88-700 WHITE - C�TV CLERK �
PINK - FINANCE G�TY O SA I NT PA U L Council
CANARV - DEPARTMENT
BI.UE - MAVOR File NO. ��O
Counc 'l Resolution "����
� �
Presented By
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D. #g9101) for the renewal of a Class C State
Gambling License by t Public Safety Post 449 DBA Star �
Shield at 408 Main St et, be and the same is hereby approved/
�..
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
��g In Fav r
Goswitz
Rettman B
�ne1�� __ A gai n s Y
Sonnen
"`�'t' MAY 1 0
Form Ap roved by City Attorney
Adopted by Council: Date ` - �.! �
Certified Pa s d Counc'l Secretar BY `�
gy � {
Approve b rMavor. Date ��Y 1 � Approved by Mayor for Submission to Council
By BY
p��i��c��D ry�1'�Y � 1988
a , �����
� U�VISION OF LICENSE AND PERMIT ADMIN STRATION DATE �t �� ��/ � e7.�' 6 �
INTERDF.PARTMF.NTAL REVIEW CHECKLIST Appn Processed/Rece ved by
Lic Enf Aud
Applicant �aYL -�^�Q2`K-� _ Home Address �}7g Wins�o�
Business lvTame � S � S�y��Home Phone �a�o�"'DoZ�] �
♦ i-
Business Address � Type of License(s) 5-�¢,.'�C. C.�q�S
Business Phone ,n ��1, ��'IU/'sf• 1-�(,
Public Hearing Date ,� 0 � License I.D. �l ���(� (
at 9:OQ a.m. in the Council C ambers
3rd floor City Hall and Courthouse State Tax I.D. �� �J��'
llate Notice Sent; Dealer �� u�14
to Applicant Q u I�
I'ederal F3_rearms ��
Public Hearing
DATE INS ECTIUN
REVIEW VERFIED ( OMPUTER) COMMENTS
A proved ot A roved
�
Bldg I & D �
N�f1' ,
Health Divn. �
�'� �
� �
i
Fire Dept. � �
; NI� �
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Police Dept. �M�� ,(�� ���
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License Divn. �
'- i
City Attorney ���� '
Date Received:
Site Plan N � 2� �
To Council Research
ease or Letter Date
om Landlord J
°.---.,_ --_ . � , : , • . . ;��_ .
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' .�,. Charitable Gambling Control Board
Rm N-475 Griggs-Midway Bldg. , For Board Use Only
1821 University Ave. Paid Amr.
- St. Paul, MN 551043383 Check Na
•:.....:'� (612)642-0555 ; Date:
�� GAMBLING LI ENSE RENEWAL APPLICATION
�['�, LICENSE NUMBER: -` � •�� i /EFF.D TE: / i� /AMOUNT OF FEE: ;• • �
Y� 1.Applicant-Legal Name of Organization 2.Street Address
Si'AA Rltia Si�iIc�b 'si�C �T � I .' e �� � ;`;�/ U:> (�G1� � �,
3.Ciry, State,Zip 4.County 5. Business Phone
St Pau., M�i �i09 �a�sey 612 �'+i-4274
6. Name of Chief Executive Officer 7. Businesc P one:. f �
� J:1/� r l'' /P/�/i� � �' /1 /�/ �= �.,%�' ' . .. .,
8. Name of Treasurer or P rson Who Accounts for Revenues . :� 9. Business Phone ;
. ./� �9!� L ,� . ('H/9 �' ` n � _
10. Name of Gambling Manager 11.Bond Number 12. Business Phone
ilathv Snveer 8�ii:�6(�9oe1`�.
13. Name of Establishment Where Gambling Will Take Place 14.County 15. No.of Active Members
Narth 5tar S.�a 4�sn St Aaui Raansev f54
' 16. Lessor Name 17. Monthly Rent:
Frantc St at i ones ��c5
18. If Bingo will be conducted with this license, please specify da and times of Bingo.
C I � DayO Times Da s Times Days Times
/..�f/�D, �; �-� � n�,;�,-
, � ^ r,,;, , f, o � ,,�
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�:1 19. Has license ever been: ❑ Revoked Date: ❑ Suspended Date: ❑ Denied Date: f:.
