Loading...
96-1202 �'i 1�� � ��� � ��� � � Council File # � d � $ . , , ". , , ��r Ordinance #` Green Sheet # 34999 RESOLUTION CITY F INT PAUL, MINNESOTA S9 � Presented By �� Referred To Committee: Date 1 RESOLVED: That application, ID # pending at State, for a new State Clas� B 2 Gambling Premise Permit by Twin Cities Autism Society at Over-The- 3 Rainbow, 249 W. 7th Street, be and the same is hereby approved. 4 5 Requested by Department of: 6 N�ys Absent 7 Baey 8 Gue�n Office of License. Inapections and 10 � Environmental Protection 11 12 Bostrom —� . Adopted by Council: Date � By' �'�^�"' �' Adoption Certified by Council Secretary Forra Approved by City Attorney BY� By: ` � � � Approved by Mayor: Date �� Approved by Mayor for Submisaion to By: ���'2� y`�,���� Council By: ** NEED COPY IMMEDIATELY ** ��j�, �0�,.,, LIEP � �T�INITIATED rREEN SHEET �° _�4 9 9 9 .� �` �DEPAATMENT DIRECTbH NIT1/UJDAATE. �CITY COtMICIL INITIAUDATE William F. Gunther - 266-9132 ��p �CIT1fATTORNEY �cmrc.�.eRK N- DA ( �p�Np� �BU0f3ET DIRECTOR �FIN.d MOT.BERVICE8 OIR. Hearin : °RDEN ❑��ca�nssisrnrrr� � TOTAL#G`OF SKiiNATURE PA 8 (CUP ALL WCATION8 FOR SIdNATURE� ACTION REOUESTED: Mary Powell on behalf of �ain Cities Autism Society requests Council approval of their application for a new State Class B Gambling Premise Permit, ID � Pendfing at State, at Over-The-Rainbow, 249 W. 7th Street. RECOMM�IDI►Ti0N8:Approv�(A)or Rs�ct(R) pL°R80NAl SERViCE CONTRACTS NUST AN�WER THE FOLLOr111N0�!lESfiON3: _PLANNINQ f�IM18810P1 _CIYIL SERVICE COAAMt8810N 1. Hes this persorUfkm aver worksd under a coMr�for tlds dputrnNlt? - _��E YES �NO 2. Has this psrwNBrm evm►bsen s city employeq? —� — YES NO _D18TRICT WuRT _ 3. Does ttds psrooNfhm p�a ekNl�wt nornw�Y Poeeess�d bY enY anant dlY�ploye�? BuPPOR'T8 VYFIICFI COUi�OlJECTIVE9 YES NO Explaln all y�s�nar�n o�apuat�sMwt and�ttaah to�n shNt INI'f1ATM10 PROBLEM,ISSUE�OPPmRT'UNITY(Who�VWat.VlMisn.VVhm�.WMI; • . RECEtY�� sEP �2 �s Cir�r ADVANTAGE6IF 11PPROVED: DI8ADVANTAOEB IF APPROVED: . �CS� , ...'���'Ch C�(ltef Stl� 16 1996 DISADYANTAOE8 IF Ndr APPROVED: TOTAL AMOUNT OF TRAMiACT10N = C08T/REVENUE BUDOETED(CIRCLE ONE) YES NO FUNDINO i0UlICE ACTIVITY NUNBER FINANCIAL tNFORMATION:(EXPIAIN) Greensheet # 34999 L.I.E.P. REVIEW CHECKLIST �ate: /�� '� �0� In Tracker?� App'n Received / App'n Processed License ID # PendinQ at State License Type: State C1 ass B Gamh1;r,g PrPmi ca pP,-,�,;r Company Name: Twin Cities Autism Societv DBA: Twin Cities Autism Societv Business Addresss: 249 W. 7th St. (Over-The-Rainbow) Business Phone: 641-0709 Contact Name/Address: Mary Powell/CEO Home Phone: 641-0709 Date to Council Research:�b/q1� ve. Public Hearing Date: So ��+�"�5_` I`1`�6 Labels Ordered: N/A Notice Sent to Applicant: �9.h District Council #: 09 Notice Sent to Public: � � Ward #: 02 Department/ Date Inspections Comments , City Attorney g��3/9� o,� q�i�-�g� Environmental Health /V A Fire /V � License s�te�an aeceived: Lease�ived: l� A Police O 1/ S{�/It"`7 �`���b ��C-O i'C.3 �e� /� 9 �� q ��e� � � � Zoning / " �' . .�� . � . . . . . . ` .. . ' � ��� . . '.� , ,.. , , , � � � �, � � '`� �, y�'� - >.r �„„,,�; ,c y T. y-r��.:r a r,� �.4 � q ,�}q . � r. ` t, `'z � FOR BOAR E ONLY , �r ; �R �!' � '.;. LG214. , ° '� BASE# , P��! �^ , ,,. ,. PP# �., � ,; ` : a FEE ,,,rr:;,; . . �,,. F+ , ,�, Minnesota Lawful Gambiing . y{ CHECK T '� a' ' Premises Permit A lication'- �Part 1 of 2`� ' INITIALS � �� � �; .a, '�n h �. ��.:;. PP `t �• , ^ s !� ;:., .�,,, DATE y4 °�`�`r ;� � . . ... , .�; t �f � At''�;,}r�.N �3 {� . '�X ., .,. 4.i�i .. �. . .. , . - , . `(' ,'t, .,ty�`�y`. . . , i . . . . :ny.v,:::ii.:.u•::.::.v.v.:nyi..:.�:.ii�i::O:�x::n;n.;y.v:.y�y.i:}v.:.:..:..v.::�.n.::.:.;....n.:i:.::.iii'•4}�•.;.�.�v:�.;...::<:ni+.. �,....�..v.;:.. .;•!Y'.�7 . S.:YY.{.;p•:.y. } iN;:• n:::::::...::::......... . . . ..::....:::::::..:�:::.:.: .....::,.:::.......:....... ..�:::::;,...........::...::.:.::::�.a:..<:::.� ..r.,' . ........................,...........__.................. .. . .....::...;�.,........ ..: Cti'::;::;x:<:::...y . ... :Y:. ::.x+v.•.:.•. :: . ... .:.. ..........�:.... • ............................................. .... ........................................................... � . .::.t>•::::::o;... ....:::::c:::::::,::.:::::::::.:v....:.;:.::y:;.:::;:;.:�::..:::::::::::.::.. <................... .............. .....,..:.:..:...:::::::.:�::::�.::::::•:.:.::•::.:�:.................. .. ... ... .. ..... . . . . . .......... .. .:.:::�:.:�.�::..:.�:•:. ... ......:,:::::.�:v:3r. . . . ... ..� .. ..... ...... ......... ...... .. ... ...... .......i....n.........>..........:::::'i ::l... r ..::::}:.:::....;:Yi:: ... � . � .......\........ .. ......... .........� .......:.. .�..::...�::r..:. v. . .....J..: ....:... :'::t,''i.>.�:^iiiii.'Gi'�:•'i'S: . �::..:. :�i:i:.ii: .. ... .. . . . . ..... . .. ... . ..... .. .. . .. . ........:...�:�:::::..�::..............n:•::::.iw::<�i�:.:�v:w::��:i:<i':'.vL::::ii:i;::�>`;:j::.•;`i:i:i>.i: . � '. . �� ,:.. .;.{..�..:�:.:....:....;.�..,�,;..:,.,�..,�...i:i'?:' ,i':.!?::�Wi':+•:':�::.i::�:..;v..;.:...::r.::.::.::r::: '. � :: ,;.,v.:'' . ?.v e<. � ..o li a t3on;;. �>;;v :..; ...... .:.. _. �......... ..:� . .: ; �: > .. .. r F i�� )r . . ;'.. Cl2S5 G�P�@RiIS@S.PBRTIII.,'..' t � �k�.�� ��� .. 1 � Renewal: t ...,�� � ':.:. (chxk`one) , ;,, "'i .� �,;' �t... . �Orgarn=atwn base license number ;: Q A(5400) Pull-tabs,Gpboards,paddiewheels raffle�sy.W.ngo . ?".�� ��` '•>.:�., ,. . u ,'' � v v � :;' ��,�.,, t_� . � ��i" r^n � `,.. ���,�r'r'°)P�� . � ' Premisea permit number' . • �B(3250)`Puli-tabs;tipboards°paddlewheels raffles � ,. ,�x F,1 , ' � New � - [] C($200) Bingo oniy t ., ' 1 � '_ ;°� k ; ❑ D(5150) Raffles ony": , � .. � � '� �`�,, } {_: f t � ., L � .�r. J Orgctniza�ivn �r�formatio�t '` ` ° F�" �' ` .:..,. .....,.. ......... ... .. ... ......... .. ...... . ...... ...... .....,.. >.{.< � ..;.... <....... < .,,..... ... ... Narne o(Organitadon '� ; ` � . . , � ' f�' ,t ti 'ill��r ���'ce 5 -�u.-E'cf ri� SOc��y : �` •- B siness Address of Organizabon-Street or P, Box(Do not use the address of your gambling manager) Gt r Z U-2 �2 � ( 'n . City State Zp Code C unry "°� Daytime phone number S' G��,,Q , yY�=N �S' Gt�s� � (d�� ?=�4 � �` Name of chief executive officer{ca not be your 9ambling manager) Tide Daytime phone number � 1► wl� _. . i.r. u,.�.�. �k�c. D� r-• ��-�.a G Y 7..°ro� 3 � � Bingo Occ ions ° ,;,�:i ,� , • ' � If applying for a class A or C permit, fill in days and beginr�ing & ending hours of bi.ngo occasions ;: No more than seven bingo occasions may be conducted by your or�anization per week. : : Day' Beginnfng/Ending Hours Day Begtiuzing/Ending Houra Day Beginntiig/End[ng Hours t � Y�. � � ] r to ' � i . H.i�.v ��.s .. ��;;� ; u'/-' •��''Y�Y�f'�d:�i"w�' r.��'�� ,M ,i w'+ t� �>;Y✓�s ay}g o i t . � _ � � r! s�i ,�.�" 5 ���:. t�- � r Y'. �� � . `�.. , .��-,.'. ��.� :. r '�,# Y`'+ 2� � r S s Y �' 'v ,- to � If bingo Will not be conductcd.check here� � ?° ''� `yf :T , ..,' k �' r �_ u'/ firy,�T". •ivr.`a:,_ - � . ' . . 17 �. 1 .�'�'y•',.YSr�i�.{N. F,St �• 'FI//;?;i'�. 6 3.:;,.- .! <F,v/:.::/....�, �,.,: "t��.i<�.K:;,{:.s:.�,...,.;.. .��,. .,y. .�<�- �� rr �is��s � ow <':` � -E ..yK F+. .�.��`'�..o.�'. "`.yt r � a�. gK,s..�.�y :.�. p .. �,,:..:.,y,�s :::::::..:.:t::.:::........:.....,.............c:•::,,.;.o�,,;...,::;.>•�.'•:•�:;•:•+>:.: ........ � .......K•.;A..;;...,'?s:r,.;� < . ' ..5:.'•i�.i J �i'•; ..1.:.�•::..i. F JS{x?.i ..'i. 'w' -. Q�.� �. :': ::+i.•..... :::............:•.:•::•:nv.:w:.::.::..�.. ................�:f�:.i^'v. r•�tiY::v:r•:.:y::�.�.4:.;v,y,.•.y::S::;::4 .4..v S . ,, �b� ��qni. .esi...Inf`ormation.::...�:;:.:.r:�r:�::�:,.::.....;,;,:.:•::'•:::<::•::;>;,:,::.::.:�•.r.�:.. .<•.. >.a.::. � tr. � r �;a».....•..:a•....�0�.�_:..:..::::........... ...:.:::.:..;.;.....,�::::•::::..::: ::..:..;;.,.....::.. ....a.:::..>.::;:.:.;�:tio. .aF.:s�:•:+, :pi,. � :r .... :<,.. .... :;�+:?',?>%:.: : r �:. , ,� ; �5 �'� `��,a e o,esta ishment re gam ing witl con f? ,; a J/����� veet►J' ss not use a,�p,ost � ice x num r� ��,,�,�,( 7`'r • y� x<;" U�.r � /��/� d W .� !� r�� WP.v,� / ���ds���/r'�`� d ���J,,t''R '�'+Y4Y�ri-!'"�i ��' �� �Is the premises�ocated wi�i�n Gty runits?�' � s O No• If no,is avmsh�p :0 organ�zed�°��;, 4unorganized'�p unu�oo�rporated.,� �,��°; .� ; � City and County where gambl'ing premises is located OR Township and County where gambfing prem►ses ts located it outside of aty G�r�mts ' , . .ry.. �, , t , t � . � . . 1�..��„a i.� i �,. 5..�.,�, �Pa�,,,(_, ..,, :(?d�,�'5.��� � � �,�, j �s� .�:,���-� �' 1 �-+ Name and addres of{ega�,own oi pre ���e ; City ;,t ��4,7 f{5.- State � �, t . �,'�„Zip�Code�t-�`'��-�? } rY , !!I�D ', a, ��-S":�C�r.c=:ti '' , ��,,;; 35 �ul ��'" /1,��� �1G��s� y.. �{z ;�� � � t . , �.� �. 3 .. � � , nrt�.�'� � .� � � *� 4,. � Does�o orpaniza0on own the buildnp whe�the yamblinQ vnll be conducted �O:YES '� �NO �. `r''- �'�rk, r *� ti�.}w� � . ^'�+u v a�irM �� > > �, '1�k: � ,y� / y��{, `■�,��� S�y 'k:' _�_��j r 1�.- 4' _, D f u�}Si Vlj .� 5*�A`r 1��Rw� q�^'! ���/nQ�a`1CY11��IV�N11Y19i1+'� ���7,).i•�d.�ial'�N� . � "'M1��e'a��'�. � �'p':t ' �:'�� �:� � �� 4 �y i 1' rd: w a( � a v�+. r,, .s +�d. Y Arr.•. ,r ,. r' v i Y1�,.� � P�= S, �'�� .r%rf��,�^ ;'�',,�,:copy d ttie lease(form 1G202)wn ms�: at leasx one year, ,��� , ,�v<<� � ; '�'� � ,'�,` '�w�''' �"^,'�`. hy a copy ot a'sketch�of the floor plan;y i r�th dimens�ons aPxiwu►p w rpon a boin9 leasad. b ,_. �,, r ",' � ,�$ �,: i�r: ,�. +�. �.A lease and sketch are not requ�ed fo.��Glass D app6cations�,..;'�r;r���,s�. "r �i,;�`�`�'�^ ,:;: 4 � ` ` �� ..... � '..� : . . . .. -. �...: . ..'�. I � f � 1 .`:'!^� . - Y. ' r '�' t S:v�. ,Yf6'r ..n< .c M tl}rSrt� tt •clY {7� k`,T`a"r r.',�jy�<s <'�'�`Lr� t .s. .rt�+�'���+� t f�,� �� I . > .� f°!�'e � /Y C., Y i�..! <.0 r +�{'q. �La�tat �kl'. f � .i, � ':.f,Y'�.S" %.^o '2, �. . � A.dc'�xe�s of'a��... �� �����` a�at'b ���� e��� �� S �. '�S.�i�t,����W'ii�.r� . f6Sir �«R;: 7 ��Cil�l � 9' p.• ry���t, `� '. -.... . + �,.c1' ;c�''�+ .� � Y� 'ry � �Yr�� v ��i� t ` � v � � .� ' �.. t' "` . n+�t' � � '� S � �'•�. � �� �a� /� ���`�{ ���� :�...� �. � � . , � . ...� �� . � �y 1 � ( �6� "�' : iu i � ':;����( .�. 'ki:t . z 'i���h > r e t j t^,.., ��; oFH} 'K" ✓.'/w1, Kir�: . .., i , �� �'.l at F+�v. �J ,x'�; jwYr� �L} lY K'.; t ''� � .. y'��.Yi�'� t ��',3 r ,:��� , y` } 1+ t� i )r $T+}�'�t f �', ca� ': .� t`�'•s i �,` w y � r 2 � , T S i � �.� Jy.� ` L r . �' �2' S 1� 5 t. tty�3^qF� 't� �tt h�+ '�'Z e` � ;n.:�,r r t�.r t i n 7 ' ` �t f �:�,. i N o,�.i $4�. � . �! ...{. } °R: �� ?G��� t,i,'��y . p" _•�(� l !'( �Z C �:-.` �St,.� Y FS � C; 1� 7.': �( �;}�`n� �JY�� . i W T. M147 �G!'. � . A �: J y`4 -!�' � dr��i��* � ' ' � 1�:� 5�/!� . 1 '�'9�ai � �` ��ty „l�i` r. e ��`.� � �r . .. t,� r f'}• f $'1 ��,G'S. t ,�r + �5 . i y fE�;si ��)''.'.�'" �.� :���t //y�� 1� .. �Y. `P H �'> >,. .; .. � . � � ! . y'.; ,�.} IY .r � Kf . . �at tir t� �, } • � uri^P � i E . . `' �1 r + ,� ' ,� �f'` � ! "� �i���,Qp�` ��' y;-. T' �4�Y������'7,��9 i��r. ;�� �4;a«4 I '{,�( _�� -Ai f r.�.�.� �w;:.,��.,r / �iN�s f 7'.,'� ,�j' �� t��jt? n+Jc.,'T � ,.F I.},'j;Sy'�.:.:i � �. '' r, � '- . , "-�.. ..., . 'r�•- *�. . , � ,.. ���. , ,�., , �.. ,.. _ �.. ... �. ,. ..�� ., � .;�.... .. „ . ..:.. ...... . . ... . . ..,, ..;. .,. �.;:. ....; . . � . . .. '.Y ...q..� � �. .. . , Minnesota Lawful Gambli;�g . Premise Permit Application ,- Part 2 of 2 . _ . . , , , . , : t . ._ ., :; , , ;;. . . . . . .. YR � V,t S"���{�4 �..•'�` .,K� � .... y. .. .� ._ ... . . �{ � !� ti; 'C i '. ' T l �� }'r�}f} � T { ; Gcx�nbiinq'Bank Account 7nforniatiort . � .. .. .. =y > f.a.��`.:.E. '°<. ...., . ` # Bank Name �� � � Bank unt N ber ' �. . a . e�� �:; i tate A ress ' h� t .. ,� ��D ���c-�- s-{� Sf �Pa �- � IJ S.S�l 7 .�.....:::.:::.:::.;..,...:::.::>:>:.:. . :.. . ... . . .:. : . __ ::::<t;::.�:.:::.�:::. .::::.::::..:.. .. ...s�iecks�:andmake;�e ts.:andnnthdra►wals. ....... . .:: . . ..................: ..:::.:.:.::::: tst�e af sorrs aud�auecf tv s �:;�:,»:>::�....... ................�. .. ................. .....?�,iii•�:;:.'l•::'::�`:!4" ...............................1!I8tJi8.addf'eSS and ...:...... ............................... .::-.�±.:.:,:�.:::.::..:::.::.::::.::.:..::,..P.?�.:..:::.::::......:::.•..p� '::i� .:.::......:.................................................�:.:.::.::.._........P.�...................:..... .,..... ...r........ :....:.:,.:.. ::::<.::. ..>. ,.:.::..,::: :�><?<::... �. ...�.r...........................n............................:... ..................................,:..:•:`:�.�:�^:::::�� ....... ...........,....... :^%���. ..Y:i+i}i:•ii'F::!::i:{C}:v , .�.. �vni.tv.;�.:...:...........y:?v::..•::i.v:::::w::.w::::::...,:.n•�::?., ...................q..;........v..... ; : .: ... '� '�'�1{$v.�:yv:}Si;... t�{:�}�N .,:..;I�i�. y:t:nv:.�:i:::..r. . .;. �r :r::•::•::.�:........................ ... .,.:;:::.•..,�..,<...tn{•k�:..:.�:.<t., � r x arrr�abonsbeasurer nvflrandie hn funds� :.f � . j ame ess, ., x �'� w ,� ,�� i e,e,�� � ���y�.���,�� � F „ . .. ' .J ♦-� �l� �"2t��v�,�.4 iy E�C .�1k Gf �iQ :y"� .. 'F � � Sc�wa�fiz.... ►a��aroo��+�-'� �= UQ��� ' �.�Ci^ �;�'r.- �r�s ll �r �� �r���' 0�,V�. l, � ..� � �nS4� 6' ��D►��wce.� �� �?�-� � ��r ° _; � ,, _ . _ . �l � c �a�-C M ���h1 �-f5�� 3 ��� ���-�ss � w�� �� ��.���.- � � .v ' . � .. ;;<.i'•i:{+.>Y:•:"•i:•:::0:•ii:a:.}?:{:{n::•:{•:iC!•i:n:�i:.i:irr.i:•:^::.:yv. /. . ...... L� � Y '' .v.`.�.. j,.�ti,4.'�/Mi � � ? . . .:. < .�.. .. ... �.. ...... ...........�..::..:::::: . ......x....n:?v�.:. .... .. ... ..... ......................... :: ....... •.::...... ..�.,•�:.,:....:::•.::::::,::.::::::.s:.:•::�!.:.. .,Y.;fi..:S::..::.>:. . .. ......4................................ . ...............................�......w:....�..:: ..:•:..:�.v.::::v:.i:iiii:.........n. ..........n.... . •.�4F•;y.i'•`ii'�ii:?'•i.Y . ......�..................:....:.::..�::�:::v:.:::•::::...u........n..�..............................:..r...;n...9...n.....� ............1...J+......... ...:.v. . .. .... ............. ... ... . .., .................i............................... .....;.........w:.::..:..:......rv..............�.�:}v.4J::.�1�.•.v:;.'i.��...;;}.:�•: . {�� .•}'f.ryi::?:Y.;�?+';iii� . .... ............. . . .. .. ...... .. . :.. .............. .v�.:v:�.:.:::::.:Y.v:ir:r::n•�..::.::v:::::. ....:..........r 2�.:v::.�::r.;{.::::.uv:�:�v..tv:�.;r.... v;:i?ir.;>r• . :. � . .......... �... .. ...;:.. ....•:,::,.;..r ......:::.K.;,S 5..::.f'•ti�': '•v;;:i:;'X::o-s.:>ry;••r,<:::::n:::' ., .....::>•:::• .so-.,::f::•.:a;;;:•.::::::::.:..:.:::::eS;;:::r:;�o-;•..�.�>::::�::.::... . 4:%...::.�...:�:.,.X ..$:4'�'.....,. ..r. _ .. ....... . �� ..f........,. .f....5�:••..... .:..,...,..,,:.�r�;r.:<:i!;::•:::<::::.>'r.<.sr.:::::: .:. ....:�:•::::�.•.::r..o+....... .:..:.:...,93>0:o:::'t•.,....................::�::,:•:::.... . ��..,. �.. ::,>......,.. ;,,•5..:.::..>.•:::.<. ., ................ ::...::.::::•:•.�::.:.::::::.:::::•::,::::.:.:::. .... Wl e111 11�::>:«.:<:,:::............:...:..........:..::..:,.;:::::,:,.:,.:::::.::::::::��:::.:..:::::::::,;.:._::<,;:::::.:::<;:::<:::.,.:>::.::.:��>;:;:�..................,,,..:.:::::,>.�:•::.:::;:.,,;<.�<.�.;:..,..,,..;;.;..:. Ackrio �clg ,:<:� .,. . ...,:. .:.,:..... . ... .:.:.. . .,,.::.. . ....... ....... ... .. .,..... .... .. . .,. _ . .. ,.,. �:. :.� (aa ng S te ut o za oa •I am the chief executive officer oi the,organiiation; ' ' :. I hereby consent that bcal law enforcement officers,the .I assume fuli responsibility for the fair and lawfui opera- ' board or agents of the board,or the commissioner af tian of all activities to be conducted; ' revenue or public safety,or agents of the commissioners, .�Will familiarize myself with the laws oi,Minnesota ' may enter the premises to entorce the law. governing lawful gambling and rules of the board and Bank Records Infotzuation agree, 'rf licensed,to abide by those laws and�ules; �� The board is author'�zed to insped the bank records of the _ including amendments to them, �; � '�� " f' ` , gambling account whenever necessary to fulfill •any changes in applicatwn information will be s,ubmitted_ requirements oi current gambling rules and law. � to the board and focai unit oi government within 10 days . Oath of the change; and , I declare thai: •I understand that failure to provide�required information �;- : �I have read this:�pplication and all iniormatian submitted or providing false or misleading informat�on�may result in`' '' ` to the board is true, accurate and complete; ` � the denial or revocation of the license " '' `�' `'" ��` '� ' ` •alt other required information has been fully disclosed; . - . ,' � � �ignature of chiet executive officer Date� a'" �' ` : ��1,t�.'L.0 ���-_ ct'�i i�.�Q„� ' : _.,�...._ ; �: . < :.: . :� � �.,. � � (e �,._ ......... :. � ::. ,. ' .� ::>:;:�:;>;>�»:<i , :, .: :::<..::...; � �....; � .�:�. . .:,:::::::::;.:..::....:.:..::;:>;::;:.: cknowled ement : ::.<;».... ;>�..:::>;<.;.::�.....: Local<;,Govemm nt.A _. ... :.:<.......:..::...::. . :.. . . ,::� .::... . 9 :. .... .: :.;.:;.;::..::.,..�:::.,: ... >,:::;:;:;.:�:.:<:.;::;::;� :„::;»::.:::. ::... . ,... .::..: :.:.,....,..: > . 1. The city•must sign this application 'rf the gambling prem- ' 4. -A CORy of the local unit of o�ve�nQ�ent's resolution ao- _ � - R,rovinq thi�a�,ol'�cation must be attached to this a��lication ; ises.is focated within,city limits.� , ' - 6. If this appl�cation,is denied by th,e local unit oi govemment, � , 2.�The county'•AND.4ownship•'must sign this appl�caUon rf"� � � � ; `• ., • . , , ,. . t be subm►tted to the Gambling Control,Board r; :, - the gambling premises is located wRhin a township. `` , ;, , � •- ` ` � � ' ' , .. �should no; ._, ;:� , � �: �` ; , ":_� ` :;; . , 3 -The local unit govemment(city or county)must pass a , �" � k� '� _ �Township� By signature below,the towriship acknowledges�' resolution specifically approving or denying this appl'�cat�on:� ;.' k, „ ; � that the orgarnzat�on is ap�,�p.lying for a prem►ses perm��d wrthin • �¢� '" 5 "�.nt+y f � s a S,�' { i ,. township limits i`. T7� � ���'�7�`^� �jr`F'�w 3 ,�titQ,f- !�s : :: �. f�. z �i�?Kt;�x '.� ;. ,:: .-. - �� t ` �:. i �. _ ;, ,. , _ � �� y : , �, � � f� � �s ' st •. , � `K��r.H,-�t�W�"� ���;M't) t •t �,����"��5,,^'s �ar t,,� r �W w¢E^��� u �w �n Cit : o� Count `� Townshl �'�`'� , �"° , � ; �' . � � - ' : ..� �sr`"sM r�^�'4 ,3' .J � r�a�t+A�.�f:r ,�,i+ �2�.�S."41'�� � . �,. � ,j�, z �...a ,.... � .. �' �� `N .. � ¢ ��x< S� �v +t {� i�� � r' j � p�. . � .. �;,.Sa,�,� )�r.� tf r xi ; sn j� F e-,:A � �.t+a �� a P � � . �i > ..�`�'•+S( �.'*A�1 i �.y �' n�,I 3, � ; City or Counry Name ,_ ,, � , '� ,_ '� � Townshi Name� �a ir � �'-��k� ��:.. ,3'';;�i� �`t���-e�+�K Ga�e.;�,r •! ��; , �r;, , . � r ;, ,.,,,�� „-�� F^,. r� � .. *'f 4� '��M1� yY�x'�,�d����'"a��a� �' "+�$a','�ta'.1a�����'�3�'v" ��a�`i<:ft�r.' �,�,�f�: i:�. i'' { i 'r�k r �+ �� w 0 7��` ST.: /r?!� � �t . � ° r4� 3 .:�.:t � s ,���� a � � �- ' F 5� *� �.':' ..i +h � u� � t 1� i �3 t w.� ay�. ,.i x J�,5'19f18tUfBa f PBfSOf1 eeeiving applicabon `�r r � � �'C � �.�'�I f1AQJ(8 0� BfSOf1 fA0@jV�fl �ICSt10I�t �'� h^ '�� � " 10�'-��� 'w��f '„ y� . , �;- a �:,�s 9. ,P ,fl.BP y� �. � a,c '` e �5.,., w i��£,f�,l} �i`., ti`�"�f'A �� a e�.rr,� �i +:� rF�4.� :�zs 1 �� � { �r�h?h.� `fy ,:.� r(y�' a �..d�,� b�.�l,p`w i� �F ?���� ��������� .. , y✓�9t.L1Xl.`�'�'�+SK:'�Fp vK, �� �1�.y( y� '<4� �y ,s� �, k" ,p C� '.�-+f► �lr�r",cR. �`L4,�+'�,,rb xk��� * 4� ^�i�+tt�'Br,�Vs7';`'+��,,`4r;'n •_ �, " �(hf�i' 1 ..y,. v K :� n;... Y:.: r u + od� .M� �, �� r � �r� ,t. :.i:, .l s� =�Y-. �> _. 4. ' �:T'id ,e�''� c. � , �6 ;Oa��e Recei ��;: Tde" '��'' y Oa R�eei.� �;��- ^ '�r�a' ; ` :'7,�4 S • �� _ r ' f , ':�h11��✓�I° ' A ��/( y ,'• ��R'�•M,�1 ;. Y'I'J b , : .� �, �, *1 i. � '!r J � ` .. � �k''x .iY ar: ._:r k t ►� " ' 'ir�+�� k; f "" �` ��'1` ��,�t.Y',,X.'�� aj�<°jIl? i-�:�fitq„S..d.;il.,. r.�r.��-=„t r�."t�. ��q r`' 'r„#f�F � L� }l�7�,]'��' �' �,..�}�'9'p� � �T#t'�:- '�r ��.+�r+f�'�' �.^�. �. 1� j`. �< t ���r, ' '�''� ;,�Fe(er to the,Instvc�ons for reqwred attactiments:±��','��',`�'�f ;" S�'���'�+; "� t� } ,.�'�'' +� ��.1R� ��� ys��.iF�:`,34 F„ �,� �ie�. � *'.it:.Y. y � .�ai't,� �'4 -,.:�.}�Ft �t., J ,��"'���s�',��°�,y��� +�..V ty'Si.���e ,,,�.���5.' �� ,'�� ���t1t�.���{'� +E?'.�,•�� � , �t�,�yki� � �,»,. 'i 7g',� ro{^�' , . �M'��,'.�!7< ��i�� � �L'i1q'�,R�i",�',� i;rSr�TT^�'r�a"��^"�� '�" �.��� %�r�,#,;. e o:�F"I "i�'-h. ..�lrrV a d�"��M 7�� f:.l�`1 +�A n x r,} k cT'� '�7 �S 5. ? � . � r Ma�l to ;; � Gambll��Conuol Board "`� r-+; '+, , ,� '"'� y. � �:' ����, r � �� �'s � �f u � � ��`%a 1��k �:: r, ..:.�,�...,.,:. .... �:� .,, ;� r.a 0�,. � � �=r,.w a`'�i,��C," ��`, ���..,t1y� K.�?�n.��,,t 1 wA.,�.�Cr ���ir � N��,,�'..t ryr �,�i �, � ^[ v) ?r �z `:.�-'� FAr.�.y,��.�.J'.. ... .. 1y,5 0� ,s,��r�: t..� { f p 5. S „i� t q�w�_• L 1,�4�1r.' �`,�i�7�a R� S�e 9� I`R`. � ({� h. ; ' �f .,�,� �, ,�� `��r�;�,Rosawood Plasa Scjuth�3rd Floor + ; „ ,r r� b� ,{��i�. �'�. r �;�.f w� a i �y �� �•��,�i� y-.� t `p.' � � �' a-� ..� � A ) r a i � � � „k' x i v��F�,1;� � �k�z.� . y711 W COUfl�y ROad 8 � '�r r".:�'y' � ;,„n'$��a�y�,�{� �7` xk ,�fcat;t ��> i�u,;;���...,,y� ,� ��.�^ ..� :r, � 7` I .P �f ��/.� ..,b/rr�� C u���S '9�" �� $�' f;�' �',U� . ��R ,��1. A 4�(l.r'+' �� T�,�i�' �til y� iJ l �:tr.�t,��y . N� ' �ti ` srS�l/ �Y... r Y J1 .fy�y7,r��{�f�7.�l�i � ��' A .. � YS�� R �x; � ! � ✓7r ��;' i ;�, T.. ,���Rosevlll� Fil Si��V:b�Y ��^ f� �;�� �1'»'4H�-F +�.� 1 F��� 1 n.�, x'�C \�::"� �1 r� �����`,LA2i4(Pa�t 2) 1. Y ti:w�y _ `I... t.. q� < <v f 1 �� � {�v.� l � ' �. �; gi t � t�k° .�: t��_.-y r a,� a.jI ��p- y" ���y� ;r l ��� �� '� w ..fi '�1 � 1 �{^i t' 1 •t �� 't lf �F'-.�f '.�iS �Y 'r{ y f ��A . \�7�ii��� �''C�b + �}l.. '�•n x��{ j�.'� :l I y t a . n � �: f � � t { �:Y "Y x.�. �' � �.1 1 r �a,�r (4 �P i..ft �L / � y r , ti s �•t; bf�i�. �Y` t r r , ti ` . . . . ` , u }.: . ..:�� .,. .._ .. . . .... . .. . � . . ,� .., ,. , .. . � . ._ . .. a.�. . } . _.. . .