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89-458 WHITE - C�TV CLERK PINK - FINANCE GITY OF S INT PAUL Council (((//////�� CANARV - DEPARTMENT J� BI.UE - MAV0�7 File �O. �:, � � - � Counci esolution �� Y 3 � ' �? -�- ; Presented By � � Referred To Committee: Date Out of Committee By Date RESOLVED: That application (ID 18 69) for a State Class D Gambling License by Minnepaul th etic Association for the Deaf, Inc. at 1824 Marshall Aven e, be and the same is hereby approved/ �-. COUNCIL MEMBERS Requested by Department of: Yeas Nays Dimond Loos _� In Favo Goswitz Rettman Scheibel A gai n s t BY Sonnen �� MAR 1 � � Form A roved by City Attorney Adopted by Council: Date Certified Pa: ed by Counc' Secreta By � � � ' J�%/- By� Approve by Mavor: Date �- MAR 171 9 Approved by Mayor for Submission to Council By F�g��p MAR 2 5 8 . - � �9- �� CITY F AINT PAUL INTERDEPART EN AL MEMORANDUM RfCEiVEQ MAR o � 19�� ;�� y�.:. DATE: March 2, 1989 T0: A1 Olson City Clerk FROM: Christine Rozek � Deputy License Inspector RE: City Council Agenda for rc 16, 1989 I have processed an application or a State Class D Gambling License applied for by the Minnepaul At et'c Association for the Deaf Inc. , and have requested that the public ar'ng for this application be held March 16, 1989. The gambling manager representin t is organization is hearing impaired, and at his request we have obtai ed the services of an interpreter for the public hearing at city expen e. I would appreciate your help in ss ring that this item will indeed be scheduled for March 16, 1989, si ce arrangements have been made in advance for the interpreter, and th t the public hearing appear early on the agenda since the interpreter is paid by the hour. CR/lb cc: J. Scheibel K. Sonnen , -.�� ' � � C�� O ' ��j� DiVISION OF LICENSE ANI) P�:RMIT A.I)MINIS T ON DATE '�' �� g� / � ��- �� INTERDF.PARTMENTAL REVIEW GHECKLIST Appn Processed/Rece'ved y Lic Enf Aud Applicant ��h �bQ,u.� ��`t'jL � S GHome Address � � �3 � �e� �`t Nw -�ro,- -�e, D.Q� f�Z.� Codn /�p�d s , M� Rusiness lvame Home Phone Bu�iness Address � b a�" M�✓5�,� r4- Type of Lic.ense(s) �-� l..�llSS Business Phone � h(im� �1 (JI.,1S2� Public Hearing Date 3 ��v 0� License I.D. �{ � 0 3�o -1 at 9:00 a.m. in the Council Chambers, g ,t .� 3rd floor City Hall and Courthouse State Tax I.D. �� A- �� OJ�S7� llate Notice Sent; 3 � � Dealer 4l �J to Applicant I'ederal F�searms �6 � p. Public Hearing --� DATE INSPE TI N REVI�,W VERFIED (CO U ER) CUMMENTS A proved No A roved � Bldg I & D � !A�� r Health Divn. � , �� , , Fire Dept. � � � � iR f I ! S.�n� f Police Dept. a�a.a I � License Divn. � � � � � Q� City Attorney � � � , � � Date Received: Site Plan � To Council Research � � Lease or Letter D te f rom Landlord �1(7 `P4S� i. . ...�..�.� ...�� . - . ., 7. , , . , � . Charitable Gambling Control Boar FOR BOARD USE ONLY }� � Room N-475 Griggs-Midway Buil ing 1821 University Avenue �N�� St.Paul,Minnesota 55104-3383 � M (6121642-0555 AMT CHECK# DATE GAMBLING LICENSE APPLICA 10 INSTRUCTIONS: ... .___._.,. ..__ ... ,.. A. Type or print in ink. B. Take completed application to local governing body,obt n si nature and date on all copies,and leave 1 copy.Applicarrt keeps 1 copy and sends original to the above address with a che . C. Incomplete applications may be returned. � D. Enclose license fee with application. Type of Application: ❑Class A — Fee S 100.00(Bingo,Raffles,Paddlewheels,Ti bo ds,Pull-tabs) OClass B— Fee S 50.00(Raffles,Paddlewheels,Tipboard , I-tabs) M�e�•wy��: ❑Class C— Fee S 50.00(Bingo onlyl �""'O�'c�'�in°��O"��O�d �Class D— Fee S 25.00(Raffles only) Check ons: s1 A. Organization has never been licensed. O 1 B. New site—Give base license number. � ❑1 C. Renewal of existing license—Give comp te I cense number. 