88-123 WNITE - CIT CLERK
PINK - FIN NCE COl11�C1I //� J
CANARY - DE ARTMEN7 GITY O SAINT PAUL x /���
BLUE - MAV R File NO. !, �'
Counc 'l Resolution %J�
Presented �
��
Re erred To Committee: Dat�
Ou of Committee By Dat�
RES LVED: That application (I.D. 28616) for the renewal of a Class C 5tate
Gambling License (Bingo Only) by the Church of St. Casimer's
Ushers Club at 934 E. G ranium be and the same is h�reby approved.
COUNCI MEMBERS Requested by Department of:
Yeas Nays
Di ond
� In Fa or
�c�
aman �G'"
e1be� Again t BY
nen
son '
Adopted by Council: Date
JAN 2 �98 Form Approve City Attorney
Certified P sse c. 1 Secret BY
sy� �
/�pproved b � vor. Date � �-(O" $� � � $�PP�oved b Mayor for Sulbmission to Council
gy _ l.v-�-c�--� By
PU9tiSHED `�F 3 G 19 88
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. > , . o�re �o a►,s corn�. - ,s. ; �'/ v
: . . .�,�. _ t����= ��y��;fl 0 0 3 2 4
y� . . DEPAi1TMENf qRECTOR � . � MAYOR(p1�A9818iMiT► �� � � � .
.. . . i�`�.5.. . .�i�I� � � . . . �A�a .� FIWAWCE i AAM�NC�IT BERVICE$ ' � CITY C�ERK � � �.
�. � NUMB R FOR , _
Il�lt b`'�� 298-5056 � euor�ro�croR _
. . . r� piK ATTORNEY . . . .
_ . E : _
Rez� applic�a�tioa� for t1�e State of Charitable Gaanb].ir�g '� C].ass C.
� �Yl
:(�►+aove GU«�(R)) c�e�t�s�acH Re�:
. . . •PLAN�IMIO � .. � .� CML SERVICE COMMISSWN OATE�W �� � DATE�Wr - -.AW1LY$T . .- � PHONE N0. � � . � -
� ����A� � 1�91Q"�' �1�9��' +�5
, � , �BTAFF � . . . . . . CFHATER COMI�NSBION �� . PLETE AS IS. -AODT.IIfO.AOOEO'� ._ ADD1 M�f�'b.�' _F�OBItpC�Af7fJED�'.� . .
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J
NfM7�iY M�1i�.OP�ORRN�IRY(INho.Wfist.'VNrn.Whero�M�M:
Mr. J Hick�y, cm beh�a].f of St. 's ChttrCh, is reguestir�g ,il appa�o�Va]. �� thea.x
. : Class C (bir�go ocil.y} Charitable G�nbling �pplication.
;; �noK t :�,��:
If their application is aPPraved, �t.�Y 11 oc�tinue t�o be all� �p�Or b,ingo sessicros
arl ��.:the houx,'s of 7:00 p. . atad 11:QO p.m. at 934 Gerani�un.
, OO�CYdICEi NNwn.ind To Whom}: ' � . ' ". , . . , , . , .
If their application is nat �, will be €o�rved to disoort the spos�ting
of hingo sessioa�s.
�,rnw►�res: . . . - �
Ns�raMr .
. . �t�s:
ii
. . ��O-����
, ' •
T�IVI ION OF �LICENSE AND PERMIT ADMI1vISTRATION DATE j�!� �t � , / �Z ��/��
INTE DF.PARTMFNTAL KEVIEW CHECKLIST `Appn Pxocessed/Received by
� rla �ic Enf Aud
�bK �r��
Appl cant � ,,rL� �� . �,5� Home Address 1(� � � , �f
Ausi ess Iv'ame �S���S �� Home Phone ��� - �a��
Busi ess Address �j �L. Q �,�,� Type of License(s) ���,,�,, � ,�.�.�,_
Busi ess Phone `�� 33 - (� ���� h'���,�
Publ c Hearing Date , � � License I.D. �{ �� �� (.p
at 9 00 a.m. in the Co ncil Chambers, 1n
3rd loor City Hall and Courthouse State Tax I.D. �t V I �q C � �D6%� 'Cx��
llate Nutice Sent; Dealer �� '1� ��1
to A plicant
Federal F3_rearms �� 1�.�1
Publ'c Hearing "'
DATE INSP 'CTION
REVIEW VERFIED (C MPUTER) CC►I�IENTS
A roved N t A roved
B1 I & D +
� I�
,
Hea th Divn. '
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i ,
Fir Dept. i r,� I� I
f �
I '
Pol'ce Dept. I
Lic nse Divn. �
i
Cit Attorney �
I
Date Received:
Site lan �,,A' ;
To Council Research
Lease or Letter Date
from andlord 2 'Ll i'
• ' ' � .