0
�' 20. Have internal controls been submitted previously? ❑Yes ❑ No(If"No,"attach copy) '
21. Has current lease been filed with the board7 ❑Yes O No(If"No;attach copy) -
_. _ . • .
,_;�.,_ , . . - - - --- - ... , . _. _v : •- -___
• 22. Has current sketch l�eert filed with the board?� ` O�(es ' O No(If"No;attach copy)�� � �
�;. , r .. GAMBLIN SITE AUTHORIZATION ` " .
;�= By my signature below, local law enforcement ofGcers or agents of he Board are hereby authorized to enter upon the site,at any time,gambling is "
"r - being conducted,to obse�e the gambling and to enforce the law f r any unauthorized game or practice. ..
"" BANK RE ORDS AUTFIORIZATION �
By my signature below,the Board is hereby authorized to inspect t e bank records of the General Gambling Bank Account whenever necessary to
fulfill requirements of current gambling rules and law.
�`, OATH
I hereby declare that:
1. I have read this application and all information submitted to the oard;
2. All information submitted is true, accurate and complete; .
. 3. All other required information has been fully disclosed;
4. I am the chief executive officer of the organization;
5. I assume full responsibility for the fair and lawful operation of all ctivities to be conducted;
6. I will familiarize myself with the laws of the State of Minnesota r pecting gambling and rules of the board and agree,if licensed,to abide by those
laws and rules, including amendments thereto.
23.Official Legal Name of Organizatiory Signature(Chie E�cecutive Officer) Date Title _
/ � �/ �t�v ) �- �-j "` f
�',;��� �; r.';� JS'�4c•��e l�f�' ,'�;� ,�,�� , ,. . .i ..¢_.
+ .�_' t� t � J� ,1 �/��LC-1/�-L 1 jf C-1 !,
, �-
ACKNOWLEDGEMENT OF OTICE BY LOCAL GOVERNING BODY
I hereby acknowledge receipt of a copy of this application. By ackno ledging receipt,I admit having been served with notice that this application will
be reviewed by the Charitable Gambling Control Board and if approv by the Board,will become effective 30 days from the date of receipt(noted
below), unless a resolution of the iocal governing body is passed whi h specifically disallows such activity and a copy of that resolution is received by
the Charitable Gambling Control Board within 30 days of the below n ted date.
;� 24. City/County_Name(Local Governing Body) Township: If site is located within a township,please complete items 24
;,��..�.� i : �-� 'j-J:t.1..c..<'� 811d 25: .
Signature of Person Receiving Application: 25.Signature of Person Receiving Application
\., ' :�;.;_ ', -i�..� �' _f�::� r�,,� .
` Title -� Date Received(tt�is date begins 0 day riod • TiNe:
�-�'�� �:- ..,! •-,--; ...�_.A�i_r i-:k'�- L'1' � � � �(•,
..
Name of Person Delivering Application to Local Governing Body: Township Name
- ��! .- �i� � ..y . �^_ �� . .. - i .
.�CG-00022-01 (5/87) ' White Copy-Board Canary-Applicant Pink-local Governing Body
• ;
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' , City of Saint Paul
Department of nance and Management Services
. Lice e and Pennit Division � ��v�
203 City Hall
' • St. Pau, Minnesota 55102•298•5058
APPLI ATION FOR LICENSE
CASH CHECK CLASS NO. • New Renew
a o � aa � � , �: ,� �,
Date 19
Code No. Title of License �i - � � ^/�
From 1�u To �I'� 19� f
�`I� ��U �r�;l�.��_� �� d�� I-rt - � �.�� � �
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n �oo ' U n 1�c. �c�:��-� �sL �.
`` i <. �.� � ApplicanUCompany N�a`ms i �. 'f
100 U. �UCI. �'tu� � ��l�L• r L
y v r� • ���(Z��l.