0 - 0 - 0 ❑1 D. Change in class of an existing license—Gi c plete license number. 0 - L.�! - 0 ❑Yes�No 2. Has organization ever received a lawful Ga bli Exemption Permit from the Board� If yes,give complete permit number ❑Yes No 3. Have Internal Controls been submitted prev usl on a form provided by the Board�If no,please attach cop�r. 4. Applicant(Official,legal name of organization) 5. Business Address of Organization MI�JNEPAUL ATHLETIC ASSOCIATION QF TNE DEA 1948 Malvern Street 6. City,State,Zip 7. County 8. Business Phone Number Lauderdale, MN 55113 Ramsey c 612 t520-4481 9. Type of organization: OFratemal OVeterans ❑Reli ous �Other nonprofit" •If organization is an"other nonprofit"organizetion,answer q io 10 through 12.If not,go to question 13."Other nonprofiY'wysnizations muat document its tax-exempt status. DYes ONo 10. Is organization incor o�ated as a nonprofit rga izati�?If yes,give number assigned to Articles or page�d book number: A c y of cerdflcate. Yss�No 11. Are articles filed with the Secretary of Ste 1 /Yss�No 12. Is organization exempt from Min�esota or er 1 income tax�if yes,please attach Istter from IRS or Department of Revenue declaring exemption. OYsa�No 13. Has license ever been denied,suspended rev ked?If yes,check ali that a ly: �Denied ❑Suspended ❑Revoked ive date: - - 14. Number of active members 15. Number of yeers i ex ence Note: Attach svidencs of 105 � YeBrs si nc f u�ded � throe ysars axistancs. 20 years sinc i corporated 16. Name of Chief Executive Officer(Cannot be 17. Name of treasurer or person who accounts for other revenues Gambling Manager) of the organization(Cannot be Gambling Manager) John L. Schurtwcher Karen Ann Pugh rtie rrtie President Treasurer Business Phone Number Business Phone Number � � none ihome: (612} 56b-5925� 1 612 ► 293-8823 1 S. Name of establishment where gambling will be 19. Street address(not P.O.Box Number) cop u ted C:lARLc� �. 7HOMPSON l�tEi�ORIAI HAIL 1824 Marshall Avenue North 20. City,State,Zip 21. County(where gambling premises is located) St. Pau 1 , Mf� 55104 Rarns�,y CG-0001-0318/88) White Copy-Boerd Canery-Applicant Pink-Local Gov�ning Body P e of 2 _ f �_ .� _ • _.._ _-- ----� __ - _ __ _ .. 0 ' � r '° , , - �� - �� ' K � Gambling License Application ' Type of Application: �Class A ❑Cla B O Class C �Class D es�No 22. Is gambling premises locate wit in city limits? �Yea�No 23. Are all gambling activities c du ted at the premises listed in#18 of this application?If not,complete a s application for each premise (ex ept raffles)as a sepa�ate license is required for each premises. ❑YesRNo 24. Datt�a 8^ketch of he p em ses ndi ati gswhat portioa nas be'��ng leas d A�ese and sketch areenot req� Class D applications. � 25. Amount of Rent Per 26. Do you plan on c nducting bingo with this license?If Yes.Time� Day mes of bingo��Time Mo�th or Bin o Occasion Day Time Day $ no lease �11fes�No 27• Has the S 10,000 fidelity bon req red by Minnesota Statutes 349.20 been 29��a Number 28. Insurance Compa�Y Name(not agency nam 1 5jj�7�;pq7 '�ies�ern �urety Company 32. Cit�►,scate,zip 30. Lessor Name 31. Address 34. Address 35. City,State,Zip 33. GamblingManagerName 1143�3 Z@d Street Northwest Coon Rapids, MN JacoL J. uraff 36. Gambling Manager Business Phone 7. ate gambling manager became Month 1 Yee� 7 4 ember of organization: � 612 ) 721-4b�8 ❑Yes 4�No 38. Has the license termination f rm en completed�Attach coPY• ❑Yes�l0 39. Has the compensation sched le n approved by the organization?Attach