87-971 WHITE — C�TY CLERK
PINK — FINANCE CITY OF SAINT PAITL Council
CANARV — DEPARTMENT - c/.�y�/
BLUE — MAVOR � FIIe NO. � � •�/
�
Cou ci es ution
Presented By � �rt'�-`�
Referred To Commi.ttee: Date
Out of Committee By Date
RESOLVED: That Application (I.D.#11220) for the renewal of a State Gambling
License (A - Bingo, Raffles, Paddlewheels, Tipboards, and Pulltabs)
by American Legion Hamline Post 418 at 900 Rice Street be and the
same is hereby approved.
COUNCILMEN Requested by Department of:
Yeas Nays �
Drew
�z,p�y+o+�/ in Favor
Nicos+e Q
Scheibei Ag81[lst BY
Sonnen
JeAeeeo
W��9on ��(� — j 1987 Form Approv d by City Attorney
Adopted by Council: Date
Certified Pas b ncil Sec ary BY
gy s.e^Y��
A►ppr � avor: Date � — � 1 � Approved b Mayor for Submission to Council
By
PuBlisttlElD ,�u i. 1 1 1987
: ^ . � ���- �7�
�°���� �
...�,,,��,„,�?2,� Charitable Gambling Control Board - FOR BOARD USE ONLY
��'�� Room N-475 Griggs-Midway Building
.3 Ucense Number
. 1821 University Avenue ,
' _ _ St. Paul, Minnesota 5 5 1 043383 AA�ID
(612) 642-0555
�'�' .• CHECK#
:� � DATE
GAMBLING UCENSE APPLICATION
INSTRUCTIONS:
A. Type or print in ink.
B. Take completed application to local governing body,obtain signature and date on all copies,and leave 1 copy.Applicant keeps 1
copy and sends original to the above address with a check.
C. Incomplete applications will be returned.
Type of Application:
�]Class A — Fee S 100.00(Bingo,Raffles,Paddlewheels,Tipboards,Pull-tabs)
OClass B — Fee S 50.00(Raffles,Paddlewheels,Tipboards,Pull-tabs) Makscheckspayableto:
❑Class C — Fee S 50.00(Bingo only► Minnesota Charihbls GambRng Control Board
❑Class D — Fee 5 25.00(Raffles only)
�� �lYes�No 1. Is this application for a renewal? If yes,giv�COmplete,license number 0 - ��w��i 0
❑Yes❑No 2. If this is not an application for a renewal,has or anization been licensed by the Board before? If yes,give base
license number(middle five digits) ;
' �7Yes�No 3. Have Intemal Controls been submitted previously?If no,please attach copy. '
4. Applicant(Official,legal name of organization) 5. Business Address of Organization
American Leqion - Hamline Post 418 '.-?0� �icQ Strpe
6. City,State,Zip 7. County 8. Business Phone Number
St. Paul, Minnesota 55117 Ra�msn Co�rnt � fi ► �3- A
9, Typeoforganization: ❑Fraternal �lVeterans ❑Religious �Othernonprofit•
_ `If organization is an"other nonprofiY'organization,answer questions 10 through 13.If not,go to question 14."Other nonprofiY'organizations
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: Attach copy of certificate. -
`- ❑Yes❑No 11. Are articles filed with the Secretary of State? ' -
❑Yes�No 12. Are artictes filed with theCounty? �
. �'�es�No 13. Is organization exempt from Minnesota or Federal income tax?If yes,please attach letter from IRS or Department of
�:., / Revenue decla�ing exemption or copy of 990 or 990T.
.v ❑Ye No 14. Has license ever been denied,suspended or revoked7 If yes,check all that a ly:
❑Denied ❑Suspended �Revoked Givedate: - -
`-* 15. Number of active members 16. Number of years in existence Note: If less than four years,attach
r:.�'-' evidence of three years
�73 4� existence.
��--� 17.• Name of Chief Executive Office� . . . 1$: N+�rne of ireasurer or person who accounts for.ather revenues_
_ °` " of the organization. ' ° - _ -
� Charles Stead John M. Knox
,,:t
Title Title
.;�� t Corr�andew/Chief Executive Officer Finance Officer/Treasurer
�;;^
� Business Phone Number Business Phone Number
�. � bi2 455-2128 ��- 612 698-5706
�� '" � 1 1 ( )
19. Name of establishment where gambling will be 20. Street address(not P.O.Box Number)
conducted
�� Yine t�undred Ha11 900 Rice Street
21. City,Stste,Zip 22. County(where gambling p�emises is located)
St. Paul , Minr�esot� 55117 Rar��y �ty
CG-0001-0218/86) White Copy-Board Canary-Applicant Pink-Local Goveming Body
� . - . , . • _ � � ��7 c��I
� �. , ,
� ,�'• Gamblin4 License Application .� Page 2
;: T�rpe of Application: � C,�Class A ❑Class B ❑Class C ❑Class D
. ;
r
�Yes ONo 23. Is gambling premises located within city limits?
� �Yes❑No 24. Are all gambling activities conducted at the premises listed in #19 of this application7 If not, complete a separate
� application for each premises(except raffles)as a separate license is required for each premises.
i.itsl� ❑Yes G3No 25. Does organization own the gambling premises?If no,attach copy of the lease with terms of at least one year.
�. ❑Yes No 26. Does the organization lease the entire premises7 tf no,attach a sketch of 27. Amount of Monthl�Rent
� the premises indicating what portion is being leased.A lease and sketch s j 5���� �
k is not required for Class D applications.
; Yes❑No 28. Do you plan on conducting bingo with this license?If yes,give days and times of bingo occasions:
Days Fri days r�"°$ 7:37-11°.�0 PM
�`
�,-
� Yes ONo 29. Has the S 10,000 fidelity bond required by Minnesota Statutes 349.20 been obtained?Attach copy of bond.
�.� 30. Insurance Compa�y Name 31. Bond Number
� �letna -- O�iet^�ann Aaer�c In
32. Lessor Name 33. Address 4. ty, tate, i
��
RFR, Inc. -- Pat Gartlan� �el'l Pnin�hurst �t. �aui�, �V 55115
�' �-""` 35. Gambling Manager Name . 36. Ad�, ,cess '' : ; ' "�` 37.:.�ity,State,Zia "
Ed Lon� 1'�3 Sar�ent A,venue �. paul „ i�; 5�1��
� 38. Gambling Manager Business Phone 39. Date gambling manager became
. ,, � 612 � 693-6771 member of organization: 939 _
GAMBLING SITE AUTHORIZATION
� By my signature below,local law enforcement officers or agents of the Board are hereby authorized to enter upon the site,
� at any time, gambling is being conducted,to observe the gambling and to enforce the law for any unauthorized game or
practice.
± „ . , BANK RECORDS AUTHORIZATION
z ; By my signature below,the Board is hereby authorized to inspect the bank records ofithe General Gambting Bank Aecount
� w,`• whenever necessary to fulfill requirements of current gambling rules and law. }_
'• � � OATH
,I he�eby declare that:
- 1.. I have read this application and all information submitted to the Board;
2. All information submitted is true,accurate and complete;
3. A11 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 activities to be conducted;
6. I will familia�ize myself with the laws of the State of Minnesota respecting gambling and rules of the Board and agree,
if licensed,to abide b those laws and rules, includin amendments thereta
� 40. Official,Legal Name of Organization 41. 'g tur ust e si by Chief Executive Officer)
�; Amer�can Leaian - Hamlin P x = �%���-�
Title of Si ner �- Date '.� �
Chi�ef Executl ve Offi cer - Corrnnander 5/2�3l37
�" � ACKNOWLEDGEMENT OF NOTICE BY L�CAL GO�iERNING`BODYJ " ' � ` �4 ' �
� � I hereby acknowledge receipt of a copy of this application. By acknowledging receipt, I admit having been served with -
notice that this application will be reviewed by the Charitable Gambling Control Board and if approved by the board, will
become effective 30 days from the date of receipt(noted below),unless a resolution of the local goveming body is passed
which specifically disallows such activity and a copy of that resolution is received by the Charitable Gambling Control
�'::Board within 30 da s of the below noted date. _
��• 42. Name of City or County(Local Governing Body) If site is located within a township,item 43 must be completed,in .
�r C1 ty Of St. P8t3� addition_to the county signature.
:��4�� '
"'' Signature of person receiving application 43. Name of Township
, �} (�
» • X t. —� iJ\ � ,t ` �.'.:� `��'ti. �.��.�
,�;� _ Titl� Date received(30 day period Signature of person receiving application
� : begins from this ate)
�� �c�_�, _ �;� • <9 .� ��`1 x
,� 44. Name of Person delivering application to Local Governing Body Title
� - 4. Spannaus
F,x
� g � CG-0001-02 (8/86) White Copy-Board Canary-Applicant Pink-Local Goveming Body
� �'
f '
� ---------- ___._ --_--_--�----- — — ____.
, • - City of Saint Paul �/ �7. G7�
`' ^ � �' Department of Finance and Management Services ���
., .
, Division of License and Permit Registration
INFGRMATION REQUIRED WITH APPLICATION FOR PERMIT TO CONDUCT CHARITABLE GAMBLING GAME IN
SAINT PAUL
1. Full and complete name of organization which is applying for license
F
American Le�ion- '-lamlin� Pn�r �1�
2. Address where games will be held 900 Ri�e Street, St. Paul,. Minnesota 55117
Number Street City Zip
3. Name of manager signing this application who will conduct, operate and manage
Gambling Games Ed Lonq Date of Birth 1%24/1900
(a) Length of time manager has been member of applicant organization
4. Address of Manager 1303 Sarqen� Avenue, St. Paul , f�innesota 55105
Number Street City Zip
S. Day, dates, and hours this application is for Friday nj.ghts evel^V week t?:3� P�'1 �n 11 :30 P�
6. Is the applicant or organization organized under the laws of the State of MN? Yes
)( 7. Date of incorporation �,(�/yIANT C',�/A,P?,(-7? f�.SUf4 !�//95�'e �Fb/.S'1.4�vT//d'�/�9���
,( 8. Date when registered with the State of Minnesota �,S' �,QOr/F'
�( 9. How long has organization been in existence? �'j,U�,!•' /939
�� 10. How long has organization heen in existence in St. Paul? ,s`/��f /939
X 11. What is the purpose of the organization? r0 S!/Pi°D�P� YC-'Tc��!'.4�t1.� G-'�O�/�s'
12. Officers of applicant organization
Name Charles Stead Name Elmer E. Steffen
Address 170� W.entworth Avenue West Address 689 S. Roy, St. Paul , MN
Title Chief Exec. OffiDoB Title Adjutant DoB
� Name John M. Knox Name Edward Long
Address 1925 Goodrich Avenue Address 1303. Sar4ent Avenue, St. Paul , NW
Title F�inance Off. DOB Title Bingo MQr/Chairma�oB 1/24/1900
' 13. Give names of officers, or any other persons who paid for services to the organization. �
0
Name �f p /�/,j/D O�,t"j�t�s Name
Address Address
Title Title
(Attach separate sheet- for additional na�es.)
.. � . ;.� � . _ �- �7-���
21". i'he proceeds of the games will be disbursed after deducting prize layout costs and
� ` operating expenses for the following purposes and uses:
X �a �iP�n�a 7',l �1�1'�1�.��cl 1�'/�/G�/ ,d.9��.�,���
)�'DU i� v�P�.9.U/Z�>'/O�s� �- 1/lT.�'.P.d�s
��, 22. Has the premises where the games are to be held been certified for occupancy by the
City of Saint Paul? Ye5
� 23. Has your organization filed federal form 990-T Y2S If answer is yes, please attach
a copy with this application. If answer i , explain 'why:
9 90 r� .vo�� iP,lD�/�,QF�'J Q�P�.qid/.Z.�T/D� f�.ls �'� U.r//.'«•�T�a /.r1 CD.��E'
iP�'4 v���,� �'o,�°��s 9 9 o r����e�.y�
Any changes desired by the applicant Association may be made only with the consent of the
City Council.
Organization
Date By:
Manager in charge of game
�
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