88-819 WHITE - C�TV CLERK
PINK - FINANCE COIII�CIl �//�� y�y
CANARV - DEPARTMENT GITY OF SAINT PAUL File NO. �`� �`� /(
BI.UE - MAVOR -
� C unci Resolution ��
�� ��
Presented By �°"`
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D. 23672) for a City of St. Paul Gamb�.ing Permit
(Pulltabs Only) applied for by the Church of St. Luke at Victoria
Crossing Parking Lot on June 5, 1988, (Grand Old Days) between the
hours of 12:00 Noon and 4:00 P.M. , be and the same is hereby
approved.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
Lo� � in Fa r
Goswi�Z
� Aaint BY
Scheibel — g
Sonnen
�
MAY 2 �¢ �U Form Appr ved by City tto y
Adopted by Council: Date ` '
Certified a ed by Council Se retary By ' '�" ,�
By
Approved avor: Date Y L �S� Approved by Mayor for Submission to Council
By gY
Pt�3llSNED ���d � 1988
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' DiVISION OF LICENSE AND PERMIT ADMIN STRATION DATE � �p �� / � � ��
INTERDFPARTMENTAL REVIEW CHECKLIST Appn oc ssed/Received by
Lic Enf Aud
Applicant n Q'� Q(,j,r�• S Home Address '
�_� L. Lo!05 �f�-I�Moun�
Business Iv'ame C, y!�'1 d�G• �e.► Home Phone o1�a -+ �� ��
Business Address ��."�'OC'1C�, �Y� IAq Type of License(s) C� �ah�lb���ny
etr C�rt y L L
`� —
Business Phone �� r(�'1(.`G ' �(,�� �N�
Public Hearing Date � ��t � License I.D. 41 a�7a-
at 9:00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax Z.D. l� �l/4''
llate ATOtice Sent; ,/ Dealer �� �,/`I'
to Applicant 'J� I(� �{p
P'ederal Firearms �� � �
Public Hearing �
DATE INS ECTIUN
REVtEW VERFIED ( OMPUTER) CUMMENTS
Approved ot A roved
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Bldg I & D �
� � �
Health Divn. '
� N �a �
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Fire Dept. ; � �
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Police Dept. I
License Divn. �j�
Ig '
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City Attorney �
5'�3"� ' N,�Ll�S CO)v1Guf' l�G�� ud'�d�kd�lif�
�I�g j� pc.�M.tr CuhS¢n+ i's
Date Received: Q.�-�G(��� �
Site Plan �
To Council Research S l�J e�
Lease or et � �j� ate
from Landlord � 3
� . .
- -
�� . � � . �'��/�
, � � �Minnesota Charitable Gambling Contro Board LAWFUL GAMBLING EXEMPTION
�:�' • Room N475 Griggs-Midway Building
. 1821 University Avenue FOR BOARO USE ONLY
. _ - St.Paul,MN 551043383
_..�::;=:�<, �', •;.....��` (612)642-0555
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.:; INSTRUCTIONS: 1. Submit request for exemption at least 30 days prior to the occasion.
2. When completing form,do not c mplete shaded areas until after the activity.
3. Give the gold copy to the City or County. Send the remaining copies to the Board.The copies will be
returned with an exemption nu ber added to the form. When your activity is concluded; complete
`= PLEASE TYPE the financial information, sign a d date the form, and return to the Board within 30 days.
'�'. Organization Name Number of Members License Number(if currently or previously
�1Li1'C�1 Of St. Luke Of 5t. P jl licensedland/orpermitnumber. YvZO�n-7i
�1 -
,� Address C y State Zip County
�`Y'� ' 1079 Stum�ait Avenue St. Paul :yiTT 55105 ?2ar;�sev
��sa�'. i
� " Chief Executive Officer's Name Phone Manager's Name Phone Number
��„ Greg Welc:� � 61� 227- u"69 JQhn DesLauriers �G1; 292-�9?6
.�.
'''�`°' Type of Organization If Other Nonprofit Organization(Check One and attach proof of ranprofit statusl.
�� O Fraternal O Veterans ❑ IRS Designation
�,z ._.
,� . R9 Religion � Other Nonprofit Organization ❑ Incorporate with Secretary of State
�:�;;:- Attach proof of three years existence. ❑ Affiliate of Parent Nonprofit Organization
- Name of Premises Where Activity Will Occur _ Datelsl of Activity,drawingls)
':;��:� Parking Lot of Victoria Crossing( ic�oria and Grar.0 .�v�nues)
;�'°' Premises Address City State Zip County
NA (above) St. Paul ��1 5�I�� P�a.�nsey �Tz:..ne � , I5E3
_ . w., _ � ,..
