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88-478 WHITE - CITY CLERK CO�IRCII rI PINK - FINANCE GITY O SAINT PAUL �d `�7 � CANARY - DEPARTMENT BLUE - MAVOR File NO. Counc 'l Resolution - �fa Presented By Referred To Committee: Date Out of Committee By Date RESOLVED: That Application (I.D. 70038) for a One Day City of St. Paul Gambling Permit (Raffle Only) applied for by the East Side Lions at 1560 White Bea Avenue on April 6, 1988, between the hours of 7:00 P.M. and 1:00 P.M. be and the same is hereby approved and the City C uncil does hereby permit Hafner's to allow the East Side Lio s to conduct this one time raffle event, pursuant to the rovisions of Section 409.08 (6) of the Legislative Code. COUNCIL MEMBERS Requested by Department oE: Yeas Nays � Dimond �� In Favo � Rettman Q. B sche;nei __ A ga i n s t Y Sonnen Wilson APR + � �� Form Approve City Attor Adopted by Council: Date � Certified Pa;- ouncil , ret BY— gy, /Approve Mavor: Date _ r� ��� Approved by ayor for Submission to Council By BY PIlB�1��l�D ;-�'�,,; i � i 88 . ���7� UIVISION OF LICENSE AND P�RMIT ADMIN STRATION DATE � OS � ��/ � a��� INTERDF.PARTMF.fiTAL REVIEW CHECKLIST Appn Processed/Received by Lic Enf Aud Applicant 1 �OMQJ Lt �r�.n Home Address ��p3� Q/NPrI��VL �� c . l , d Rus ine s s Name C.Q� j� (..lp Home Phone � ����p S Business Address ��� Wh.t� Vr � Type of License(s) C �\/ I�QMb�CVIL� Business Phone T1.�jYlt,"� ' �Q,.���„ �1`1 �v Public Hearing Date y .S g� License I.D. 4i � oa 3 g at 9:00 a.m. in the Council Chambers, N �� 3rd floor City Hall and Courthouse State Tax I.D. �1 llate Nutice Sen • Dealer 46 N �A to Applicant g� Federal F�_rearms �� N ,/�'� Public Net�ring DATE INSP 'CTIUN REVIEW VERFIED (C MPUTER) CUMMENTS A roved N t A roved Bldg I & D I � u l�°r ' , Health Divn. ' , __ ; N�� � Fire Dept. i � ; N �A I Police Dept. f �� s�� � � License Divn. Q � i � � City Attorney � I Date Received: Site Plan To Council Research L�j)aQ �� Lease or Le�t�r �i Date from Landlord yQ,d. .�'.3 �a D 7 - ��.� .. RY£Z ra,^r., � �� �� ,��7qaq c � '°q'c'.'mFS +��a'., � :_�.q�tr x�c�7�r fF ..,4.' j�h� .. I `#'i . . ' y :�.'�''��'�.��� �t'+�+' L .} $ P r . 3'y �t; A w;-� � , ,4[ �-^.3,z�•s y x ,�r/' 3� G"' t,� f:.�r � �: ��.�� , �} �r �,�. {„a�"?F ',"Li l„}� -. �� y.�a � ., y,�a+ti �: e��� ,�r t�..* +e�. ,v�s . � �-s.f �� � ��'�' tc:- tc- - ° J; �. '�� � _ }"i.,.r ,`� '7�i� � Fa '�.,,. ,,�.-� a�,. c <^ . 4 ' . ! ., . •,�: .�{ =ti_. `. y '. -,.. . .,. - ». , � . �: ,,; . . . "' Minnesota Charitable Gambling"Con Board �,�, �mf'�*" " ' 'LAWFUL GAMBLING EXEMPTION ,� � u � � ` `:� '`��Room N475 G�iggs Midway Building;' � � `,�'�; ° '� .,�. � . � :, ., �-. ;� _ �',1821 University Avenue ���p`R s� "' , �� �� rFOR BOARD USE ONLY ��, f� r� .J ' '��1�:r�.� � ¢ �'S r i°` �, { .T��+t.ci�xs . ���'i : C ,, � � t4��4ua." �;. ' .,�f,�� � �`. �' ;h� >.; ��.+- .:. �- St Peul,MN 551043383 ,� ,��: .s.�,. 5 ��. � ���. a' � ' ''� (612)642-0555�� t �. �`*��. � ' � � _ �� n; � ,�, t -.:; �3�,. �'- �,an�. ,f � 'G � i..-k . � � l. � -K'�` �� ? Rf�iv ..^�, w'"p` �� ���'�� �� :a �r����* .. y� � �: � si�d .�.�.'' . .�X�y ``� :. .. � �.;� • . ��' � x ,:` ZS� �•y� � t .!LFj�oi��, . 1:�� r�..'}�,'�a�,,��' t'>� ���JNSTRUCTIONS ,1 Submit request for exe�pUon a eas't 30 days pnor fo the pccas-0on. ,;: ,_ � . 4�,�,��������.� �� �.;�`4 � �,. • 2 When completing form;•do not c mplete shaded areas until'after the activity:� _ ;;, ��s�-"^;� , �4°` �� � ' � 3 �Give the;gold copy to the City o County_Send the remaining copies,to the Board .�'The.copies will be;��� .��-� ���' ,°returned with an"'exemption nu ber added to°the form When your activtty is concluded, complete '�L�� ° ��r'PLEASE TYPE ��^ ' the financial info�mation;sign a d date the form;and return to the Board�within 30 days. .. "`�:�..� '�;�� �� ,A �,�; 'Organ� t�on Name �-. � J�1� ; � rt Number of(�1embers License Number(if currently or previouelyy;��¢ �, ,�� ;:, ���'}�� . .� P�":� Fy�• ���V ��� p � �� f44�� `�7 �g^��y�' y�f 5 J „ � t ,A : �,�Z : licensedl and/or pe�mtt number fr��� � ,,,y�' �,;_ � ._ - . .. .. _ .o .� -- ,M;. ., ., , .... . . :::'�r.: . °�.Address ? rt�' , � :, '- q�4� �. '��,, C ' '� ;State " Zip ;. �� C ��[y�Q��`''�` ,r � ��' �'':� k�' c.:. ��"�.+s.� ` �;�- �z ��"���� �. M�� .+i� .�:�.rn>a ���'I�d�#�k�.+'��� 1 �'`i l{ � d�,q,y'�;• �r. ,;7 .� �::��,�c,� ,� x-,sr. >�._ Chiet xecutive Officer s Nam ,� '" Phone '�='_' Manager's Name �* e L � Phone Number � ! �`.fs— v .�"- , ��"� '���'7 �+�', '`,�p �F���,��f��� � + , � ;" �!�- ' � 3 ,�7 b tt :. . ;� xs�s�'� w {;: ( i : � ., :-� s,�;b ,� � L ! , • f a �s, r .`Typ6 0f O�gvl�ZaUO - �t ` ���v� T Ga� ��,_ H 0�1Br Nonprofi[O�bO,rt. Q►Ie s[Id�pr0of Of Sf��.��`�,,, �•.�''? ,�r �°.�'Fr�terna� .<�'`�I � s ,�r��� ����"�: �� � Q IRSbesignation'� ���a�' M�:�'�t'.��': � �x� �.� ,� ,; , . . .�, .; .. . ,r. . y„ s, t .�,v' i tr . . , , -� �� e: a » s r`' i� r D Reli ion ��..,.L . r rofit Or arnzabon � _ ° _� . �' ' � �' g � Qp g �,� �� ❑Incorporate with Secretary of State .,; � � �k �._ �=' � { .. � < �� � � ., . :. � � � �ss ,�- '-Attach proof of thre years ezistence .�•zk �.� � �: � �Affiliate of Parent Non rofit Or anization � �� �� '-��� � _ : �• .�t� _ �.. , � , .r` , ,.., ; �� „�. p. .,� ,. 9 , , .., , y .P? � ro�,��w,_. Name of m s here A Wjl��¢cur " w'� ` � �'*x � 9 r a x s '�*,� D�ete(s)of Actnrty d►awmglsl *� 'T �� �.��.` � � +'�ql+. � � ���g� +,t .'� �}`wz ����a�a�'�3�r e s�,� . x � '` � .�, : ��� � A_ � �r^s'Cd `l.i � F,, ^c „I m;s.�"# 1 r-Z .�k� µ.. S � `2 _ �r' s'r'G .�S'� a.. ^+CK: � ±�� ,. .".. . � ,a �1� . . . . .; • �. �.`''��,��i���,� '4 , /P►e ddre �?, C S t -� Zi At � -� R � (r r �^;� y � `�'��o �k� I3`� >>�`� `�f 1"���"���.,��' k� ��t�`.�tJ ��'����� `�'���'�'�d ` �'�„� �� �~�` ` .:�� : __: ,� . � - .�, ; ' � rt,�^�" ' . .. . r t.. �'.aa^ ak.y ?� ,�rj` e sy � z' .�. ?s t� i .�. t• . ::�- �` i- �.; _ �; '���Game °� _:Yes No :�` 'n�. �.�, � }:ti A1 ,� ��„` �- e.: �r � �,Bingo: �'�� �` "'`�� _'� .�.,�rt. , �yft �.. ... -i- R,. � .; a"'�i>.�};' Y � �A�RB��Qr.S. � r �'� r yi q� d '�� � .3'e.:� s�,,�.,``•.4 ,��,_.�, �5��. � �.., `"r�` :,t a�� � .:r' .. �_� �Paddle�eels ��,,.,; 1� � r �,.ra ;�.t •< -.. �,k� �t " .. . �?� �:. '+.'�.r y' � a x '^: �e, -Tipboa�s ���>>;%°��� ; � �f p�. F � � ;� �'��j: , , _ , a'Pull Tabsx�� � �Z; ? r z ��i� Y�; 1 �� �� . , � r� ��-.kUseofProftt"'X�, t�' ��� �"4.,k+ . '�°� a�� '�.i� r� ,v� �b�� v z�;.�� i #+x �, t�z��, "�> �w � fi !� �`�� i����.��.��� :,� �° � ��+,.�„�, ���k�. $��wr'�r � i�t� � . 'x�.. �.��:r,��.kt '"��,.. ;:,F_ ,�* {�"9f�� .T+: .,�,,+ "7.;_.Z µ �) f � �•. Yt} '` v �'• x" =F'affir afl mformation submitKed.to the�oard is t�ue;a �eor-; K�•; , r d's. ° y ate,a'nd complete ��� :�.�.�•` 3'�q� � �, t� � '�� 1 r .ri ' ; x�.!: �,,����� ` .� ,,�.� �.h����.��'� � . � - .;��'4� .��`,•' z,';�'�a=�° .�4`?�5t'� :�'�C��,xr.?;�_ �' ,�i�^ � .�'�',_ �,��.�f��� .� ;'w �., f r.;:� Chief Executive Officer Signature -�'�t � _ , '; ate '' �� � . < �t� . ACKNOWIEDGEMENT OF OTICE BY LOCAL GOVERNING BODY `� �.�;�� � �� ` � ,, , '�1�1�`�.�3 r�:, �� e�.�.� r�'�-::� :. �e' --i'A.",�+.F ..i: x:.;:; x .�. :�.x+(,b�'?'rrin�'��:�:. �� -'+�i;iwYi�Yi•� �._;�. �R`�: �"-.r"#kr.. -:'�%,.d.�i.`_ `�. c_a� r . '�t+, �;, �: �.� . 'I hereby acknowfedge receipt of a copy of this applicatio �y acknowledging receipt,I admtt havin been served with notice ��' �Y�. , 9 , : 'that this application will be reviewed by the'Charitable amblin Control Board and will become effective 30 da s from the; � ., 9 Y �date of receipt(noted belowl bx,the City;or County,unl ss a resolution of the local governing body is passed which,specifi�� ��: �"",�cally disallows such activity and a copy of that resoluti n is rece�ved by the Charttable Gambling ConVOI Board within 30 �° � `' `� 3ry- � �� .� ,s. ;� x :��. �,-, k � � �' _ �; days of the below noted date �'�,Z ,�t'.°, ,� ��,.�� ��x���� � � � . r. �„ , �' �� x� � ;., k. � ,� >. , " ��M _ `CITY OR COUNTY . "`�'� �� �`��° �"'x. � A -TOWNSHIP ` �� �' , ^:Narr�of al Govemi Body,d ity or Coun , Township Name IMust be notified when County is the approv�ng body) � ��S .���E���"r : t r �` 'S+ . . . � � ' �r � -j. '`i'• ` _,'y. i a t.`"d!�� .�Y� K',�. �v�, .,r . $ignatur of PeY Receiving Applicebon �1+ '� ,; S�gnature of Peaon Receiving Applicat�on y �f Nx ���c� ` ';i� �'V�t.1J `t k.:+�-� "� y� •`; .1J� ..Y.. L, ti F�6ip^: v.!s y ,���h � ���t., * 7 � � Title :a' Date v Title _ �.�� Date x`^ �H , .._ . , (� ����� ��.�/� � ; � j -/�'� IX �g. ,t�. .. ' '�w/'�'r\��' . ' �` ', '. ���C� �(.1,'.. "�t_ Cf ' '�r.6S r�,�'§a?�' R�y�:'� �r �"'�,�" , F . . �- .. . ._ _, .. z . �-„� � .: .. .:. _ vy�, -.��. . . . �.: .. .. .- : ... . .::- � .. .. ...<, , �.- a,✓� # '' CG 00020-07(6/87) � WhRe—Board. ' , • ` � r Canary-Board retums to Organization to complete ahaded areas e �' ,.�. .•`=` '• -. Pink-Organizaa�'ortt�„r '',,' ... ��i��Gold=City or County �,�- r. :� � � �4 .. ' v �'..� � � .: .'. . �i:- .r.: '...:. .v. �.� " . 4i: � ��/ g.. . . +" s. _ � .�- .. � �a. -"� �.. � .,' � �., . � a"• `�-*,��t ���F ���� �S="� ..t... .. ., �'�-.:��.�r.�...�±�..•.a ,.....a�..__y,... . . . ... .,,,_..,Je..�i'w� ...rai_ ...�r� _ ...._� , . . . � . . ..�.�. .�. , ` ' ' ez�t F SAINT PAIII. (,��`�� �� ••'' DEPARTMENT OF EIN CE AND I�lArTAGII�NT SERVICES , ` DIVISION OF LICENS AND PEBMIT ADMINISTRATION INFORMATION REQtTIRED WITH APPLICATION FO PERMIT TO CONDUCT G�LING SESSZON IN SAINT PAUL . . Four sessions are allowed per year, wit each session being a ma$i.mum of four consecutive hours.. This application and all requir d attachments must be ffled with the Licease Inspector at Ieast thirtg days prior to the requested date of the gambling event.. -L) rTame of organization � ' L��vit/,S 2) Address where organization's regula meetings are held J .� ��(�� �_ � 3) Day and time of ineetings ,�oo j� 4) Address where gambling session will be held /.5� L(/�y T ��,C� �G�^ 5) Is applicaat owner of property wher gambl.ing session will be held? Yes �No 6) If Ieased, who is the owner of prop rty where gambling session will be held? D C� 7) Name of officer making applicatioa E G/_�� 8) Address of officer 30 �- : .S CG': c9n Date of birth ,�=3/-3S 9) Name o f manager who will conduct g ling sessioa ��6�,�5 ���-�,,P t�,4/ 10) Address of manager Date of birth S/f�jr/�' I1) ra counection with what event is th s gambling session being held? �d E � - 12) What type of gambling device(s) wil be used? Paddlew�eel Tipboard � Ra fle �_ Pulltabs Bingo 13) Specify when gambling session(s) wi I take place: / HOURS: Day(s) ��3; Date(s) �I� �lJ From: .�c� �To: .0'0 .� (Maximum of four hours) 14) Will prizes be paid in money or mer andise? /ye�►�Fy 15) Is the applica.at association organi ed uader the laws of the State of Minnesota? ��S 16) How long has the organization beea ' existence? �s l�t�s 17) WEiat is the purpose of the organizat on? �/f�/�/�lTj � �0��/.e�r'/S 18) For what wilZ the proceeds from this event be used? ��' ��-� �,Q6����o�t/S 19) Give names of officers or anq other erson paid for services to the orgaaization. Name-Title Address Date of Birth �P,��/ ��M l � � �'- S .�' L �-9�s' l��e� ��i��,�/,�E� 3 ft��/T s� �? /a�'� 2�) 0'f�icers of the orgaaization: /��'00�7� l Name-Title Address Date of birLL �' 21) Ia whose custody will records of or anization's gambliag sessions be kept? Name � ��� -. Address �,��� 22) Attach a cover Zetter defining the vent for which you are requestiag this license. 23) Attach a letter of permission to co duct the gambling session at the requested address. 24) Attach a copy of your organization' membership roster and date each member joined. 25) Attach a copy of the Department of he Treasury, -Internal Renenue Service "Return of Organization Exempt from Income Tax', Form 990. [Chapter 419.04 (1) J R- 26) Attach a copy of Department of the reasury, Internal Revenue Service, "Exempt Organi- zation Business Income Tax", Form 9 OT. [Chapter 419.04 (2) ] R- 27) Attach the annual report required o charitable organizations by Minnesota Statutes, Sectioa 309.53. �Chapter 419.04 (3 ] 28) Have qou read and do you thoroughly understand the provisions of a1T laws, ordinances, aad regulations goveraing the opera ion of gambliag sessions? 29) Any changes desired bp the applican assaciation may be made onlq with the consent of the License Com�ittee. 30) Has any person(s) participatiag in he operatioa of any of the gambl.ing sessions covered by this license ever bean c nvicted of a felony in the State of �Iinnesota or in any other State or Federal Court. Yes No If answer is "yes", provide names, addresses, and birth dates. � Organiz ion: By: (Officer itle) �� c� � and State of Minnesota) ( ger in c gambling session) ) ss County of Ramsey ) �-e Q.� and beiag duly sworn say that they are the etitioners in the above application; that they hane read the foregoing petition and kaow th conteats thereof; that the same is true of their own kaowledge. Subscribed and sworn before me this ��_ daq of �}'y(�tf � �� I9 � � Notary blic, ,Q�o�,�.�, County�•+�' oEa°':':�,':-- ,_ ._.__ . _ .w�,r,. My Co ission Espires _ -.,... ° � �d�'�l� o��e �eo a►�e cow��o �. ca���a� ' �f����i �I���T �ro. 0(�1 fi 2 8� o��r�►�r o�,�on �►�i«,�r� Christin� Rozek � � �a�r�� 3 an«� o�rr. — auooEr oinr�c3n — _ ' � 2 Council Research `Finance/Manage�ent `�t8--5@:5f 1 ��,�� • . Application fo�c a one day City of St. Pa 1 gambling permit (zaf�le anly) Notifieation Date: N�arch 28, 1988 Heaxing Date: ri1 5 1988 7t�a:i�vn�ou+(�)«�N+)) R�se�alPVar: xa�ra oo�oN crvR.eea�nce�xs�on oa�t w ok� b+u.rsr �o►�aa. / �wa� �ezs�yoo�� �j �ZjS , . . .. $FMF . , . . CFY�RTEH CW�AAAIS910N� . . A3��. - L IM�O.ADD�D# _._F�A�7.RIfO� r.� �ADDEb*.� . . D16TRICT00tJllCIL� - * � . � . e�sMnNq�aou+c�oerecmtev . �r�u�Crll ,�(�.J'�'.,1�tih ti�slltivi : MAR 2 91�g •�.�..�:��,►,�:��.�,�: Mr•. Thoaas I�esforen, on behalf of the Eas Side Lions, �equests council approvai of their appli�ation ft�r a one day City of St. Patx gambling per�it (raffle onty) . The xaffle �vill �be ��d in cc��L�nction with a benefit din r at Hafner's, 1560 idhite Bear Avent�e, on April; :., g, ��:, .b�t�+�aen the haurs of 7:00 P.M. li:OO P.M. Proceeds £�ra this event W.il�-b� do�� to Tias�`Side Chaxities. ���� �, ` �ions and fees have been submi ed. , i�a�,�ee�a.f: _ : : '::If �cae�c,ii �tprava3 is gra.nted, the East S de Lions, which have been in existence for 35 yea�s, �►i11 be able to hold this gamb�.ing. ession. ; oa+reo�twn�.wn«+.,.+a Tc vwaaq: _ - •: . ; ; - , . - -: , .:: If cc�uncil approval is not given, the East Side Lions will not be° able to hold a gamb2��ng session at thier benefit dinner. �r:�.. _ ' c,oNS • - � Msre�w . �u.�: ..