME FULL RESPONSIBILITY FOR THE FAIR AND LAWFUL OPERATION OF ALL GAMBLING ACTIVITIES TO BE CONDUCTED; I WILL FAMILIARIZE MYSELF WITH THE LAWS OF MINNESOTA GOVERNING LAWFUL GAMBLING AND RULES OF THE GAMBLING CONTROL BOARD AND AGREE, IF ISSUED A PREMISES PERMIT, TO ABIDE THOSE LAWS AND RULES, INCLUDING AMENDMENTS TO THEM; ANY CHANGES IN APPLICATION INFORMATION WILL BE SUBMITTED LOCAL UNIT OF GOVERNMENT WITHIN TEN DAYS OF THE CHANGE; I UNDERSTAND THAT FAILURE TO PROVIDE REQUIRED INFORMATION INFORMATION MAY RESULT IN THE DENIAL OR REVOCATION OF THE TO THE GAMBLING CONTROL BOARD AND OR PROVIDING FALSE OR MISLEADING PREMISES PERMIT. SIGN OF CCHIEF EEXEC_LU..�T�I7VE OFFICER DATE 5/17/95 LOCAL GOVERNMENT ACKNOWLEDGMENT -'1. THE CITY* MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES IS LOCATED WITHIN CITY THE COUNTY ** AND TOWNSHIP ** MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES IS ,LOCATED WITHIN A TOWNSHIP. FOR TOWNSHIPS THAT ARE UNORGANIZED OR UNINCORPORATED, THE COUNTY ** IS REQUIRED TO ATTACH A LETTER TO THIS APPLICATION INDICATING THE TOWNSHIPS STATUS. THE LOCAL UNIT OF GOVERNMENT (CITY OR COUNTY) MUST PASS A RESOLUTION SPECIFICALLY APPROVING OR DENYING THIS APPLICATION. A COPY OF THE LOCAL UNIT OF GOVERNMENT'S RESOLUTION APPROVING THIS APPLICATION MUST BE ATTACHED TO THIS. APPLICATION.. IF THIS APPLICATION IS DENIED BY THE LOCAL UNIT OF GOVERNMENT, IT SHOULD NOT BE SUBMITTED TO THE GAMBLING CONTROL BOARD. TOWNSHIPS 4031- SIGNATURE BELOW, THE TOWNSHIP ACKNOWLEDGES THAT THE ORGANIZATION IS APPLYING FOR A :,PREMISES PERMIT WITHIN TOWNSHIP LIMITS. CITY* OR COUNTY ** TOWNSHIP ** `CITY R CO NTY .AME ?5SIGNA TOWNSHIP NAME E VING APPLICATION 1 SIGNATURE OF PERSON RECEIVING APPLICATION T E DATE RECEIVED 14/4-7C2 cS c7 4- TITLE DATE RECEIVED REFER TO THE MAIL 1711 CHECKLIST FOR REQUIRED ATTACHMENTS TO: GAMBLING CONTROL BOARD W COUNTY RD E — SUITE 300 S ROSEVILLE. MN 55113 Page 25