88-259 WHITE - CITY CLERK
PINK - FINANCE COUflCII ����_/
CANARY - DEPARTMENT G I TY OF SA I NT • PAU L ys �
BLUE - MAVOR File NO• —
Cou c ' Resolution
. � ag
Presented By �
Referred To Committee: Date
Out of C mmittee By Date
RESOLV D: That Application (I.D. #47823) for a State Class B Gambling
License applied for by the Attucks-Brooks American Legion Post
#606 at 976 Concordia be and the same is hereby approved/�e�ee�.
COUNCIL EMBERS Requested by Department of:
Yeas Nays
Dimo d
Long [n Favor
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Re
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Adopted by ouncil: Date
FEB 2 3 � Form Approve by Cit ttor
Certified nc' , re BY
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Approve � avor. Date 2 5 Approved by May r for S bmission to Cauncil
gy BY
ISHED iYi�i� � � 1988
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' NUMBER F 7
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Fir�ar�oe & t. � 238-50�6 oaoER: l �.��Y
_ . . '
Applica for �1 of a State ot ' Charitable Ga�nbli�g I�.vense, (Pulltab�
(�l.y�
APPLI WAS �37 BY I,ETTII2 L��D 2 /88 THAT
tans:� c�«�c�� co� n�oar:
��►+++wca cm a�vice cowissrora a���n o �awe i+o.
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m�io �eo eaa xHOO�eo�ao
sr�. cw�n ooe�nissroN ns is —� _��i+�� ,��Gn�*
as�cr couwc� ��vuw�Taw:
auv�artrs wr�c�ca
Councii Research Cen:t�r
FEB 11 i98$
�� �n�,�,�,�,.,�.�:
Mr. Leoa� . Dodd, o� behalf of Attudcs- �rnerican I.egi�n Pc�st, reqt�e�ts Caanc�l appraval
,. of t�eir -].�cat�oan for a State of ' C�itab].e.�a�nbl.ing License C].ass B.
: ,�et�„oK: �.r+�r. . . . . ., . . ,.
All applicati.oa�, feeS. dnd hav+e be�ri �`ec�eiv+ed. Tf app�o�ved, Attt�cics-8�ls8
� ��nerican ia�n Post wi.11 be allc�red to t3nue tt�eai,r spa�s�c�r�h�,p of ptalltabs at their
�76 ' lcicati.on. _
�: wnr+.:.nd to wi,a,�>:. . .
If ' approval i.s r�t given, Attwcks frooks �,11 r�at b+e ail� t,o �or�ti�us the sale
of pull at thei.� 976 Coa�oor�da.a locai;i . .
. ,y.uww�s: . . c,o�e
wsronv .
. _
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DIVISION 0 LICENSE AND PERMIT ADMINISTRATI(JN DATE �! �� � o / � � ` ��
INTERDF.PAR FNTAL REVIEW CHECKLI$T Appn Processed/Received by
Lic Enf Aud
Applicaut � �. `_> ��G� ��' Home Address ���� V�ajM't-�-�..
Business ame - [���--D-� Home Fhone
���.� ���`�� �a�-�
Business ddress q 7� � Type of License(s) ,��
Business hone �
Public He ring Date ��a�l �� License I.D. 41 � � D v�3
at 9:00 a.m, in the Council Chambers,
3rd floor City Hall and Courthous State Tax I.D. 4� N jA'
llate ATOt'ce Sent • ;J � � Dealer �l � ��-
to Appli ant ��� � � .
`� Federal Firearms 4� Iv �'
Public H aring
DATE INSPECTION
REV EW VERFIED (COMPUTER) COMMENTS
A roved Not A roved
Bldg & D �
N (� ;
Healt Divn. '
N ��4 !
�
Fire ept. � �
� � I� I
S-�v�
Yoli e Dept. a/�/�,!/
( I�
Lice se Divn. (`��� �/
al��f 1�X
Cit Attorney �
I
Date Received:
Site lan N �a- (/
To Council Research a � � �(
Lease or Letter l . C`} �� Date
from Landlord �wn b+�-� �"^ � ��
� , . ����
,.,.,,
���f�'''�- Charitable Gamblin Control Board
.e�o,�eo�h�;?�<: 9 FOR BOARD USE ONLY
:;;,-`� `'s'�'��`=, Room N-475 Griggs-Midway Building
- :'� 1821 University Avenue ucanse Number
_ St. Paul, Minnesota 55104-3383 AMT
� - - - (612)642-0555
+ ; - • •
�: •'...."• � CHECK#
� L�' '� `" AMBL NG U EN E A I T DATE
, _� G I C S PPL CA ION
� ,-
INSTRUCTIONS:
A. Type or print in ink.
; - B. Take comple ed application to local governing body,obtain signature and date on all copies,and leave 1 copy.Applicant keeps 1
copy and se ds o�iginal to the above address with a check.
C. Incomplete pplications will be returned.
Type of Applicat on: -
❑Class A — Fe 5100.00(Bingo,Raffles,Paddlewheels,Tipboards,Pull-tabs)
�lass B — F S 50.00(Raffles,Paddlewheels,Tipboards,Pull-tabs) ��Spayaaeeo:
�Class C —. F $ 50.00(Bingo only► M��nsto��Charitsbls Gambing Connd Board
�Class D — F e S 25.00(Raffles only►
C�Yes�No 1. �s this application for a renewal? If yes,give complete license number 0 - �� 3 '� - a�-�
❑Yes�No 2 If this is not an application for a renewal,has orqanization been licensed by the Board before? If yes,give base
license number(middle five digits) �? � �+ �'��
C�SYes ONo 3 Have Internal Controls been submitted previously?If no,please attach copy.
4. Applicant( fficial,legal name of organization) 5. Business Address of Organization
. „ ,�
i� ,��- � _: J ,� � / 'T _ •
. i �� . .n /i:,- .�.�r.�.d ��%�� �.+�,>,. �� ���r. �,r 60.± ! i'O �r✓:'..'�.L').X.L:i�
6. City,State Zip 7. County 8. Business Phone Number
�«ry. ,.�L '�,. . '?� C�j ^ sl . ?�'�,,,.,.� ( y. i � ('u:�.j—;jl/J.../�
9. Type of or anization: ❑Fraternal C�Veterans ❑Religious ❑Other nonprofit'
•If organiz ion is an"other no�profit"organization,answer questions 10 through 13.If not,go to question 14."Other nonprofiY'organizations
must doc ment its tax-exempt status.
�Yes ONo 0. Is o�ganization incor o�ated as a nonprofit organization?If yes,give number assigned•to Articles or page and
! book number: Attach copy of certificate.
❑Yes�No 1. Are articles filed with the Secretary of State?
��DYes ONo ' 12. Are articles filed with the County?
[;�Yes❑No 13. Is organization exempt from Minnesota or Federal income tax?If yes,please attach letter from IRS or Department of
Revenue declaring exemption or copy of 990 or 990T.
C3Yes�No 14. Has license ever been denied,suspended or revoked?If yes,check all that a ly:
ODenied OSuspended ❑Revoked Givedate: � - - �
15. Number of active members 16. Number of years in existence Note: If less than four years,attach
evidence of three years
• � ,� ,:.� ,• existence.
17. Name o Chief Executive Officer 18. Name of treasurer or person who accounts for other revenues
� � of the organization.
�1E,�, �� ..;-i �`�:i�> i � �U � � - �
Title Title
� , ,,r- - - ,
� .
Busin ss Phone Number Business Phone Number
, ( �� !1 1 •',_„,y _ , 1 ,D/'� 1 .r.�.. — / . ';/
19. Name f establishment where gambling will be 20. Street address(not P.O.Box Number)
cond ed #
� � . Cl �� ;� ��.� � �.•..." ' �'�- �e 6 5 �G �,-�M�.� � .w
�� � 21. City, tate,Zip ' � �. , . 22. County(where gambling premises is located) {n.
•b� . ' n . ' r� . ._ � � � � _ � . � .. .... ' .". . f,� . � .J-. ... . . . . ..
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� . .•.LG{.: ;�j:L+ti.y�i �v ��� � �^.C%-dr+ilj � .
CG-0001- 218/86) White Copy-Board Canary-ApplicanY Pink-Local Goveming Body
� � ��a�l
Gambling Licen e Application Page 2
Type of Appiica ion: ❑Class A C�Class B C Class C ❑Class D
l�Yes ONo 23. Is gambling premises located within city limits7
-_- l�Yes�No 24. Are all gambling activities conducted at the premises listed in #19 of this application? If not, complete a separate
� : .�' applicatio�for each premises(except raffles)as a separate license is required for each premises.
�`''
,�;;. �,1(es�No 25. Does organization own the gambling premises?If no,attach copy of the�ease with terms of at least one year.
�:�
-�"'�~BYes�No 26. Does the organization lease the entire premises�If no,attach a sketch of �27. Amount of Monthl Rent
� � the premises indicating what portion is being leased.A lease and sketch S
- �ry�"' is not required for Class D applications.
�Yes C�No 28 Do you plan on conducting bingo with this license?If yes,give days and times of bingo occasions:
Days Timss
�iYes�No 2 . Has the S 10,000 fidelity bond required by Minnesota Statutes 349.20 been obtained?Attach copy of bond.
30. Insurance ompany Name 31. Bond Number
32. Lessor Na e 33. Address 34. City,State,Zip
35. Gambling anager Name 36. Address , , 37. City,State,Zip
1) ` -1 . .- `� . •w �. i ' .i � .''�
�; !.1� .;.�� '�:
38. Gambling anager Business Phone 39. Date gambling manager became
( � ,j���,� . � ��, ,�- member of organization: ���:
-- GAMBLING SITE AUTHORIZATION
" By my signat re below,local law enforcement officers or agents of the Board are hereby authorized to enter upon the site,
at any time, ambling is being conducted,to observe the gambling and to enforce the law for any unauthorized game or
practice.
BANK RECORDS AUTHORIZATION
By my signa re below,the Board is hereby authorized to inspect the bank records of the General Gambling Bank Account
whenever n cessary to fulfill requirements of current gambling rules and law.
OATH
I hereby dec are that: -
• 1. I have r ad this application and all information submitted to the Board;
2. All info ation submitted is true,accurate and complete;
• 3. � All oth required information has been fully disclosed
4. I am th chief executive officer of the organization;.
5. I assu e full responsibility for the fair and lawful operation of all activities to be conducted;
6. I will fa iliarize myself with the laws of the State of Minnesota respecting gambling and rules of the Board and agree,
if licen ed,to abide b those laws and rules, includin amendments thereto.
40. Officia,Legal Name of Organization � 41. Signature(must be s�ned by Chief Executive Officer)
� :.�,:� � ;:,;� „ X -� �c„�� •'-
Titte,of Sign r ' Date�� � �
/ r�.,:, � !.� �; ` �
ACKNOWLEDGEMENT OF NOTICE BY LOeAL GOVERNING BODY
I hereby a knowledge receipt of a copy of this application. By acknowledging receipt, I admit having been served with
notice tha this application will be reviewed by the Charitable Gambling Controt Board and if approved by the board,will
become e ective 30 days from the date of receipt(noted belowl,unless a resolution of the local gove�ning body is passed
which spe ifically disallows such activity and a copy of that resolution is received by the Charitable Gambling Control
Board wit in 30 da s of the below noted date.
42. Name f City or County(Local Governing Body) If site is located within a township,item 43 must be completed,in
- addition to the county signature.
-� _ '
, t '—,c ��
Signature f'perso`�receiving application 43. Name of Township ^
. , � �, 4�
� X '� ,, ,� .�,.,
Title �' Date received(3Q day period Signature of person�eceiving application
��" } q begins from this date)
!�' `�,'.!i.r::�'a,., � � �i;�yi.''Jr,�. )- Z ��_ ri s✓ X - � . . -
44. Nam of Person delivering application to Local Goveming Body Title `
• ; ,a
- . �_.
CG-0001- 2 (8/86) White Copy-Board Canary-Applicant Pink-Local Governing Body
, . Cic;� o: Sa�r.0 Pau1 �� � ���,�
Deparcmecit o[ Finance and Managemenc Services �� '
Division of License and Permit Registration
INFORMATION E UIRED WITH APPLICATION �'OR PERMIT TO CONDUCT CHARITABLE G?,.*iBLING GAME IN
SAINT PAUL
1. Full a complete name of organization which is applying for license
S UX e �can/ �d� 7` # 60�
2. Addres where games will be held �'�, �a,vcoaa.� 05�-�,frJ1, S S/0'�
Number Street City Zip
3. Name o manager signing this application who will conduct, operate and manage
Gambli g Games �AIiR+/�=S,�I�i�f�fiS .�iIZ Date of Birth �/ � �
r
(a) Le gth of time manager has been member of applicant organization /�JS�
4. Addres of Manager j(�¢/ yR6�roi� S�-�v�, �'Sf/�
�umber Screet Cfty Zip
5. Day, d tes, and hours this application is for
6. Is the applicant or organization organized under the laws o: the State of MN? �
7. Date o incorporation /y�b
8. Date en registered with the State of Minnesoca /4 4�(0
9. How 1 g has organization been in esistence? � g��
10. How 1 ng has organization been in existence in St. Pau1? f5�y
11. What s the purpose of the organization? �����a;f,�s l"±F��,��v�. •�-��• ..r
I2. Offic rs of applicant organization ,
Name . *iame �[�i�, f���
Addre s j 3,�c� L�f�,,�Me„�t Address / .G%/�k.•2-�
Title ,n DOB ��(,�3d Tit1e r.�� ds � DOB %y
Name � ? � � Name r>� ,.v g�c� ��s 1 J.0 G�
,
Addr� s � / � • ?,ddress � �� S �'�' /�,--��.�, ,�1,,.�
I/
Title DOB Title y �e ()' nc..�- DOB ����
13. Give a es of officers� or any ot:�er persons who paid for services to tne organization.
Name Name
Addr ss address
Titl � T_��Ie
(Attach separate sna�� `.^.r acd±__or.s: ::�_as. '
. ' . C�/`��° ��
14. Actach d hereto is a list of names and addresses of all members of che organization.
15. In who e custody will organization's records be kept?
Name �fj� � � Address /�y/ �
16. Person who will be conducting� assisting in conducting, or opera ng the games:
Name �'�" Date of Birth � 6 ��
Addr s / 5'' �.�G�fi .
Name o Spouse ,� L 6� Date of Birth / /y
Dates hen such perso�. wfll �conduct, assist, or operate
��l ��/
Name Date of Bisth
Addres
Name o Spouse Date of Birth
Dates hen such person wi11 conduct, ass�st, or ope-ate
17. Have ou read and do ;rou thoroughly unde:stand the provfsions of aIl laws, ordinances,
and r gulatior,s �overning the operat:on oi Charitable Gamoiing �ames? -,C)
18. Attac ed hereto on t?�e form furnfshed bv the City o� St. Paul is a Financial Report
whic:� itemizes ai'_ receipcs, e:{�enses, and disbursements oi the applicant organization
as we11 as ai1 orgar.izatfons who zave :ece:ved _unds ror the precedizg calendar year
which has been s:�ned, Frepared, and veri��ed by -��� ��,..�,�
� �ame
� �
�� �� �s�i� �. �, � /�°G6G /G
� ?.adrzss
who i the�� �� �' �
� � . �� oP the applicar.t Q-ganization.
vame oz Of�ice
19. Opera or of premises where �ames :��1:. be heid:
Name � , ����
✓ �� � lvd �
�
Btrsin ss Addres " ��
Home ddress � �
20. Amoun of rent paid by applicanc Organi:,acfon ror re�c oi the hall; specify amount
paid er 4-hour se�ston
��_ �� -
� ����
21. The pr ceeds oi the games will be disbursed after deducting pri2e layout costs and
operating e:cpenses for the following purposes and uses:
f w,� �w. - cw_I�-%_ � v�^�n0-�i �-i/�, .
� �
22. Has t e premises where the games are to be held been certified for occupancy by the
City f Sa�int Paul? � ��
23. Has y ur organization tiled tederal form 990—T? ,(�,�J If answer is yes, please attach
a cop with this appiicacion. IE answ2r is no, �lain crhy:
Any change desired by the applicant 2.ssociatfon may be made only with the consent of the
City Counc'1.
,�Tl�'k� E; �r'cdl�, �i�T � Q b
Organizacion
� � � �
Date �� . B, . � � �cy�.s-�
Manage: in charge oi gam2
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„ �,*.� CITY OF SAINT PAUL
o;�� '�� DEPARTMENT OF FINANCE AND MANAGEMENT SERVlCES
�` '�����p 'p DIVISION OF LICENSE AND PERMIT ADMiNISTRATION
�h ,�,� wa Room 203, City Hall
Saint Paul,Minnesota 55102
George Latimer
Mayor
February 5, 1988
Attucks-Brooks American Legion Post �C606
976 Concordia
St. Paul, MN 55104
Dear Attucks-Brooks American Legion Post ��606:
Your application for a State Charitable Gambling License has been
received in this office.
A hearing on your application for Class B State Gambling License ID ��(s)
47823 will be held before the St. Paul City_ Council on February 23, 1988
at 9:00 A.M. , Third Floor of the City and County Court House. This date
may be changed without the License & Permit Division's consent and/or
knowledge. Therefore, it is suggested that you call the City Clerk's
Office at 298-4231 to confirm this hearing date.
You are hereby notified that your attendance is required at this
meeting. Failure to appear may result in denial of your application.�
Very truly yours,
-'±f"' � .., ' ,I� ; � ��'
,�--�� � � , � -�� �� � � ;�,;�:n/� {lrti.r�r
Jo� ,/ �s =,.�..
h F.�Carchedi
License Inspector
,
JFC/Ik `
►
. � ����1
_4�.�,*.;. , CITY OF SAINT PAUL
DEPARTMENT OF FINANCE AND MANAGEMENT SERVICES
; �i i °�
�, „ DIVISION OF LICENSE AND PERMIT ADMINISTRATION
,��� Room 203, City Hall
Saint Paul,Minnesota 55102
George Latime
rNayor -
2/4/88
To: Virginia Baisley
From: Christine Rozek �'�
Re: Record Check
In connection with an application for a Class B State Gambling License
by the Attucks-Brooks American Legion Post # 606 at 976 Concordia Street,
a record check is requested on the following people:
Leon L. Dodd James Murray
1324 Edgemont 941 Dayton Avenue
St. Paul St. Paul
Birthdate: 4/6/30 Birthdate: 9/2/18
Larry Neal Donald Russell
173 Charles Avenue r 757 St. Anthony
St. Paul St. Paul
Birthdate: 5/ /27 Birthdate: 4/13/26
A copy of the application is attached. A hearing date has been set for this
license application for 2/23/88. Please send us the requested information
by 2/16/88. �
, CR/car
attachment