87-630 WHITE - CITV CLERK
PINK - FINANCE GITY OF SAINT PAITL Council Q..�� ���
CANARY - DEPARTMENT
BLUE - MAVOR File NO. 6
Council �s '
. �
Presented By
Referred To Comm' ee: Date
Out of Committee By Date
RESOLVED: That Application (I.D.#91924) for the renewal of a Class B
State Gambling License applied for by Twin Star VFW Post 8854
at 820 Concordia Avenue be and the same is hereby approved.
COUIVC[LMEN
Yeas Nays � Requested by Department of:
Cire1^;
�–��y�y,g�,/ In Favor
;t«�.,�;
scne;�, , - � -- Against BY —
Son^,:,�
1��<��� �Q� � -�7 Form Appr d by City Attor ey
Adopted by �ouncil: Date —
Certified Y s Cou . Se ta BY
By� �7 p
App v d y Mayor: Date --�_
i � ��U7 Appr ved y Mayor for Submission to Council
By — BY
�t°�� � � , 1987
p �rs
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�. ;•• � • Charitable Gambling Control Board •
�
� �' Room N-47.5 Griggs Midway Building �, �'�� FOR BOARD USE ONLY �
� 'i � �Y. � ... � it ��` �;r y uCBR89 NUlilblf -'ti,C1'+aax ;:. f �s , 'x� ;,
{ � 1821 University Avenue.��__;,- .� E ;� , .. :
"";}� ''� St.Paul Minnesota 55104 3383 S ��.; �
, � ���' (612) 642-0555 4 �.� PAID ��
� •••+1 � ,�', � AMT r�
}�'^t�-- . `� �, c r, .� b � � CHECK#T .�.� .:k
�l�vOF- s�r �. : �e� ,Ft r�'"' � ' a ¢ -r pc�.� �,�,
.F��dr�t� �,; ��' - .�� '� =.��- ��� DAT� �' .�S�'� `� .:F�t.1G:�:� �'''� '�:h�.G�y
�;�;� 1T .��GAMBLING�LICENSE AP LICATION � '_y �,,-� Y�� � �
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A. 'Type or print in ink. _ �;+. �`�
. ,
¢~.;.. .�_. .
�:�6 . Take completed application to local goverrnng body,obtam signature and date on all copies,and leave 1�copy App�icant keeps 1 ', '
��'.� ,� copy and sends original to the above address with a check � `' ' �' "" ' }:, ' , �;
' C. Incomplete applications will 6e retumed. ' `" ` ° � ,,
�
TYPe of Application:
❑Class A— Fee S 100.00(Bingo,Raffles,Paddlewheels,Tipboards,'Pull-tabs) � `
�Class B — Fee S 50.00(Raffles,Paddlewheels,Tipboa�ds,PUII-tebS) Makecheckspayableto:.' . �" � :
=: �Class C — Fee 5 50.00(BlflgO 0111y) �'r Minnesota Cha�ItaWeGambGng Oontrql Board
OClass D — Fee� 25.00(Raffles only)
�Yes pNo 1. Is this application for a renewalT - If yes,give complete license number � - � F� �• 42
s;, ,.
-��" ❑No 2. If this is not an application for a renewal;has or anization been(icensed tiy the Board before7 If yes,give base
•� .,,
,lf;�:' ,.,:;: �s
. ,. .: . . .. . �. ,.
� license number(middle fiVe digits)" "` `-� `� �"` ` °' '' ,.:;.,�.
"" es�No 3. Have Intemal Controls been submitted previously?If no,please attach copy.� ` •,"-;= '
�:�a�4 •Applicant(Official,legal naMe of organization) 5. Business Address of Org"anization,. ' : �
TW!N S7A1� VFW POST #�8t�54 820 Concord I a Avenue ,
; 6. City,State,Zip 7. County � ';z 8:-;Business Phone Number'
5t. Paul , MN �5104 RAMSEY `
` (:�: 612 1 221—Q314 . ,
9. Type of organiiation: ❑Fraternal �Veterans �Religious OOther nonprofit" .�.� ' � .�
'If organization is an"other nonprofiY'organization;answer questions 10 through 13.�f not,go to question 14�''Other nonprofiY'organizetions '
must document its tax-exempt status. ,�::.
_:. ;
�Yes�No 10. Is organization incor orated as a nonprofit organization?If yes,give number assigned to Articles or page and •
book number: * F��1 Attach copy of certificate.
�Yes❑No 11. Are articles filed with the Secretary of State7 ���K
�Yes�No 12. Are articles filed with the CountyT '�
. ; _. .
� �Yes❑No 13. Is organization exempt from Minnesota or Federal income tax?If yes,please attach letter from IRS or`Department of �
Revenue declaring exemption or copy of 990 or 990T. �-:�,
�Yes�No 14. Has license ever been denied,suspe�cfed or revoked7 If yes,check all that a ly :�=' _� `�
�Denied ❑Suspended ❑Revoked Give date: Q� - �g - Sg �� ' � '
:, :
15. Number of active members 16.-Number of years in existence , ; Note: If less fhan four years,attach
131 , 2� Yet�rs ' evidence of three years �
exlstence. ,
17. Name of Chief Executive Officer 18. Name of treasurer or person wt�b,accounts for other revenues
of the organizatiori.: "`° �
Gordon W. Ktrk ; � ' James G. Kirk Jr. �% .. .�
i ,... .
Title Title K .�'
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Business Phone Number � Business Pf�one Numlier ' � � ',
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,19 ;Name of establishment where gamblmg wil(be;'��'''s; 20 x Street address(not P0 Box �ber) � � `F 4��
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�a.mbii�g ucense Applicatio� � � •�� � '`�'� �'` z '' `" fi� h���' �. "�
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�Type of Appl�cation � �Class A ���ClassB �Class C OClass D�: s�=�;�..�L ,� ��,�,1 m ����..
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-�. �DYes ONo' 23�Is gambling p�emises loc.a`e w'it'h�n city)imits?. Y •::'���r,�,x�� ��� :�,x� � :-� _ <;�Lr,�r .�.�i �;;�.
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�. < C P Y e s O N o : 2 4 "A�e a l l'gam b ling ac tivi thes Co�nd uc te�a t t he'premises�liste d in'#19 of,this'�appbcation7 If,not;'complete a separate`'� -'
� E.,..� _} ...:application for each premises,;lexcept raffles)as a separate I�cense is required for each premises.
; � a •�..:�. s..-... . _ :.
�:D�Yes ONo '`2��>Doe�organization oWn.�h, a g prerT�ises?:If rio,attach copy of tf�e�li as:�'vvith terrps'of:et least;one year: :;w,;;•v�
�OYes ClNo^:�26�Do�s tf,j�e organiietion i,e s - i e #ses?If no,at�ch a":sketc�;"o` ."?��,,;qmo"�i nt of Mon#1il Rent�; ..,�:�' '��
` .r 9 ' ; �T,t�t�e p�em�ses Tndica�ng a •. io s e ng.leased A;�ease and sketc . ,, i,t"-"Y�`+'�"t ..$ 'r �F +�. '� '+i ',` ���. '
~"�� � '�'i � .is not required for Class . �cetions.. f ��`'�'' °���'�,�"�4t �`' �e f xs,�`* k;i��'��n�x:� ���?�x�^�3,i` � Y,
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��,�, ❑Yes QNo : 28-�Do you plan on cond�7cting= hgo,`"i�"t�iis IicenseT if yes,give days:end��m" es'of bingo�c�a�fo7��'�'�'`�",�"� -
r�' yi�.> - - � .� tc,,f ,..�7 �r -�- �? 7.�i '� TImO� �` �w ' �� .�'�`f �§i' ',�y a .? � -` �:�� �'kxr nY
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<'` D'Yes ONo .29. Has the S 10,000 fidelity bond require�d by'Minnesota Statutes 349.20,been obteined?.Attach copy of bond. '''
30. Insurance Company Name : � ' $�1��: r���• 31 :�Bond Number � .
TransAmer(ca 1 nsurence Com e�n - � ��
P Y�s.F� � >a 1 ,':�. 5364-19-32.
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.;;;_32. Lessor Name `: � '" 33 �`Address " - i�
�. �� , �_r , 34. City,State,Zip'
;; x.���,� < �.�. _
_ 4»M �1 .h';1�F::_ . .. . . � �.4-
35. Gambling Manager Name ;,f�i,�Y t. 36 �'Address : , 37: Gty,Stete Z�p �
Aeron ,J, Dooi�ey,,`, . --- ���^ �� �:..��p�4�cor.�:].� AveDUe _.=�.c��;; S1'k Paui ,:.MN. 35104 -�`
� : 38: Gambling Maneger Busi�ess'Phone �� �39 Dat�a'rnbiing manager became r r""-�o.� � :� f ;' c `°s �'- �
� :, . _ .. . � � ���� `'" .. �'7� 1��4aMf• .,Y � �.y. * s 1 t�-5,.�.� t?
� . ..� 612 -) �221-0��'�}„""�, � a ember of organization '`1 �` � �"
d. _ �.��.��a:�.: --� �. .��r;�:
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' . . '�: ,:,���GAMBLING SITE AUTHORIZATION .�� ' ' i ; ' � . { 4 �
- �,;
By my signatu�e below,local law enforcemenf office�s or agents of the Board are hereby authonzed to,enter upon the site, :;„. a.
,� at any time, gambhng is being conducted,To observe the gambling and to enforce the law for any unauthorized game'or; � ,
�� practice. .�- ,�6'�����Y,4,.� � : ., �. :;�. ;, �,�� � �r �. s ;_:
�' ���, ;ri �BANK RECORDS AUTHORIZATION •:§ � r :.. : :"' `"
' By my signature below,the Board is he�eby vautfiorized to inspect the bank record's of the General Gambling Bank Account ;'F ��
� whenever necessary to fulfill requirements of_cu�rent gambling rules and law. ", ° =` ; '
, , . � .;�
", ,4 , : '? OATH � ' ,' ; �, ` *�'
I hereby declare that: . . ,�, . a;Fr�`�,��: . � ? �t •, :` y � � :�i "'
ri� '� :` '�� C .•��, "`� � a:�
1. I have read lhis application end all information.submitted to the Board, �� � �� , - ; �.
2. All information submitted is true,accurate and complete; ^� ' r• ` ` .} , ' ,_; . �F
, 3. All other required information has been_.fully disclosed '`: 3 .;,r,. .� '�:,;.
- 4. I am the`chief executive officer of the o�ganization; ? ��':
5. I assume full responsibility for the,fair and la'wful operation of all activities to 6e'conducted, � - - ���., '` ' k A
6. I will familiarize myself with the lavi/s of tFie State of Minnesota respecting gambling and rules of the Board and agree, : �
i f license d to a bi de b t hose laws'and"rules,includin amendments thereto:-• - �
40. Official,Legal Name f-Organization ; k'�r, �� ''` .� 41. Signature(must be signed by Chief Executive Officer)` . .
, , ,`
TWI IJ STAR VFW P S��#8854 ...:� .,-:: . . .. , X . . .. ._;:.: _ .,. , :.: , ._.. ;
Title of Signer y f` �' y Date �`
Corrrnander �`�l'�i`i;.� �C.�+','��.,-� ``�• f�f�
�� ��: .. .: „ : .. ,, . .�. r,; �, , '; t "`
` ' ` ' ACKNOWLED�aE . ENT OF NOTICE BY LOCAL GOVERNING BODY� ` ' '
� I hereby acknowledge receipt of a copy of this application. By acknowledging receipt, I admit having been served with ,'
`; n o t i ce t ha t t his app lica tion wi l l be rev iewe d by t he C harita b le Gam b ling Control Boar d and if approved by the board, will
.become effective 30 days from the date', of receipt(notedbelow),unless a resolution of the local goveming bod�r i.s passed
which specifically disallows such activity"ai�d a copy of that resolution is received by the Charitab�e Ga bl�ng Control ;�., ,�
Boardwithln30da softhebelownoteddate':�*� . � �,. � �,;t���`'��� ;,,�:,;: Y�f. °� �;t,,�,r3�*;�;.� '�,
w=`� 42. Name of City or County Local Governing�odX) ' �b�� � If site is located withi,�a township,�tem 43 must be com le4ed,in
,
*�` � � ;
' '' y �,�k addition�o the county signeture ' , �a ��- �a
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�. -,`'� Signature of rso r ceiving applicaUon �xt�."': ` ` �, 'if �: ;<,, 43 `'Name ofrTownship' ° s ; �: s �.:`�' ; ; z,�•.< ; ` �� ._= ` '
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. s'� • cicy of Saint Paul /�� a
� � • ,/ Departmeiit oE Finance and Management Services V' �� ��
Division of License and •Permit Registration
INFORMATION REQ.UIRED �ITH APPLICATION FOR PERMIT TO CONDUCT CHAR.ITABLE GAMBLING GAME IN
SAINT PAUL
1. Full and complete name of organization which is applying for license
TWIN STAR VFW POST #8854
2. Address where games will be held 820 Concordia Avenue - St. Paul . MN 55104
Number Streec City Zip
3. Name of manager signing this application who will conduct, operate and manage
(
Gambling Games L Lc.�.� Date of Birth ) D � � � I �--
(a) Length of time manager has been member of applicant organization $, `? �J '
4. Address of Manager ��3 � y C� q� � x r°�"� t�� s� �a�
Number Street City Zip
5. Day, dates, and hours this application is for Daily - 10:00 a.m. to 1:00 a.m.
6. Is the applicant or organization organized under the laws or the State of MN? Yes
7. Date of incorporation September 21, 1965
8. Date when registered with the State of Kinnesota September 21, 1965
9. How long has organization been in esistence? 22 years
10. How long has organization been in esistence in St. Paul? 22 years
11. What is the purpose of the organization?
12. Officers of applicant organization
Name Gordon W. Kirk Name Otto Burrou9hs
Address 958 Fuller Avenue/St . Paul 55104 Addrass 1013 W. Central Avenue/St. Paui 55104
Title Commander DOB 03/23/23 Tit1e Sr. Vice CommanderDOB O1/03/18
Name Walter Archer Name James G. Kirkr Jr.
Address 985 Fuller Ave - St. Paul 55104 Address 1005 St. Anthony/St. Paul 55104
Title Jr. Vice Com. DOB 03/17/30 Title Quartermaster DOB 06/19/20
13. Give names of officers, or any ot?�er persons �atto paid for services to the organization.
Name None �ame
Address Address
Title Ti�le
(Attach separate sne�r� :. . acci�_ons_ ^�^zs. '
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. } � �7- ��
14. Attached hereto is a list of names and adCresses of all members of the organizatio�� ',�
15. In whose custody will organization's records be kept? �`
Name James G. Kirk, Jr. Address 1005 St. Anthony/St. Paul 5510 -�:
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16. ,Persons who will be conducting, assisting in conducting, or operating the games:
i", � � � �
Name ��,� �,���-�`� Date of Birth
C
Address/`��`S ,
Name of Spouse None Date of Birth
Dates when such person will conduct, assist, or operate January 1, 1987 thru December 31
1987
Name Date of Birth
Address
Name of Spouse Date of Birth �
Dates when such person ai11 conduct, 2ss�st, or ope-ate
17. Have ;�ou read ar.d do you thoroughly understand the provisions of all laws, ordinances,
and regulations governing the operat:on of Charitab�e Gambling €umes? Yes
i8. Attac`�ed here�o oa the •fo�m �urr.ished bv the City o�' St. Paul is a Financial Report
which �temizes a11 receipcs, e:cpenses, and disbursements ot tne aoplicant organizat�on
as well as a'_i organizat'_ons who iave �eceived :unds �or the preceding calendar year
whicn has been s�gned, prepzred, and ve_ified �y Aaron J. Doolev
�iame
1024 Carroll Avenue - St. Paul , MN 55104
�ddress —`
who is the Ciub Manager o� the applicant Organiza.tion.
Vame o� Ot:ice
19. Operator of premises whe*e zames a�l'_ be held: �
Name Aaron J. Dooley
Business Address 820 Concordia Avenue - St. Paul , MN 55104
Home Address 1024 Carroll Avenue - St. Paul , MN 55104
20. Amount of rent paid by a�pl�csnt Organi�acion ror rezt o: the hall; specify amounC
paid per 4-hour se�s�on $75.00 paid to TWIN STAR VFW POST for the month of March '87
1 �' P
•
, 21. The proceeds of the games will be disbursed after deducting prize layout costs and • "
�
operating expenses for the following purposes and uses; %�
Individuals & families in distress; community projects; churches; disabled
senior citizens.
22. Has the premises where the games are to be held been certified for occupancy by the
City of Saint Paul? Yes
23. Has your organization filed rederal form 990-T? YeS It answer is yes, please attach
a copy with this application. Ir answer is no, e:cplain why:
Any changes desired bv t7e applicant assoc�ation may be made only with the consent of the
City Council.
TWIN STAR VFW POST #8854
Organ�zation
Date April 21, 1987 "
By: �� Q•��
Manage: in charge of gam�
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