� �,.
._ .. _._� � F
Fti
e�an
, ..,, �� �.. ,.
�-�:���� � Game Yes No �.Rece ��� L�a�Pni�"� ��s ,
�:: Bingo X
,.
.,,,. .
� � Raffles X
�`•
:�. Paddlewheels g
.,�.,.,;
� Tipboards y,
�
,,:-�..:� �� _ ,
�-,- Pull-Tabs g
�„ .
iM;; Use of Profk Stl Luke's Sahool Sparts P�ograr:ts
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xx �rv �. �� `:��`�� +�
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_ I affirm all infprmation submitted to the Board is true, ccor- ffi� fi�' �`� w� "� � �►���:��;�'����
� ate,and com lete. ��,. � �
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Chief Executive Officer Signature Date �"��
"�*'� ACKNOWLEDGEMENT OF NOTICE BY LOCAL GOVERNING BODY
�`:
o-�:-:.
�,i,--. t hereby acknowledge receipt of a copy of this applicati n.By acknowledging receipt, I admit having been served wit notice
�3' that this application will be reviewed by the Charitable Gambling Control Board and will become effective 30 days from the
°" date of receipt(noted below)by the City or County, un ess a resolution of the local governing body is passed which specifi-
�'�• cally disallows such activity and a copy of that resolu ion is received by the Charitable Gambling Control Board within 30
��, days of the below noted date.
��` CITY OR COUNTY TOWNSHIP
��:='
Name of Local Governing Body ICity or Countyl Township Name IMust be notified when County is the approving bodyl
{�� _ �: , �; �;;.,;Z r�:-crc �;
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� - Signature o Person Receiving Application � � ` Signature ot Person Receiving Application
�r.�� `; �l�,-'"'.,_.1 �� (�:L. ..� 1 �;f j. � ..
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rK�e _,_... _Dats 'ved Title Date
���� . � ( . _ � 14./ --�_i'l:�'-,.K-!.✓ "_. �_ �•..,_/ � ��1 %
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�� ' CG-OU020-01 16/87) White—Board Canary—Board retums to Organization to complete shaded areas.
5" Pink—Organization Gold—City or County
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� . . City of Saint Paul
• Department of Fi ance and Management Services � � -
. • Licen and Permit Division � ��p
, 203 City Hall�
� St. Paul�Minnesota 55102-298-5056
APPLIC TION FOR LICENSE
CASH CHECK CLASS NO. New penew
: ca a c� �
o$te � � ,9��
Code No. Title of LiCense From � � ��To 6 '.`���'�-� 19
rJ
0�0�(0� .Y �I �� < c�, t�c (c: . S
� �� �'r�v � �6� �-?-�— ��t. L�K�
ApplicantlCompany Name
,00 �a r �� ��r,. 10-� - �,��c��'� G. ��r a�::�„
100 Bualns�e Name � � S
\1 r 4,n � lc�.
`-___.
�� -% � • C�.� .,_1 �'� � l
Businsss Address Phon�Na
100
100 Maii to Address Phone Na
100 � : "'
�n �, , � ��L `� � << :, v � F � _
ManapsdOwns�•Name
100 ��/ _� —
�---- , a.
1 J ic `- i- � ± � �r��i_r �r � �` t,:�,,
100 AlanageHGwner•Homa Address Phon�No.
dpg8 ApplfCatfon Fee
Recefved the Sum of 2 �� �y� • �I �t i, �`''1 Y}
�!! � ,� � Manaqer/Owner•City,State��ip Code
100 T tai 100 .
..1/ . �.�.. ,
�
�'�.,�:;�� ;1��.v�.��%;z-�
Ucense InspeCtor � By: ��r , • i Signature o(ApplieaM
Bond•
Company Name Policy No. Expiration Oats
Insurance•
Company Name Policy No. Exqration Oate
Minnesota State Identification No Sociai Security No.
Vehicle Informatfon:
Serial Number P ats Number
Other.
THIS IS A R C�iPT FOR APPLlCAT10N
THIS iS NOT A LICENSE TO OPERATE.Your applicatfon for 1 cense wili either be granted or rejected subject to the provisions of the zoning
ordinance and completion of the inspections by the Health, ire.Zoning andlor License Inspectora.
$15.00 CHARGE F R ALL RETURNED CHECKS
�.,� �" � I 5��l'�g �►'t�
� � '�l �
� • � � CITY OF SdINT PAIIL ���/C,'
� � DEPAS�NT OF CE AND M9NA�II�I1T SERVZCES �
.. �.� � . . DIVISION OF LICEN AND PEHMIT ADMINISTRATION
INFORMATION RE UIRED WITH APPLICATION F R PERMIT TO CONDIICT Gal�IDLING SESSION IN SAIPT PADL
Fbur sessioas axe allowed per year, wi each sessioa beiag a maaim� of four coasecntfve
hours.. This applicatioa aad all ed attac�eats must be filed with the License
rnspector at Ieast thirt9 days prior t the requestad date of the gambling eveat..
I) Name o f orgaaization �'�'- (�2� O DS � Ci�
2) Address where orgaaization's regu meetings are held /U(o� S(,c.vr1 YY1.L�
3) Dap and time of inestings �5� l,� Q� � ' 0✓1�-�1
4) Address where gambling session will be held �-V'C��n,�( � I��G�z�tZc d� ���• ��pa�c��
r
5) Is appI.icant owner of property wher gamblfng sessioa will be held? Yes � No
6) If leased, w�o is the owner of prop rty where gambliag sessioa wi1Z be fleld?
���liar,�. l,� ��-
7) Name of officer makin a lication �
S PP � �r�.Vl .2S`,-L°c-u-v'i�t_'r�
8) Address of officer �(o (.� - --� Date of birth D{ �� �_
f .
9) Name of manager w�o will condnct g I.ing sessio� �� � �2 S ��.t-�U i-�✓S
IO) Address of maaager �-�'l� Date of birth �Y.s�s.�
TT7 ra coffiectioa with w�at event is s gambliag sessioa beiag held?
��u�� D( ` � S
12) Wizat tppe of gambliag device{s) be used? Paddlewtseal Tipboard �
fIe Pul.ltabs �_ Biago
L3) Specify w�en gambl.iag session(s) wi take place: �/
�] �, HOIIRS: � �Q� � 7',�� ��
Day(s) Q� A. Date(s) �l�- � From: To:
(Maxilmim OL LOLl= �IOAIS�
14) Will, prizes be paid in money or mer a�dise? ���/(E.�! __
LS) Is ti�e appiicant associatioa org ed under the laws of the State of �tianesota? /�_
L6) How long Eias the organization beea eaisteaca? ,//� �-�Q(�S
17) Wiiat is the purpose of the orgaaiza cn? r ✓h p,n e S G�h�t ;�- � �
Gt7` . G� , s �� ,
L8) For what will the pr.oceeds from this event be used? Ur� r e✓tt".f-s ���s
�u' u�'Gt�-G�`c. fp ra iu rx s acf- G.�k�1'
19) Give names of office=s or aay other ersoa pai.d for services to the a�aaizatian. s�v�,�
vame—Title Address Date of Birth
/I/ ;�1�
20) Officers af the orgaaizatiaa: � • .
NamrTitle Address Daze of b3rth
__._ _.-- . . ,
21) Ia w�ose eustody wi]S rmcords of organization's ga�liag sesaions be Isept?
N�e J�l�,►� (l-�s���;��s �ras$ /=-�;r►���-t�I� sr��r
s��Gs
22) �ttach a cover Istter daf3aing the event for which you are raqn�sting tftfs license.
23) Attac� a letter of pezmission to ccaduct tf� gabliag sassfon at ti�e requested address.
24) Attac� a copy of pour orgaaizatioa`s members�ip roster and date each member joined.
25) 3ttacia a copy of tfte Deaartmeat of the Tressury, Iateraal Revemie Servi.ce "Retura af
Orgaaization Esempt from Iacoms Taa", Form 990. [Chaptez 419.04 (I)I
-OIt
26) Attaca a copp af Deaartsaent of tha Treasuzy, Iateraal Reve�a Servi.c8, "�'�.xempt Organi-
zatioa Buaiaess Iacame Taa", Form 990T. [Cbapter 419.04 (2) ]
-OB-
27) Attac� tfie annual rsport required oi c�aritabl.e orgaaizations by �iaaesota Statutes,
Sect�oa 309.53. [Chapter 4I9.04 (3) j �
28) Save. poes read aad do yon thoroughly uaderstaad ths provisions of Iaws, ordinaaces,
aad ragssiar�.oas goveraing ti�e operatioa of gsmbling ssssions? eS
29) �ay chaages desired by the applicaat assac�atioa may bs made on1.y with tfie coasent of
the L�c�nse Ca�ittes.
30) Has aay psrsoa(s) participatiag in tf�e opezation of aay or tiie �ambling sessions
cavered by this licanss ever besa coavicLed of a felony ia the State oi �iaaesata or
:a aay ozher Stata or Eedsral Caurt? Yes Yo �. If aaswer i.s ";res", provide
names, addresses, aad birtfi daces.
t 1
Orgaaizatioa: s GY` ' S Y�
. /
By: (Officsr-Title) �Q. ' ��S�i�"e✓
aad S�,r vYl e-
State of :4iaaesora) (Maaager ia cf:arge oi gamciiag session)
) ss -
Couat-� of; / ey ) � '
> ��
�e=ag dulp swora thac theq e the petitioners ia ab applicat�on; tfiat they have
:ead tha �oregoi.n pezition aad ow the coaceats thereof; tfiat the sae is true oi ti�eir
awa �aowl.edge.
cribed aad sWa.ra ore
da.y ,L9 , `
I
Yozax� Public, �Count9, :Siaasso �
:iy Ca�.ssioa F.a{�ises
' • ��i��
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I have given my permission to St. Luke's Sports Booster Club f
to use a section of the parking ot on the Southwest corner of
Victoria and Grand Avenues to se 1 Pull-Tabs during Grand Old,�
Days; June 5 , 1988. � , ., j '
<� �' � ' / -
��� `�
,
Bill Wengler '� 5/5/88
. ...
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ar�F.: c�a�_; : , . ' t��L�i� �i1��' �o fl 017 2� - ,
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Applicatiori for a CJine`T3me Cit� ot:S`aEin Paul Ga�a�.3�ig. �mit (Pt�l.ta�s c�3.y� .
, , NCm]FICATIGN DATE: _ 5f10/88 �: �/24/88
' �or�a:c�awa.�+►t a�t�l� neirc�rr: '
_
.�COMN88�ION . � � � 3C�HOOL BON�iQ � �s�� Q Y� D��. g y..AIML � . . � . PFqNE N6. � � .
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ar�: awsr�cana�nsa� As�s �t.a�o: • ��p�o�r�:
.. . . . � . . - . . � . _.,-POR IWDL MIO. _F��11DG[D*
� DIBiiUCT COUNCL - . * . .. � _, .. � .. .
� �911lNOIit�YMMC1��00UliCLCB��G'TIVE9 ��. � . � ' - . �. . _ . . -.. -..� . . ' . . � . . . . � � .. � . . ,
- Coun�il Research Certter.
MAY 18�
,1�1� �..tl�,OP.�f�TtN�.TY{1Mq.,Nh�.,IYMn.�Vh.n.�N�M: .: ,
Jc�lai D��. pz� ber�alf of � Clwrch f St. Luke, r�ests Cp�ncii_appraval of his
_�p]:�c:�tic� f�.� Ehie Time C'�aarda3�atr�g ' (Pu].zt.�ab� c�lg�• f�oe G�ar�c3 <?]:d Day�s, � 5, 1�88<,� :
� the 2� of :12:00 p.m. atx3 4.00. m. TY�e pt�i.l�bs v��I be � f�+oete a bvotr► s� `up
` �`iri�t�e 'V:'le�bc��3�i'�o�s;ing parlting lot. o�wneY`'s.p�nissi+ot� �as �a�.subonit�,ed.. :
,�n�noK cco.ue«+.n�.. w.r�.r . . ; : . . ._ ,
All fe�: and a�pxi.ca�ans ha�v�e beeri su}xni 30 days in sdvat�ae.
Q011�67M�i�!lNM+�vYh.n,+inA 1�aMhon�):�, : : °: , : _ .
,.
_
If �;� app�o�v,al i.s given, St. Luke's will be abl� tA sell p�.t�tabe a� Gr�d Old `
Days. �f CAUnc.i1 ap�val is not given, . Lt�lce's will be �able t�o apoa�pr a �3.ng
. sessinn� a� Grar�d Q�� �yg• -
, .
+�.� c��,s: . -
. i.s,nom►,rn�xrs: - . ,
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