100 eusinesa Name
� 1 �
1� -� 1 • ��( �.L-1 ('!i
Business Addroas Phone Na
100
100 Mail to Address Phone No.
� �,
100 � ) l.� �l ��l) .ii:-N' T
ManaperfOwner•Nama � � � �
100
4 i �i (-����51ou� �'�'�
100 AtanagenGwner•Homa Addmaa Phone No.
4098 Applicatfon Fee 2, 50 ���./.,�
Recelved the Sum of 100 �,i• �() �L � y J ,
cx �•SV Manayer/Owner-City,Statt 3 Ztp Code
100 T tat 100
` f� �i /�-:J, �r,! ,y.i<,,/
LiCense Inspector ��J By: � Signature,ot Applicant
Bond•
Company Name Policy No. Expi�ation Oate
Insurance:
Company Name Policy No. Expiralion Date
Minnesota State Identification No. Sociai Security No
Vehicle Information:
SeMal Number late Numbsr
Other.
THIS IS A RE EIPT FOR APPLICATION
THIS IS NOT A LICENSE TO OPERATE.Your application for li ense will either be granted or rejected subiect to the provisions of the zoning
ordlnance and completfon of the inspections by the Health, re,Zoning and/or License Inspectora.
$15.00 CHARGE FO ALL RETURNED CHECKS
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z City of Saint Paul
' �� ' Deparcment of Fin nce and Management Services
'� � Division of Lice se and Permit Registration
�
INFORMATION RE UIRED WITH APPLICATION FO PERMIT TO CONDUCT CHAR.ITABLE GAMBLING GAME IN
SAINT PAUL �
/ r� � ! •
1. Full and complete name of organizat on whfch is applying for license � �
_S� � , .S' ' e �. .
2. Address where games will be held � �
Number Screet C ty Zip
3. Name of manager signing this applic tion who will conduct, operate and manage
Gambling Games Date of Birth
(a) Length of time manager has been member of applicanc organization
4. Address of Manager C ` �
Number Street City Zfp
Y PP �l_ d �A��P�L� /t .�?
5. Da , dates, and hours this a licat 'cn is for �o d �rJ��/�u../,V �/
n z d unde the aws oi the State of MN? �
6. Is the applicant or organization org i e r 1 �
7. Date of incorporati�n / �—
8. Date when registered with the State f Minnesota � /% /��
9. How long has organization been in ex stence? �j I� �t�L �
l"7—T—
10. How long has organization been in es scence in St. Paul?
�
11. What is the purpose of the organizat on? Q- � p �
I2. Officers of applicant organization
Name � • � �Tame „�d !2 ��.!�c C�c°-��I^'�
Address ./� � Address �� � �� �,S`IO �/
Title ('���^ d�� DOB ' '� " ' Title y� DOB �
Name � .� Name
�
Address address
Tit1e��Ne.p�C�_��,pOB � Title DOB
13. Give names of officers, or any other ersons aho paid for services to t:^.e araaniaatfon.
Name Vame
Address Address
Title '*i:le
(Attach separate snee* `^.r ada'=_or.s: ^a�as. �.
14. Actached hereto is a list of names and addresses of all members of the organization.
15. In whose custody will organization's records be kept? ,
Name � !.��
V Address �,�-� � .s� �.
16. Persons who will be conducting. assisting in conducting, or operating the games:
Name Date of Birth �
Address ' e U p �,.. �s^
Name of Spouse Date of Birth
Dates when such person wfll conduct, assist, or operate
Name Date of Birth
Address
Name of Spouse Date of Birth
Dates when such person wi11 conduct, ass:.st, or operate
17. Have you read and do you thoroughly unde:stand the provisicns of aIl laws, ordinances,
and regulations governing the operat:on oi Charitable Gambiing games?
18. Attached hereto on t�e for*. furnished by the City o� St. Paul is a Financial Report
which itemizes aIl rece±pts, espenses, and disbursements of the applicant organization
as well as aIi organizat'ons crho have recei��ed funds ror t:�e oreceding calendar year
which has been s�gned, prepared, and ve:i`�ed ?�y �
N e
1.Jd o v— �-
�ddress
�
who is the yl of the applicaat Organization.
vame r Off�ce
19. Operator of premises where �ames .rill be held:
Name J�(� 1/-�J'� .�T� v-� l7 1 CL4 �s-S/L.
B�rsiness Address �T�q,�� � .S��Q �A�( �S � Q -�.
Home Address
20. Amount of rent paid by aoplicsnt Or3ani�acion ror reat oi th�e hall; specify amount
paid per 4-hour se�ston �[���/���_��r S"� �-�./` � �
, . . . . � �- ��
� 21. The proceeds ot the �ames will be isbursed after deducting prize layout costs and
operating expenses for the followi g purposes and uses:
' , � � �
�.-
.
22. Has the premises where the games ar to be held been certified for occupancy by the
City of Saint Paul?
23. Has your organization tiled iederal form 990—T? �_ If answer is yes, please at�ach
a copy with this application. If a swer is no, explain why:
� ---
Any changes desired bv the appl=canc �ss ciat�on may be made only with the consent of the
City Cc+uncil.
t'V���.`�i�-l��1i) VlT_rgan� ��ion ��J+�,(2
Date 6� By:
Manager in charge of game
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1 �=ty oE Saint Paul
� , . , ClPpartment of� Finance' and Hanagemenc Services
' Division oE icense and Permit Administracion
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UNIFORM CHAR TABLE G!1ltBLINC FINANCIAL REPORT
' Dat� March. 1988
t. N�a of Organization Ameri Le ion Post 449 dba Star & Shield
2. Address vhere Charitable Cambi ng is conducted 408 Main St. St. Paul
3. Report for period covering rC�'1 19 8� through February �g 88
4. Total number of days played SZ
5. Croaa receipts For above pariod S 6�.1(F(F.�
6. Groas priz� payoucs for above p riod ; 53,144.�
1. Nec receipts - 11ne 5 minus lln e s 14,��.�
8. Expenses incucred in conducting and operating gamo:
A. Cross vagea paid. Atcach v rkec list vith
namea, addresa and gros� wa es. S 42�.�
e. Renc for 52 veeks i 5�/�60.00
C. Licanae fes ; 2�3.�
D. Insuranc� ;
E. Bond $ 50.�
F. Dishonor�d checka noc recov� ed S 2�6��
C. Employers F.I.C.A. f 30.�
H. sai.s T.x ; 1,389.00 �
I. Mlnn. U.C. Tax �
J. Federal U.C. Tax ;
K. Hiscellaneous f.Ypanses. Idaa ify the a�ouat
and co vhom paid.
1• Tipboard (machine) s 59.00
2. Bingo Chips(KC Hall) = 48.00
s. Tax preparer � 100.00 �
a. Bingo Balls ; 58.00
Stamps
9. ?ocal Expensea � TOTAL ; 8,115.��
10. Net Income - line J minus line 9 S 5!$$S.QQ
11. Checkbook bslance beginning of period S F,'n��_Q�
12. Total of line 10 aod 11 f '11 �A7h.9�
13. Tota! eontributions froa line 17 s _�(�62�.�
14. Chackbook balance end of reporting period -
line 1Z leae line 13 f 5,344.93
15. Specify use mada of amount on line 13:
Checks iven to Post 449 for reimbursement of charitable donations.
List of donations is attach .
COMPl.�:1'L� TIIE REVERSE S1f)E
. , ,
`' page 1 of 2
• �, AMERICAN ION POST 449
• d
STAR SHIELD
CHARIT LE DONATIONS (3/87 - 2/88)
3/87 Pens for Vets Hosp. 7.48
T.C. American Indian Pos 419 50.00
Vet Early Bird Donation 100.00
St. Paul Police Vest F 350.00
John Poses Boy Scouts 100.00 -
Legioriville 220.00
Legionville transportati n 28.00
Boys state 250.00
Mn. Correctional Facilit (Red Wing) 25.00
Sauk Centre c,orrectional Facility 25.00
4th Dist. Fund Raiser (I e fishing kids &
Easter egg hunt) 60.00
Boys & Girls Club of St. Paul 50.00
Bingo at Vets Hosp. 50.00
1290.48
6/87 Girls State 115.00
Cerebal Palsy 50.00
Poppy Cards 37.00
United Vets 15.00
Girls County 20.25
Boys County 28.00
Boys State 125.00
North St. Paul #39 60.00
Hospital Vets 25.00
Ober Boys Club 200.00
Cretin High School 200.00
Memorial Day Assn. 100.00
Boys State Transportation 30.00
1005.25
10/87 Memorial service at cemet ries 84.80
Police memorial service 85.00
Assoc. for retarded citiz ns 100.00
Legion baseball 500.00
Service mens center 100.00
Boys state 50.00
St. Paul Police (retireds 300.00
Cambridge State Hosp. 100.00
Brain Science Program 200.00
Memorial Day services 50.00
Memorial Day Rifle Squad 100.00
1669.80
. - . , . � �� -7 �
� STAR & SH ELD - Donations page 2 of 2
11/87 Cambridge Hosp. - Chris s 100.00
Brain Science 200.00
Memorial Day Assn. 50.00
Memorial Rifle Squad 100.00
Vets P'heasant Dinner 50.00
National Emble�n Sales - ags 371.25
Legion Auxiliary 227.00
National maps 30.00
Auxiliary Poppy - Dept. f ction 9.00
Service mens center 25.00
Fort Snelling Chapel 50.00
Lady of Good Counsel Canc r Home 300.00
Salvation Army 200.00
Gospel Mission 100.00
Minn. Vets Homes 100.00
American Lung Assn. 10.00 1922.25
2/88 Bingo - Vets Hosp. 50.00
U.S. Pencil - Vets Hosp. 44.92
Fred Brewitz Pens - Am. ucation Week 120.00
Sauk Centre School 25.00
Red Wing Training Center 25.00
Legioriville camp repair 100.00
VCR - Vets Hosp. 228.98
Name plate for VCR 2.00
Buttonworks - Canbs for V ts Hosp. 140.30 736.20
TOTAL NTRIBUTIONS 6,623.00
...�.� e . . : . � .. .�-"► . ✓ DME� 7iD.� . COleLlliD. . A � �� ��u ��_���1 �+ �
Mr. Carchedi � . � �r�71�� �N7��T 'NO. �V�C?9`�
oob►�cr n�v�m�r ox�croA �ra+�op��rtj
` C�ir�.Stine �ozek '� �e��o�cron 3 c„r«�wc :
, �. . R FOR — . _
Finance $ Mrtgmnt. 298-5056 : . - • -�— .�� � Cov�ci2 Research
Application for the renewal of a State f Minnesota C3ass C` Ga�b3ing License .{Biago E}n2�)
NOTIFiCA�2Q1�T DATE: _ xi� �6 1988 HEA,I�NG DATE: �!a 10 19$8
�b1�d10�7�:(�61+►ov�e(N a fi�j�t�(R11 !�$EA+ICM aEPOfifi:
_ PLA1YiN�OONYOBION � -CIYIL�OOM1�810N � DATE IN . � . . . DATE 01J� � AIW.YBT- . � � PlIOME N0. �� . � �.
��� ���� j� 1 �/�-9 K-�
�,� : �� � ,�� _„��.,,�•. �„��,� �„3,�,►
. _FOR AOD1 O�FO. .�_FEF�BAGI(ADDED*.
DIBTNCf COl1iCL * . � � � .
` �BUPPGNI8.VMNGi COIMCIL.OBJFCTNE7 � . . � � . � � .. � . . . . . . .. � . . .
��ur��it Research Center.
MAY 0 319�8
..ra»,s*NO.tsM.�.orPOi+n,Mrt,►Mnw,wi,u.wn�.wnen.,wMl: _
Don Schaefer, on behalf of the P�b1ic Sa ety Post 449'DBA Star � Shie�d, requ�sts couneil
approval of his renewa2 application. for State of Mi�esota C1ass C Gambling License
� at 408 Main Street. The gambling sessio s are he�d Wed.nesday a�texn�ons between the
�Ao�rs o£ ;1:3U P.M. and 5:30 .P.M. P�coc�e s-are used for various c�iari�ies.
.�U�71RGt1Dlt(CoM/B�;Atl�nlpes,R�ulb): ;
All applications and fees have been subm'tted. If City Counci� approval .is gr�nted,
Public :Safety,Post 449 will be ab�e'�to .c tinne �sgansoring their w�ekly bingo game.
�4�.wr��+a Ta r�:- ,
If council approval is not granted,; PubZi Safet� Post 449 wil}. be unable to sponsor
theix week�y bingo game.
.
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