87-628 �N111TE - CITY CIERK
PINK - FINAN�E G I TY O F SA I NT PA U L Council ///� { �/
CANARV - DEPARTMENT F11C NO. �+ / �//��+
BLUE - MAVOR
COZ� Z SO tZ ��
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Presented By
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D,#31652) for a One Day City of st. Paul
Gambling Permit (Bingo, Raffles, Paddlewheels, Tipboards,
and Pulltabs) by Northwestern Alano Society at 170 Maria Avenue
between the hours of 7:00 P.M. F� 11:00 P.M, be and the same is
hereby approved.
COUNCILME(V Requested by Department of:
Yeas DfeW Nays �
Nicosia [n Favor
Rettman
Scheibel �
Sonnen __ Agel[1St BY
�Teeeses
w���� M�Y ' � �g87 Form Appro by City Attorney
Adopted by Council: Date
Certified a. - Council et BY
By�
Appro d by Mavor: Date — � Approve ayor for Submission to Council
By _ By
Pt�i��ED ��i�=l1' 7. � 1987
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DIVISIO;i Or Lli.i:iS� :��17 P�.�iti•f'iT r.DT1I:?IS�:;�1'='IOid �
r;C�UI3:.,� ?�iITi? t���'°LIC�TICPd t�Q�? P'_�'?r"ST i0 CC?•;7UCT GAi•T T_'G S�SSIOT? I.; ST. Fl•_UL
.:�, �: �.�o�.:i:aty��: Ho,��wEs��r �Ql.�iva SoclEr�v
N� r �
;,;ldress where Qr�anization's re�ular :neetin�s are held�70 � ,� A /���.
3. �a� ar.d time of ineetin�s � � F g=�� ]�/�'1
!� , Add:ess where Cambl�n� Session :�rill he held �'0 ��%� �V� . �
' j. !S a�','�1C2I'lt C?•4:"t82' OI 7JI'ODG'rt1 -�;rerF iar.bli�� �25.i''O:'? T�rill r�e �'lAiC�? /� v23 O
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O. Ti .i.p3.S8Q� ?^J�iO 1S o�rr.er Oi pror,erty ;•ri:sre v2.ITl��li:7F' :�GSSIGP. 'J-!=�_ nP �'.°�Cl�
��,� �` ' ' r ,� �� �J/ Jl��� _ � 7 �'' �
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. ;. If leased, a�tach letter of perrnission to conduct Gartblir.e Session, s=�ned by �essor.
�
�. :�a:ne of officer maI;in� applicatien VoND •
9. xddress of of_°icer making appiication�y� ' /V �� . Da�e of birt:�.�2��
10. ::a:�e oi manager who will conciuc+ GaMb�ir.g Sess�onS�N D� (�D D� ,�__
il. �;dress of r�a.r.a�-er,��� �(,5�� �� . �zte of rir�r • •�
12. In connection with what event is this Garablin� Session beir.g held? �
5 K. � s �►�.
13• :;hat type of ga.mbling device(s) will be used? Paddle4rreel �''_�pboard �Pzf"le ��
._� ----
11:. �a�r, dates and hours tnis a�pl�cation is �or and number oi se�-s�ons. ,�y/ (!r�� ���F '�
/�( `- i l � .
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Da;,�(sl J�T.. DatesS� •� :?ours ���ss�ons �--
1�. �.i�ii prizes be D3iC1 in ?�onev or merchandise? �d TI'� _
15. Is tre apnlicant association err anized tmder ��he la=.,�s o_' �?-:e State o':' ':'irnesota?�
i i. i:cc•r long nas Cr�_ani�at�or. been in existenee? /��S • �
i�. ;•;ha+, �s the purpose of tl:e Or�anization: �d(, •
* �
19. Officers of the Organization
`+a�e Title Address ;';����j�,��� %;; ,� ,�ate of birth
��� ��+ � 7 • '���r��'Cl,fF7'/� �f :�-1 i ��� �� '% B' _ > 1,�
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� � •T � • � �� :
14 � '�i � ;3�_ � �
�o F� ��'v�►r,�sk, 1�o /Y►" �-% �- /� f'�
(,���-���
20. v_ a r.ar;es of o��icers er a.�,* other persor.s paid ior serv�.ces Lo tre �r�-ani,
' , c;ame-Title rladress :ate of ��1
�;
LC ;`�'`,�'� ��'�i t- > �'� � �i I - `-�j.
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21. In wl:ose custcda- T�rill records oi Or�anization's Gamblin� Sess_ons ce �ept?
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,�a�e-��l1;' ���'/) �'C i'/:�;>� i�' Address �' '> � !� � '�' //�d'�� � � i"�;
22. Attacr a copy of your Organization's membership roster and date each member �oir.ed.
23, kttach the Ganhling Sessior. i`anager's bond.
�'� . :;�tac�, a c�py of the uepartrert oi t:;e ?'r('�?St�z^T� In±.ernal ''ever.ue SeMrice ''n.,etu-7-: of
Orga:.i�ation :;xe�nt fror� Ir.cone '_"ax't, rcrm 99�. (Cha�+er �,,�.OL (1). )
'L,. Attac'r. a cc�J of Lepartment oi the '"reasur�;, Interr.al ?e.•er.ue �ervice, ''"xe*�,nt Cr�an-
ization Business Income Ta�c", iorm 9°OT. (Chapter f�19.04 (2). ) �
26. Attach the annual report required of charitahle or�anizations by :•Tinnesota Stat?ites,
Section 309.53. (Chapter 1t19.0� (3). )
27. Have �ou read and do you thorou�hlv understa.nd the prov�sior.s o�' all laJrs, ordi.nances
and rec?ilatior.s �overnin� the onerat'on of Ga.r!r,lir.F� Sessions?
��. i�ny chan; es cies=:ed b3* tre appl�car�t associstion �nay �.e r�ae�e only *.•n th �he cor.se:�t o°
the License Corunittee.
29. iias a..ry person(s ) participat�ng in tne operation of any of `!-e ga^:blin� sessior.s co�r-
ered by �his licer,se ever been convicted of a felony in tre State of ::innesota or in
any other State or rederal Court? �es ;do . If ar.s�.,�er �s "��es", provide
narr.es, addresses and birth-dates.
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�ar��ati on
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�tate of .:innesota)
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Co�uzty of °al�!sey ) �
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beina duly sworn sa;.� that tre,,v 3-�e the petit�oners in the above arplication; that the;r nav�
r��d the fore�oin€ pet�tion and .'rno�r the contents t'�ereof; Li1a� �he same is rra� o" '-!:�;r
o:•rn kr.oi•rled�e. �
Subs;.r�bed and staorn to bef��re me t^,is
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i;ota�• �ublic, ,�;:t .-<�c:;Z Count Y �nes '"
�-`r cci�.�ission e ires 9 - A.ODALEN
� -�� NO7kR'Y PU[3LIC-h91YNE�OTA
�: UA�(OTA COU"�TY
��tildinF; �epart:�ent dpproved �X-��iRE�eu .2�. �ss� bY
r'-=e �eaar�:.ient Aoproved �-isapproved by
Police �epartr,ent hpproved-�isaporoved-'�y
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