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
,
Current Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
�,.� City of Saint Paul �-��_/�3' /
� � � , ' ' . 'Department oE Fin nce and Management Services `�
�� • - Division of Lice se and Permit Registration
t
INFORMA ON RE UIRED WITH APPLICATION FO PERMIT TO CONDUCT CHAR.ITABI,E GAMBLI*1G GAME IN
SAINT P
1. Ful and complete name of organizat on which is applying for li�ense
St Casimir Ushers Club
2. Add ess where games will be held 9�4 E. Geranium Ave.� SC. Paul� Nll+1 55106
Number Screet ity Zip
3. Nam of manager signing this applic tion who will conduct, operate and manage
Gam ling Games Jim Winter Date of Birth 02/28/19
(a) Length of time manager has been ember oi applicant organization 29 Years
4. Add ess of Manager 851 Tewanna P ace St. Paul� N�T 55119
Number Street City Zip
5. Day, dates, and hours this applicati n is cor �PM — 11PM Thursday
6. Is he applicant or organization org nized under the laws o= the State of MN? Yes
7. Dat of incorporati�n No
_ .
8. Date when registered with the State f Mianesota Approximately 36 Years Ago
9. How ong has organization been in es stence? 53 Years
10. How ong has organization been in ex stence in St. Paul? 53 YeaCs
11. What is. the purpose of the organizat on? To help and assist the church in financial
su rt
I2. Offi ers of applicant organization
Name Jer Hickey *tame Gene Pasiuk
Addr ss 1098 Oran e, St. Paul, NIl�I 55 06 Address 1246 Greshari�, St. Paul, l�t 55119
Titl President DOB 04/20/35 Tit?e Vice Presiden� DOB 10/30/43
Name Bob Wyganowski Name Joseph Zimliah
Addr ss 1151 E. Jenks, St. Paul� 1�1 5106 Address 880 E. Rose� St. Paul� NIl�T 55106
Titl F�eoc�dirg Sec�tary DOB 07/24/37 Title �� '��' DOB Ol/25/40
13. Give ames of officers, or any ot:�er ersons who paid for service3 to tne organization.
Name vame
�
Addre s �ddress
Title Tic?e
(Attach separate she�� .`^.r acdi=_or.s_ .,a�as. ,
.. . . �
;��/�
14. A tached hereto is a list of name and addresses of all members of che organization.
' ' l
15. I whose custody will organizatio `s records be kept?
N e Jose h Zimlich Address 880 E. Rose, St. Paul, NIDT 55106
16. P rsons who will be conducting. as isting in conducting, or operating the games:
N e James Winter Date of Birth 02/28/19
Ad ress 851 Tewanna Place, St. Pau , l�ll�T 55119
Na e of Spouse Bett Winter Date of Birth O1/O1/20
Da es when such person will conduc , assist, or operate Thurs�ay Nights
Na e Date of Bi*th
Ad ress
Na of Spouse Date of u�irth
Dat s when such person will conduct ass�st, or operate
17. Hav you read and do pou thoroughly unde:stand_ the provisions ot� aII laws, ordinances,
and regulatior,s �overning che operat_on ot Charitable Gambl.ing games? Yes
18. Att �hed hereto on the form :urzishe by the Cicy o� St. Paul is a Financial Report
whi h itemiaes al'_ receipcs, expense , and disbursemeacs oi the applicant organizatfon
as e�l as aiZ organ:zat�ons who hav receit�ed funds tor the preceding calendar year
whic has been si3ned, pre�a*ed, and verif�ed by
.fame
851 Tewanna Place, St. Paul, Minneso a 55119
�ddress
who s the Bin o Manager of the anplicant Organization.
vame oz Of ice
19. Oper tor of premises where Aames uil� be held:
Name St. Casimir School Hall
_ Bu�sin ss Address 934 East Geranium venue
Home ddress 851 Tewanna Place, St. aul, Minnesota 55119
20. Amoun of rent paid by applicsnt Or3a i�acion ror renc oi che hall; specify amount
paid er 4-hour se�ston None
_ ,.
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•21. The proceeds o= the games will be d sbursed after deducting priae layout costs and
ope ating expenses for the followin purposes and uses:
St Casimi.r Church's Needs
22. Has the premises where the games ar to be held been certified �or occupancy by the
Cit of Saint Paul? Yes
23. Has your organization filed tederal form 990-T? No If answer is yes, please atcach
a c py with this application. If a swer is no, explain why:
In ome Tax ex tion b the Archdio ese of St. Paul
Any chan es desired 'oy the applicanc .�ssociat�on may be made only winh the consent of the
City Cou cil.
St. Casimi.r Ushers Club
Organization
� �� �
Date 12 14 87 By:
Manager in charge of game
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�""''� Cha�itable Gambling Control Board
'�"'"�. For Board Use Only
. � �; Rm N-475 Griggs-Midway Bldg.
.� 1821 University Ave. P�d��
��t:. - - St. Paul, MN 551043383 Check No.
*: . •:....+'� (612)642-0555
Date:
GAMBLING LICE SE RENEWAL APPUCATION
`�r IICENSE UMBER: �-p�$�2-�,� /EFF.DAT : 03/19/87 /AMOUNT C�F FEE: fSQ.(!0
.i�::
;�=��: "; 1.Applicant Legal Name of Organization 2.Street Address
� ':`° CFN�i DF CR�I�IIRS E1�..�rZ3 CLfJB 5T PRUL 851 ieaanna Alace
'�'''" 3.City,Stat ,Zip 4.Counry � 5.Businass Phone
.<a�;�� St Paul. ; �53t16 Ra�nsev 6�2 735-3899
6. Name of hief Executive Officer 7. Business Phone �* ,�.,'
��` S� �� _ ,3
8.Name of reasurer or Person Who Accounts for Revenues 9. Business Phone ;
�.:_ . .
/G . .•
10. Name of ambling Manager 11. Bond Number 12. Business Phone
:'�'': 3a�es Yint BLA�&(ET 7 .
s.;.:-
�y�'' 13.Name of stablishment Where Gambling Will Take Place 14.County 15. No.of Act'rve Members
���'.� 5# Cas+�ir' �afeteria S� Raul Rae�ev -�$--
;�_` �' 16. Lessor Na e 17. Monthly Rent:
. SO
18. If Bingo w I be conducted with this license,please specify days nd times of Bingo.
s Times Da Times Days Times
�?'`�,� 19. Has licens ever been: ❑ Revoked Date: ❑ Suspended Date: ❑ Deni�ad Date:
." :; .
20. Have inter al controls been submitted previously? �Yes ❑ No(If"No,"attach copy)
21. Has curre t lease been filed with the board? �Yes ❑ No(If"No,"attach copy)
22. Has curre t sketch been filed with the board? �Yes � No(If"No,"attach copy)
•r: .,,.____ _ . , ,�
' "GAMBLIN SITE AUTHORIZATION � ' ' � �'
2 By my signatu e below, local law enforcement officers or agents of t e Board are hereby authorized to enter upon the site,at any time, gambling is
° being conduct ,to observe the gambling and to enforce the law fo any unauthorized game or practice.
BANK REC RDS AUTHORIZATION
By my signatu e below,the Board is hereby authorized to inspect th bank records of the General Gambling Bank Account whenever necessary to
fulfill requirem nts of current gambling rules and law.
OATH
1 hereby decla e that:
1. I have read this application and all information submitted to the ard;
2. All informat n submitted is true, accurate and complete;
3. All other re uired information has been fully disclosed;
4. I am the ch f executive officer of the organization;
5. I assume fu I responsibility for the fair and lawful operation of all ctivities to be conducted;
6. 1 will familia ize myself with the Iaws of the State of Minnesota re pecting gambling and rules of the board and�ree,if licensed,to abide by those
laws and ru s, including amendments thereto.
� 23.Official L I Name of Organization Si nature(Chief Executive Officer) Date Title
ST. ' ��r�.� ' � � ' �C o
ACKNOWL MENT OTICE BY CAL GOVERNING BODY ��
I hereby ackno ledge receipt of a copy of this application. By ackno ledging receipt, I admit having been served wMth notice that this application wil!
be reviewed b the Charitable Gambling Control Board and if approv by the Board,will become effective 30 days from the date of receipt(noted
betow), unless resolution of the local governing body is passed whi h specifically disallows such activity and a cop�r of that resolution is receivedby ,
-. the Charitable ambling Control Board within 30 days of the below n ted date. ; �� '
� ' °
24. City/Coun Name(Local Governing Body) Township: If site is located within a towriship,please complete items 24
�� t Of $t. P1U� and 25:
k Signature of P son Receiving Application: 25. Signature of Person Receiving Applipation
��_ �� �, -
Jose h Carchedi -�
Title Date Received(this date begins 30 d period Title:
' o nsoector 12/21/87 �
Name of Perso Delivering Application to Local Governing Body: Township Name ' .
�''� ; CG-00022-01 87 White Co
( ) py-Board Canary-Applicant Pink-Local Governing Body