copll- . � p.m. 40. List the day a�d time of the regular meetin of t organization.Day nd tUi'dd tt10►1� y Time • 2. Ba�k Address 43. Bank Account Number 41. Bank Name y65 Whi te 8ear Avenue wi l l open account t�iidwest Federal - lewood, MN 55109 first funds are rE E�iapl ewood Cff i ce p MBLING SRE AUTHORIZATION - By my signatur s�nW conduc ed to obse e t e gamb/ng and to enfo c e the taw for any u�authonied game or p ac t i m e g a m b l m g 9 N K R E C O R D S A U T H O R I Z A T I O N By my signature below,the Board is here y a thorized to inspect the bank records of the gambling ban k accoun t necessary to fulfill requirements of curren ga bling rules and law. I hereby declare that: OATH 1. I have read this application and all inf rm ion submitted to the Board; 2. All information submitted is true,acc rat and complete; 3. All other required information has be fu y disclosed; 4. I am the chief executive officer of the rg nization; 5. I assume full responsibility for the fai and lawful operation of all activities to be conducted; 6. I will familiarize myself with the law of e State of Minnesota respectin9 9ambling and rules of the Board ar licensed,to abide by those laws and les including amendments thereto; 7. Membershi list of the or anization ill available within 45e Sd9 e�e;TU ��ed by Chie fExe utive Of 44. Official,Legal Name of Organization ._.. l�INNEPAUL ATNLETIC ASSOCIA7I0 0 THE DEAF D e � _ Title of Signer � � '" � President ACKNOW D MENation.B�acknowfed9 g`e e IpER ad�'n heD ng been served with I hereby acknowled9e receipt of a copy of his pp this application e��date of1e ce pt(noted bel w) unless anresolution of the local govremen9 bodY s�Pa�d'Wh ch 60 days from th of tha res lution is received by the Charitable GamWing Control Board within 6C disallows such activity and a copy below noted date. If site is located within a township,item 47 must be c 46. Name of City or County(Local Gover ing dY) addition to the county signature. If township is nc Ci ty of St. Pdul county must sign. Signatu�e of person receiving application 47. Name of Township ' -. ; • ��. , X � � :i��:_i,, • ::�.:� f �.` Title , Date receiv d( day period Signature of person receiv�ng application • begins fro this ate) ! , ;- X '� t_ . � ��'� +�� " � "' � j � 48. Name of persort defivering application t ` I GoJemin9 BodY Tttle �� .5��y s� 5G� V m� �� Pink-Local� CG-0001-03 18/881 Wh e C y-Boa�d Canary-Applicant Page 2 of 2 .. ...�, . . __ . . � l�� 9 ity f Saint Paul ' „ � DepaMment of Fin nc and Management Services �„� �_�� ' Lice�s an Permit Division C(ty Hell St. Paul, inn ta 5510Z-298�5058 � APPLICA 1 FOR LICENSE CASH CHECK CIASS NO. ew Re�ew � 0 � � � � �te � � t9� Code No. Title of Licenae Fro�°2°2- 19�To �—°Z� 191Gc �ls C �G�s bl, ll� � (� �oo /-1�n n�A2 u� R�-1,l e�-!L �SSvG � -�, �� . (� AOWlean N t0o �QG f -�hG � �Sa � Mo�h� rc �U � �oo ew�n�s.N.m. , , ,� s7� ��ul, �-i� s �` �oy � Busin�ss�►ddnss PAon�Na 100 700 Mail to Addnss Phon�No. �oo J Q C O � �� i r4-F f Manap�HOwn�r•Nart►� 100 11 y3� Z��< S� �� 100 AtsnaqNlGwna•HoiM Addn�t PAOn�No. IOpd Appliestion FN Z. � �cNwd th�Sum of �00 �OUr� �\C� �� d�� '1 �5�3 3 � �Q�o� , Ma�.9.now�+.�.c�cy.s�ai.a np cod. 100 Tot 1 100 � G�uM� Ue�nse Inspector ` By: �'�- s�qn•tun a Appiteant Bond• CompaMr Name Pdkp No. Expintion Dat� insurance• Comp�ny Nam� . PoHcy Na �o+�•na+o.e. Minnesota State Identification No � Social Security No VehiCle I�formation: � S�rial Numb�r at� umb�r Other THIS IS A REC iP FOR APPLICATION THIS IS NOT A LICENSE TO OPERATE Yow application for lic ae ill either be granted or rsjected subject to the provisbna o(the zonin9 ordinanc�and compl�tlon of th�Insp�ctiona by the Health. Fir ,Zo iny andlor Licsns�Insp�ctore. �15.00 CHARGE FOR AL RETURNED CHECKS . d, � �.e r l-�e � �- . C.� �l ( h�e .� _ �-�� z� � � / � `� , • � . � � '� �� ' City f S int Paul ' . Finance and Management S vi esjLicense & Permit Division INFORMATION RE UIRED WITH APPLICATZON FOR E IT TO CONDUCT CHARITABLE GAMBLI.IG Gr1.�fE I�T SAINT PAUL (To be used with the followin : ew A & C application, renew A � C Licenses, and new and renew B in Private C ub .) 1. Full and complete name of organizatio w ich is applying for license MINNEPAUL ATHLETIC ASSOCIATION OF TH D AF, INC. 2. Address where games will be held 82 Marshall Avenue St. Paul 55103 um er Street City Zip 3. Name of manager signing this applicat on who will conduct, operate and manage Gambling Games JdCOb J. Graff Date of Birth 1/4/43 (a) Length of time manager has been m mb r of applicant organization 14 yedrs 4. Address of Manager 11438 Zea Street or hwest, Coon Rapids, MN 55433 Number treet City Zip 5. Day, dates, and hours this applicatio i for Evening, second Saturday each month 6. Is the applicant or organization orga iz d under the laws of the State of MN? Yes 7. Date of incorporation March 31, 19 9 aritable Organization 8. Date when registered with the State o M nnesota RegiStration-.Statement attached 58 years since foun�led 9. How Iong has organization been in exi te ce? 20 years SinCe incorporated address moves with secretary's; 10. How long has organization been in exi te ce in St. Paul? buSinesS in St. Paul often 11. What is the purpose of the organizati n? To foster and conduct amateur athletics for hearing-impaired persons; Qualif ed Amateur Sports Organization; physical education 12. Officers of applicant organization: 1 o fiCers ; see attdChed Name Name Address Address Title DOB Title DOB Name Name Address Address Title DOB Title DOB 13. Give names of officers, or any other rs ns who paid for services to the organization. None Name Name Address Address Title Title _, (Attach separate he t for additional names.) , (� O ! �� 14. AttacE►ed hereto is a Iist of names an a dresses of all members of the organization. 15. In whose custody will organization's ec rds be kept? Name Harvey J. Hoffman Address 1948 Malvern St. , Lauderdale 55113 16. List all persons with the authority t s gn checks for dispersal of gambling proceeds: Name Jacob J. Graff Name Address 11438 Zea Street NW, Coon Ra id ��dress Member of Member of DOB 1/4/43 Organization? YeS DOB Organization? Name Karen Ann Pugh Name Address 2295 Shawnee Drive, North St P ul Address Member of Member of DOB �/2�/52 Organization? YeS DOB Organization? 17. a) Does your organization pay or inte d o pay accounting fees out of gambling funds? yes no X b) If you do pay accounting fees, to o will such fees be paid? Name ddress DOB Member of Or an zation? c) How are the accounting fees charg d t? (flat fee, hourly, etc.) 18. Have you read and do you thoroughly u de stand the provisions of all laws, ordinances, and regulations governing the operati n f Charitable Gambling games? Y25 19. Attached hereto on the form furnished by the city of Saint Paul is a Financial Report which it .emizes all receipts, expense , d disbursements of the applicant organiza- tion, as well as all organizations wh h e received funds for the preceding calendar year which has been signed, prepared, an verified by Karen Ann Pugh 2295 Shawnee Drive, North Sain Pa 1 , MN 55109 Address who is the Treasurer of the applicant organization. Name 20. Operator of premises where games will e eld: xame Sue Johnson, Chair, House Commi te , Charles C. Thompson Memorial Hall Business Address 1824 Marshall Aven e, t. Paul , MN 55103 Home Address same as business addres ( he and husband are caretakers of the hall ) ' � � , ` . � � ( -�� . � 21. Amount of rent paid by applicant or an zation for rent of the hall: None 22. The proceeds of the games will be d sb rsed after deducting prize layout costs and operating expenses for the followin p rposes and uses: enhancing opportunities of deaf p opl for physical educational advancement and contributing to their physical well- ing by fostering and conducting amateur athletic competition for deaf per on and training deaf athletes. 23. Has the premises where the games ar to be held been certified for occupancy by the City of Saint Paul? Yes 24. Has your organization filed federal 0 990-T? N p If answer is yes, please attach a copy with this application. If an we is no, explain why: Any changes desired by the applicant asso ia ion may be made only with the consent of the City Council. MINNEPAUL ATHLETIC ASSOCIATION OF THE DEAF, INC. Organization Name Date o�� — g� gy; '' Manager i rge of game vK � Organization President or CE � 7 � _ � z` :n � — n .. — 's O 9 9 < � I � � � 31 � ? rr rr r0 t � S � a r► � � . ff t1 '� ^f y I O' A !r ,r A 7 � ti '0 � � ; .7 7 'J � � '' � 7 3 '< � n r0 3 `C � � 3 •� :�,ANVyVNyyls '�s T re ►R.. +� = c � "� �j r► � A r+ � n ' a T ��;i� � �' ti > > � •s - o � � _ ■- �- i:ll = ^► 3' 3 n g �% � � � = n n = 3 " • s „ • • � O I + = I�C R ., :� � m I /` a a = f_ — � �e � A = � 1 � T� y ` � _ . . r' ,7 r+ 7P A � � = � A � z��n N � = � �O Ql a 9 'd '< � ^��rZ � ,9 = I� � `�t. ..i ... v �7 �f S c' _c�Z '+ O � � i �I g `N° p � ^' 4 7 � � � I � � ■t — � : Z � C $'n � :0 � n �0 � �= S � ��`�' ( � ' �° _ ^ � r 3 , � �I `y � -+ I � I s a �eI o o � � � � ; � ^ c� :r 9 �. � _ n c=� � p , � ; � � �,� � ; � � � ' �= a vw�nnnn�vv�t I � c � ^. T s � I • d � � �A A � � I ' 1 < a o I � � � r► A � � � � a � 9 � � � a � ! I = � � � � ] ; I �°Q 7 O A � � � � � a .. i i � � . � ��.� �,n� . �+ n �. �= �- y�� , a� ��'�`GE� ��.�'�� NO. �W��4�. J. Carche�i ' � �T� - . . � . � . . . DEPARTMENf DIRECTOR �� MAYOR @OR-7�TAKI)... . Christine Rozek � — �.�� 3�«� � �. � �. �� — �a� 2 Council Research - Finan e & t. Z98-5056 °R°�: �.�A„� . . Application for a State Class D G mb ing License (RaffT:es Only). Notification Date; 3�z�$� Hearing Date: 3-�6-89 II�ObM�lIDilff011S:(Apprare(P)��(R)) OOUIK�L REPOR'f: . . � PLA�NiR�O COAM1IS310IJ � � . . CML SERMICE�ION � DATE IN � DATE OUT� .. � ANALYST . . - � PHONE NO. �. . � . . . �OMMIO COI�M�MS&ON - 19D 876 8Ci1001 BOARD � . . . � . . . � - SfAPF � . � qiARTER��W . AB � " - AUDL NJFO.AODED+ . .RET'D TO�CONiA�T .�CONBTRt�Bif � . . � - . . _,_ . . _..�F+019 ADD1 IWFD. _FEEDBACIC ADDED� . DISTRICTCOIIWCIL t ExP�/WA � . .. . . � BU�Pf�11I5 NMiClf�COUNCIL O&IECTIVE9. .. . . . � . . � . :. . . _. .. . �. . . � _ . . . . . . . . . �� : .. :. ... . . � � . . . , .'. � NiMiM6 PRO!{.�r�.O�PORT{lN11'1�(Who.W�t,UM1en.1M118ro.MIFy): Jacob J. Graff, on behalf .of.the in pau1� Ath1etic Association of the Deaf, Inc.., requests Council approva1 0. h s �ipplication for a gambling 1ice�se -at. : 182A� .Marshall Avenue. . Proeeeds f am �he s.ale of :raf�fle�:�ca�endars will be used � to foster and conduct amateur ath et cs for hearing-impaired persons. .N�i1�lcA„oM!G'a«l8.rn�r.Ae�rNnq�:R�): „< , .. _ -Itll .fees and applications have be' n ubmitted. ,. �lYNiYt.,NR�,�nd ro Whan):_' > . ..> . - , , _. �. , If Council approval is given, the Mi epau1 Athletic Association wi11 hold raf#le_drawings at 1824 hlars ai Avenue. ,tw�►n�: ; . _- - .. . . ca+s �u CO;; .rj� �staRrtan�rs: r��aR � �� : �.�: