88-885 WMITE - CITY CLERK
PINK - FINANCE COUflC1I /�/,��/y•
CANARV - DEPARTMENT G I TY OF SA I NT PA U L� �/�
BLUE - MAVOR File NO. �� �+�� -
Counci Resolution �.J
,
Presented By
Refecred To Committee: Date
Out of Committee By Date
RESOLVED: That App�ication (I.D. #1 138) for a one time Gambling Permit
(Raffle Only) applied for by the Nativity Church Men's Club,
1900 Stanford Avenue, for June 9, 1988, between the hours of
7:30 P.M. and 10:30 P.M, e and the same is hereby approved.
COUNCIL MEMBERS
Yeas Nays � Requested by Department of:
Dimond
�� [n Favo
Goswitz �
Rettman
,�� _ Against By
Sonnen
. �I�TL�°�i�
�AY � i � Form App oved by Ci ttorney
Adopted by Council: Date ' _
Certified Pa s y C �i�Se ry By " �—�'�
By, ��.a'V
t�p d by Mavor: Wfi —� _ Approved by Mayor for Submission to Council
By
Pt�tiswEO -'���3 i i 1988
. ���f�
UIVISION OF LICENSE AND PERMIT ADMINIST TION DATE � � g�/ `�/� ��
INTERDF.PARTMF.NTAL REVIEW CHECKLIST Appn Pro essed/Received by
Lic Enf Aud
Applicant �,� ��n �f"�o�e Acldress 1$ �g �Y� r"'C�
Rusines5 Name �,Q�n 1�4/'� Home Phone �1 �O ' ��S
Business Address l�� �n-�I�i Type of License(s) �IGrH1t� �
Business Phone ��', 1 VY� i r� �' ►`�T4K.�
Public Hearing Date � �j O� License I.D. �� !�� 3 g
at 9:00 a.m. in the Counci Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �l ���
llate Notice Sent;.q Dealer �� /V'A
to Applicant } � �
I'ederal Fi.rearms ��
Public Hearing
DATE INSPEC ION
REVIEW VEKFIED (CO UTER) CUMMENTS
A roved Not A roved
�
Bldg I & D �
� l� �
Health Divn. !
; N�,� ,
Fire Dept. I� �
� N�q
; i
! � �
Police Dept. I
s��ti«
�
License Divn. �
��13 $g; 4�.
City Attorney �
SI��I�
l
Date Received:
Site Plan � '"'f' � (�
To Council Research �1Z�' g b
Lease or LpY PY ��� G� Date
from Landlord 6
_ _ , 1 • F
`���'� 1 Minnesots Charitable Gambling Control Board LAWFUL GAMBLING EX M���
:;� ' . RoomN47fiGriggs-Midway Build'mg
1521 lln/V9fSity AvA11ue FOR BOARD USE ONLY
S�Pau1;MN 551043383
� .' (6?21642-0555-
�- `� , ..
r- ,�
INSTRUCTtONS:. '�.:� Submit request for exemption at east 30 days prior to the occasion.
,:�..�'. Z.- When completing form,do not c mplete shaded areas until after the activity.
T�+ � 3. Give the gold copy to the City or ounty. Send the remaining copies to the Board.The copies will be
,,Y`�, returned with an exemption num er added to the form. When your activity is concluded; complete '
�.. PLEASE TYPE the financial information, sign an date the form, and return to the Board within 30 days.
�Org�►�¢ation Name � Number of Members license Number lif currently or previously
.,� �1 f, 1 f,/I � s�•� V /l� � ."% �r�7 ���; L^,: I j - �� Iicensedl and/or permit number.
v, , ,� �;
i Address Ci State Zip Coun
<; -i ' i��) S� - ,vF�R.D � V� T p ��L M!�/ .��1 �s l�i r1��;�•�
p Chief E ecutive Offic 's Na e Phone / Mans@er's Name ,/� Pho�e Number
'" �(� . � �'1� ��1�1lD��— r�-� J :�Ni'✓ R. U !ji (�/'��►rr�5' ��S �J
��`� Type of Organization N Otl�er Nonprofit Orgenization ICheck One and attach proof of r�onprofit statusl.
Fraternal ❑ Veterans O IRS Designation
:�Religion 0 Other Nonprofit Organization 0 Incorporate with Secretary of State
„ Attach proofi of three years existence. ❑Affiliate of Parent Nonprofit Organization
� �~ Name of Premises W ere Acavity�II Occur „ Datelsl of Activity,drawinglsl
9� ;►v�rY of �c�,� L�/�✓� � �avL
- �r ises Addr City State Zip Coun � '� �� ����
-F l ' D� �T�JN F�R/� Av¢ ST P�<�� /�I/'/ �1�5 /��•�1���`� J�r `,� ,
�" Game Yes No
y-.
..'BI(19,0
_�Raffles
,�Paddlewheels
r: ��;Tipboards
''`�'� Pull-Tabs
�..
Use of P►ofit
�,;-S�a,►SoR V R�a s Svc,AL sP���T� �✓ ��i� F��e i��s ���Rcy � scxrilL
��-=-
� .
�`-=1 affirm all information submitted�the Board is true, a cor-
�.;.ate,and co pl�. � +
-�.: . , y f j �`
_ . .� f f'� '_
'-•.Chief Ex 've Officer Signature ate
� � ACKNOWLEDGEMENT OF OTICE BY LOCAL GOVERNING BODY
��I hereby acknowledge receipt of a copy of this applicatio .By acknowledging receipt,I admit having been served with notice
=that this application will be reviewed by the Charitable ambling Control Board and will become effective 30 days from the
��„ date of receipt(noted below)by the City or County, unl ss a resolution of the iocal governing body is passed which specifi-
� cally disallows such activity and a copy of that resoluti n is received by the Charitable Gambling Control Board within 30
��� days of the below noted date.
�. ;::- CITY OR COUNTY TOWNSHIP
--�� N f Loca/�t3ov i�g�yry(Ci �or�) Township Name IMust be notified when County is the approving body)
'.,: �,:� ' T GU.:(r-
c ,
^Signa�u re rson Recei�ngApplic,8tibr►�� Signature of Person Receiving Application
x�:. V ' �Lf.r'rf.! r�:t. � � 'y
»�,{€ ���� ."��i
� �/ De vsd Title Date
,�J '-.�v_�� � �
� �, � �;�'�.z.. .s 1 �
�=
`'-.GG-00020-01(6/87) White-Board Canary-Board retums to Organization to complete shaded areas.
, P'ink-Organization , Gold-City or County
�w,.,.. -:, ::._-.. _ --- - —
ity of Saint Pauf ����
� �' Department of F ancs and Management Services �; -
, Ljcens and Pennit Oivisiort � � ' 3 _
. zos cicy►�atr
• St. Paui, ianeaota 55102-298-3058
' � APPLlC T10N FOR LlCENSE
•';:�CASH CHECK CLASS NO. New Renew , :
��4-a a �� a � ��
'" Date 9
. Cods No. Title of License From v � f9�?To�N' 19
c� �� c7•'1�
(� �G f � ��t�' ��m��,n — .1. � -r
� r' , ,00 �1 a-�-����� ( �t�,�c..h - �'�`�Prr S �Icc�
�G �i-�Z. C�PU� A��canucon+vaM
�� l�J 0 0 �!r r��oY�I a-t.�.c��
100 BwlMSS Nantt
,00 �i ��4-t��.( , -�'1 n 5:�/�lS�
Busin�ss Addross Phon�Na
100
100 Mail to Addross Pnon�No.
,� Jo� ,, � ,4 �
ManaperlOwner•Naa� (� (
r) �-_ j (� �I ^
��^�
�� �� �-� Q �.TI'p ;i't!j� �7 �'t',.�-c� ..N..
100 AtanaQeHGwner•HOrt�eAddnss PhonsNa
1088 Applicatlon Fee . C ^ (,�
�celwd the Sum of �100 J� � �'��� 'i r' 1 ��� S.� �a S
� •�� ManaqsNOwn�•qb.Stat�d ap Cad�
100 T al 100
Ucenae InaPector G gy: �� �� � j Stqnatua of icant
Bond• �
Company Name Policy No. Expiratfan Oats
Insurance:
Company Name Policy No. Expintion Dat�
AAinnesota State Identificat(on No Social Security No
Vehicle Information:
Serlal Number �t� �
Other
THIS IS A RE E1PT FOR APPLICATiON
THIS IS NOT A UCENSE TO OPERATE Your applicatlon(or Ii �ense wilt either be granted or rejected subiect to the provisions of the zo�ing
o►dinancs and complstlon of the inapectiona by the Health, ire,Zoning and/or License Inapectors.
_ `,� ` $I5.00 CHARG� FO ALL RETURNED_CHECKS
,� \% ��
'� , u� � �2
. ���u�,�� , � "
' �,��
, �� ,�.'gg ,c,�c,
�\ �, —� 5 f�z�g �
� �
�,.
. . (,.I" 40 �i�
• ; CIT7C F SAINT PAIIL
`� . DEPARTMENT OF CE AlID MANAGF�tIIy'P SERVICES
� DIVISION OF LI AND pEBMIT ADMaTIST$ATION
. INFORMATION R� IIIRED WIT$ ApPLICATIpN Fp pERMIT Tp CONDIICT GAI�LING SESSION IN SAINT PAUL
Four sessioas ara al.lowed per year, wi eacii session beiag a maximu� of £our conseautive
hours.. This applicatioa aad all requir d attachments muat be filed with the License
Iaspector at Ieast thirty days prior to thn requested date of the �gambliag event«
.I.)" Name of orgaaizatioa � C �'ry..11 C�
2) Address where orgaaizatioa's regula mnetiags are held I�DD ST�n-Fo�c o /�vF �.Si P�u 4
r� ^- .
3) Day aad time of ineetings �� �l•( ,¢C on, PT-Jun.E •3TI
4) Address where gambling sassion will be held � 9Od STAirFOR�o �v� " Si /9yv
5) Is appl,icaat owaer of propesty wher gambling session will be� held? �_ Yes No
6) If� leased, who is the owaer of prop rty where gambling session wil7. be held?
N
7) Name o£ officer makiag applicatioa. OH/✓ �/ r✓
8) Address of officer � � � —S� �� ` Date of birth 0 � `��
9) Nams of manager who wiI.l conduct g liag sessioa c/ OHN �. �9i✓
10). Address of manager l g y 8 S � Q p /� — � P L Date of birth /d����y�
rr) � coaaeatioa with wha� eveat� is th s gambliag� sessioa. beiag hel.d? �
N r Fr✓ � c. a � i✓o �
LZ) T�at tqpe of gambLiag device(s) be used? Paddlewheel Tipboard '
Ra fle �_ Pulltabs Biago
13) Specifq when gambling session(s) take place:
,� HOURS: �
Dap(s) �/.tNRS/�gY Date(s) �� From: - 7;3v PA� To: � : 3f� P
(Ma�rim*�m pf f 0uI' hOUrS)
14) Will prizes be paid ia moaey or mer aadise? n'1 0/l//,;;� ,
NQ
15) Is the applicant associatioa org ed uader the laars of the State of riianesota?��rtqit H�
16) How Iong has the orgaaizatioa beea eaisteaca? ,�y�. (,✓,�,��_/Q��/�c.E�p �q79
PQo�,o►T� �Krr Sp/Q/TN�v �N ,�.���- v TK�
17) What is the purpose of the orgaaiza oa? yOc�Tif OF TNtF P�9�ClsN
SOO�SdR f�i9Rjd�s SOG��?�+�P?�TS
I8) For what wil.Z the procesds from this eveat be used? �v��i� FD? THE C�,►uRc'rr .-S Ck o�L
_
19) Give names of officers or aay other erson paid for services to the orgaaization..
Name—Title Address Date of Birth
J�H,� � �JAN-P,��SIO�.� ► �t� S N 2� �9V -s% P � �a/ISI��
n P 9sT �o%y/.SS
Ku � UUOZ(�r; pR�S�o�N? `I 0 G- �✓J' AVr - � A �
ZO) �OFficers of the organizatioa: "' ��/
,
. � Name-Title Address � Date of biitia �
v���'
�o� /� l7��o����^ P�e��r l9/ o ✓� — S'� P�v� �/ ol lyy
� �1�FF��y R. Da�,��,� - �������� ��� �� - �r ��a� /s8'
�oH� 8. PA4n�i�R —S,�r���,�r I � i9��•- Sr P k�. 3�b� �'f 7
21) Ia whose �ustody wi1.]. records o£ org izatioa's gambliag sassioas be icept? '
Name /�' � Address 1�f � N��or��R� �✓�',1
22) Attach a cover Zetter defining the e eat for which qou are requestiag this license.
23) Attach a letter of permissioa to con uct the gambling session at the. requested address.
24) Attach a copy of your organization's membership roster and date each member joiaed.
25) Attach a copy of the Departmeat of c e Treasurq, Iaternal Revenue Service "Zstura of
Orgaaization Facempt from Income Tax", For� 990. [Chapter 419.04 (1)J
. . -0 -
26) Attach a copy of Departmeat of the T easury, Iateraal Reveaue Service, "Eaempt Organi-
zati.on Busiaesa Iacome Tax", Form 99 T. [Chapter 419.04 (2) J
-0 -
27) Attach� the aaaual report required of charitabZe orgaaizations by Mianesota Statutes,
_. Section 309.53. [Chapter 419.04 (3) ] • ,
28) Have you read and do you thoroughly aderstand the provisions of alI lawa, ordiaaaces,
aad regul.atioas gove�iag. the opera on of, gambliag sessions? �,�5 •
29) Any chaages desired by the app].icaat association may be made only with the conseat of
the License Co�ittee. •
30) Has aay persoa(s) participatiag ia t e operatioa of aay of the gambling sessions
covered by this license ever been co icted of a felony ia the State of Mianesota or
ia any ather State or Federal. Court? Yes No �. If aaswer is "qes", provide
aames, addresses, aad birth dates. ' —
Organizat on: � C L ---
, �:
Bq: (Officar-T tle)
. aad .
State of Miaaesota) (Maaag ia charga of gambliag session)
. _. ) ss . �
Couaty of Ramsey )
—J D Nr.7 1��A,J aad J C�l�l cJ �. � ,�
beiag duly sworn say that they are the. pe itianers in the above application; thaz they have
read the forego�iag petition aad kao�r the oateats thereof; that the same is true of their
own kaowledge.
Subscribed aad swora fore me this
� daq of � 19
� i MARTiN L. BENSQN a
Mianes ta f �� ��CpU���A �
Nozarq Public, Couacq, � R
My Commission Expires �' � q = � OAy ConMn. Ex�Idav. i4. 1�45'.
.,,,.....,....,.:
, . ���/
:::-.:-:::=::_ _�. ;...::_-::�� �::.�. . �
s
.. ....:..:::;.,:�:�:
:;..�
�:}:::;:::-.
_::;_::
:..�..
�:>:::
,.,�`::
,
.,
t
\
;,
THE CHURCH F THE NATIVITY
� 324 South Prior Avenue
Ssint Paul,Minnesota 55105•1699
April 22, 1988
To: John Dan
President _
Nativity Men's Club �
Dear John,
Permission s he with granted to c nduct the drawing of Nativity Men's Club
raffle ' t eeting room a Nativ'ty School.
Rev. Patrick Lannan
Pastor
The Church of the Nativity
,
_.. ,
. .. ,,, . : ..
.. �� . - ��`-�`�-
� '
THE CHURCH OF THE NATIVITY .
324 South Prior Aven e
Saint Paul.Min�esot 55105-1699
April 25, 1988
City of St. Paul
Licensing Division
Attn: Christine Rozak
The Church of the Nativity of Our L rd has been conferred a tax exempt status
as a charitable organization by bot the Federal Internal Revenue Service and
the State of Minnesota. The IRS id ntification number is 41-0693956. The
Minnesota tax exempt number is 8339 82.
Membership in the Nativity Men's C1 b consists of all members of Nativity
parish. A copy of the parish membe ship roster was recently furnished your
office by the Nativity Council of C tholic Women.
Sincerely,
r�-� ���;�
Gerald T. Kelly
Director of Finance
. �'�'�i��
r � ��►=.e, CITY OF SAINT PAUL
"� " ' DEPART ENT OF FINANCE AND MANAGEMENT SERVICES
e � �
±, �: DIVISION OF LICENSE AND PERMIT ADMINISTRATION
' ,��� Room 203, City,Hall
Saint Paul,Minnesota 55102
George Lstimer
Maycr
May 13, 1988
To: Lt. D. Winger
From: Christine Rozek
Re: Record Check - License Applic tion #I7138
In connection with an application or a One Time Gambling Permit -
Raffle Only at 1900 Stanford Ave. , a record check is requested on
the following:
John R. Dan Kurt Budzi�en
1848 Stanford Ave. 1900 Sargent Ave.
St. Paul St. Paul
Birthdate: 10-15-48 Birthdate: 6-14-55
Jeffrey R. Domler
1911 Goodrich Ave.
St. Paul
Birthdate: 8-26-58
CAR/jl
_ _ _ _
.
,mq o��xaru► o►rE c�eno �:�'�p �
- �. ,�. �a�t�ea� ���;���r��`i�fi�`E�' No. U(31751.
�„�� . ��,��� _ .
C�ri�tine Rozek � -" �a��� ��«.�
. � nart+ce RounNO — �� � Counc�l �Researct�
!�. n t; , ` ��8-5t156:. '.°r�' � �A„�,�, —"
Application fior a Dne Tame Gambling Perm t - Raf�1e Only.
Notification Date: 05-18-88 Heari Date:
�s:t�aa�e!�)a�e�.a(�►� coul�ca nEVOn`r: _
� � PtAD1iM10 C011MI88�OP1 . . �� CIV�.BBIVICE OOMA�19910W� . ��� � �����. � . . . .MIOl16 ND. / . . .
� . mfM16 CCI�M118810N .19D.l16 9CNOOL BO/IAD . . . �
' . '. .SMFF - � �CWIRS�CdM89pN A813 � _�AOdL�NiFO.ADDEQ4 - -�7�p7p�µT�ct: � . �g�{ ...
AOA ADC1.MVFO.{ _-F�CBAdc ADOm*.
DI6TNC7 OOUIiCII � . ;� . � . .
� .BUPYORI8 YMtl[:M OOUNCII 0lJECiME7 � . . . . . . � . - .� . . ..
Council Rese�rch Center
:
MAY 2� 19$8
..n►,.�.�.�.��n�.�.,,,�,a,.,�..�>: _ ;
Mr. John Dan, on behalf of the Nativit� C urch Mens Cl:ub, requests Council approval
�of their a�pplicat�on `for a One Time Gamb7 ng Permit (Raffle Only) for June 9, 39$8:
The raffle will. tie held at Nativity:Schoo , 1900 Stanford Avenue, between the haurs
of 7:30 PM and �10:30 PM. Proceeds will be used to sponsor various sacial ar�d sports �
� events for the church and schaol . _
, .+us�s+er►��.,�e�arwn...�: . , _
_
All fees and applications have been submi ted 30 days prior to the event.
_
., ��.Wlwri�end To WFamk , .
If Council approval is give�, the Nativit Me�ns Club will be able to ha7d a raffle
on June 9.
If Council appraval js raot give�, a raffl cannot be held.
a.�+►nirac co�s .
►�sramirn�rra:
�mu.�: