87-1049 WHITE - CITY CLERK
PINK - FINANC�E G I TY OF SA I NT PAU L Council
CANARV - DEPARTMENT File NO. ��-/���
BLUE -MAVOR
�
, C cil Resolution ,.�---�
Presented By
i' d
Referred o Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D. #69808) for a City of Saint Paul Gambling Permit
(Pulltabs « Raffles) by the North End Business Club Inc. at Rice
& Lawson playground for August 2, 1987, between the hours of 1:00 PM
and 5:00 PP�, be and the same is hereby approved.
COUNCILMEN Requested by Department of:
Yeas Drew Nays
Nicosia
Rettman [n Favor
Scheibel
�� � _ Against BY
Weida
WilsOn JUL 2 � .�87 Form Appr d by City Attorney
Adopted by Councii: Date
Certified Pas Council S t BY
/ ;
gy ,�
or: Date � Approv d y Mayor for �bmission to Council
Approve by Mav ,�
By BY
Pli�i�t� i`;U G 1 19$�,
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� . , DIVISIOPi OF :S�E:�Sa r1iID PLiu9IT ADMIidIJ,.��.el'�0:� "' ' .
I21r^QF?�ATION �CUI,�D L1ITH AP°LIC�TIG:1 FOR c�T'F.:�Si TO CC2•1DUC� GAi�3LI?iG SEJSIOt: IiJ ST. Plti'JL
North End Business Club Inc. '
1. ►:a��e of ��r;anizat�on '
2. Address where Qrganization's re�ular meetings ars held 1638 Rice street
3. Day and ti�e of :ne�tiin�s �� First Wednesday Each Month--Noon
!t. Add.�sss where CamblinP Session c,rill. he held see attached ,
5. Is aop?icant owr.er o.f property ?1�''8I'9 Ga�-�bli:.F Session ��rill t�e helC': x °es ??o
6. If leased, :•rho is owner of prooerty w��re Gamblin� Session �i:ll �e he�d'
see �attached '
. 7. If leased� attach letter of perrtission to conduct Gar.�blir� Session�' signed by lessor.
Gregory M. Sheehan
E. 41ame of ofiicer mal�.ng applicaticn
1215 Rice Street � 1/27/51
9. Address of officer making application Date of birth .
Lloyd Bergum �
10. Ziac�e of r�ana�er who will condwct Gamblir� Session �
Il. ��ddre§S �of manager 960 Western ' � Date of �irth 12/16/24
12. In connection with wha.t event is th�.s Gambling Session beir:g held?
. �.. • . . , . _ . _ .. ..
-.`- -- •= ' ' Rice Street Festival � " ° '` '
13• �a� tYpe of garibling device(s) �i.11 be used? Paddlerar�el � Tipboard x P.a..ff'].e
1lt., �7ay� dates and hours this application is for an� number of .sess�ons.
Day(s) Dates Hours Pio. of Sessions
<:.,:: . - Money.--• • .
"=< 15�• �r7i1Z. prizes be paid in money or merchandise? _ , .�- . .
16. ..Is,tY:e at�plicant association organized under the la�rs oF tr.e State o£ I��innesota? yes
17. How long has Cr�anization been in existence? �6 Years
le. tir'hat is t�e purpose of the Oz'Fanization? community development
. ..--..;._
19..• Officers of the Organization . �
Piame-Title Address Jate of'birth
Greg Sheehan, President 1215 Rice Street 1/27/51 -
Lloyd Bergum, Vice Pres. 960 Western 12/16/24
Linda .Bergum, Tresurer • � � 960 Western 2/20/49 ,
� Lil Linder, Seeretary 275•Wheelock Parkway
. 20. �ive za.cles of officers or anr other persor.s pa�d ior sez�v;.ces. to the Or�-ar�.'zatior�.
tiame-Title . , : �Lddress . � �ate of birth , .
21.� Ia wrose'custody •�ri.11''rocords of Qrganizaticn's Ganblin� Sess�ons te �:ept?
i,atne' Lloyd Bergum ` � � Adciress 960 Western
22. Attach a copy of your Crganization's membersr.ip roster and date each member 3oined.
. 23. A�tach the Gacahlin� Session ifanaFer's bond. , . ,. . -.,..:
2l�. �'lttac� a copy of �he 'uepa.rtmer_t of the Treasuz�, Inte�al :'.evenue Ser�ce ":teturn of
� 'Grganization .�cer.ipt Lro� Incor�e ^_'ax", Form 99�. (Cha��er l�19.0l; (1).)
25. *r Attach a copy of Depart:.�ent of the Treasur*,�, In�ernal ?evenue Servics, "'�'Yecrmt Orpan-
; •_ization Business Income Tax", Form 9?OT. (Chapter l�19.0l� -(2).)
26. xttach the annua? report required of cY,aritable organizations by ,'•3nnesota Statutes,
� "` Section 309.53. (Chapter L�19.0ls (3). ) `
\,ti''.. . � .
27.�"'�F'ave you read and do you thorou�hl� understand the provisions o�' all Ia�rs� ordinances
and reFulations �onernin� the operation of Gamblin� Sessions? yes
. ..__ ,. _ .....
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t 28.�,�dr�y, c�an.�•es desired by the applicar.t associa�ion may he made only t�th the cor.sent of
�__.�.. .. .
the. License Co�nittee. ° -
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'"29:�"" �ias any person(s) participatir.g in the operation of any o�/the ga*nblin� sessions cov-
ered by this license ever been convicted of a £elony in tre State of riinnesota or in
"'""""""""':'arYy other State or Federal Court? `�Yes Plo xX . If' answer is ";�es", provide
names, addresses and birth-da,tes. • , . . _ .
.. ..... �w.. . ... . .. ... . . .. � : . _ . _ . . .
, << North End.Business Club, INC
. argani tion
- .._ � , . .._ _ _ . Ey ��5
" ._ _.. ...;,�:._.. .. �wr . , . . . _ . .. _._ �Officsr-Titl . � .
... .':'� .�` � _... ?^ a' : and � c'
� (tlana� in c!-.ar�e f Camblin� Session
.,-�� . --
State of i4innesota) � . .
��ount� of ��attsey -')Sa ,� .t ,�, , , , ,
ana
!be;np duly sr�rorn sa� that they a:,e the petit;oners in the above a�plication; that �Fey havs
r�ad the foregoing petition and 'rnow the contents. thereof; illat the same is tr�ae of +.reir
o:•m kno�,rledpe. , , _ .
� Su�scr=bed and sworn to bef.,re me t. s •M��������M���ti�^^�^�■
I (p� da bf � o ��_ i'��r��LK, ^ °9'EC E' .R�' -c � ,
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..i,�otar� ?ublic, untp, :Linnes�t ��NVw�w�r' . ..
.�{7 co�mission' expires � . .
.. .
` � _... ._ _ __
� ' Buildin� �Jepart:�ent Approved � �' ' Disaoproved � by � • ' ` '
�rire Je�artnent�� �� �LDproved Disapproved bv
� Police ���oaz��ent - ^Approved'�`"��isapproved-�y
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DIVISION OF LICENSE AND rERMIT ADMINISTRATION DATE vL+ ` � g''�
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INTERDEPARTMENTAL REVIEW CHECKLIST
Applicant ��Z.-�.��,���,c,,n,� C�, .1^-�' Home Address�.�
.
Business Name �,Q,H,`,.� Home Phone ��"� - �a�S
Business Address � o(�� � A�.�.o�-y -� • Type of License(s) �,��Q. ��,,
Business Phone �-�'�1-(�'I(03 �a,,�:.. _ �-a, `6�l �:�.r�� 4.�,,,s�.���e�r�-�
Public Hearing Date d License I.D. # �_Cf �(�
at 10:00 a.m. in the Cou il Chambers,
3rd Floor City Hall and Courthouse State Tax I.D. # l�lr/Y
REVIEW DATE DATE INSPECTION
APPN REC'D VERFIED COMPUTER CO1rIlrIENTS
boved Not raved
Housing & Bldg (
Code Enforcement � I� I
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Public Health � I
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Fire Prevention � 4
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Police �
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City Attorney �
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300 Foot Notice I
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License Inspector's Commen
I HAVE BEEN GIVEN A COPY OF TEiIS NOTIFICATION AND UNDERSTAND THAT MY ATTENDANCE AT
THE PUBLIC HEARING IS REQUIRID.
�.�,•. � ' .tr°h�' ,:f'. "`_"N. . :.� M1��.._. _ �`'._ . _ . . . . , , . ,.. . .. , . . .
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
New Officers:
Stockholders:
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NORTH END
� L
RIC � ST . FESTIVA
�O-SPONSORS
N0. ENO IMPROVEMENT CtUB • N0. END BUSINESS CLUB
P. 0. BOX 7014
ST. PAUL, MINN. 55117 ��
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RICE ST . FESTIVAL
CO-SPONSORS
N0. END IMPROVEMENT CIUB • N0. END BUSINESS CIUB
P. 0. BOX 7014
ST. PAUL, MINN. 55117 `��'°
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� � , City of Saint Paul ��7_/�7� ',
• • Department of Finance and Management Services ! ; c/
License and Permit Division 1_ ��� D
' 203 City Hall L�
. St. Paul, Minnesota 55102-29&5056
APPLICATION FOR LICENSE
CASH CHECIk� CLASS NO. New„ Fienew
L� '� � .�l 0 _�� � -�
Date 19 �%` �
�7 �,
Code No. Title of License From � � 19�/To � � % �_19
`� ^�� I�r �� A � a /i° C'� �� } i � � �I r —►.
� t oo l �� N 1.�5 r>�.�L �!�'.-.��
pplicanGCompany Name
,� � G���
100 �ness Name
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100 �^ !� ! �'r��..r / ��`y=-
Bustness Address � ` Phone,N"o.�
100 �^ , ;t"'� � t� � �!
`� � � � � P(`{'l 1 ;
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100 Mail to Address —, �-� � ��—Ph'on/e No.
Y c,�� —
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,00 139L'-.;�
ManageNOwner•Name
100
100 tifanagerlGwner•Home Address Phone No.
4098 Application Fee 2. 50
Received the Sum of 100
I � G ManagerlOwner•City,State d Zip Code
100 ?otal 100
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License Inspector By: Signaiureo(Applicant
�
Bond:
Company Name Policy No. Expiration Date
Insurance:
Company Name Policy No. Expiration Date
Minnesota State Identification No. Social Security No.
Vehicle Information:
Serlal Number Plate Number
Other.
THIS IS A RECEIPT FOR APPLICATION
THIS IS NOT A LICENSE TO OPERATE.Your application for license wiii either be granted or rejected subject to the provisions of the zoning
„ .
ordinance and completlon of the inspections by the Health, Fire, Zoning andlor license inspectors.
$15.00 CHARGE FOR ALL RETURNED CHECKS
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' �Minnesota Charitable Gambling Controt Board LAWFUL GAMBI,ING EXEMPTION
Room N47��riggs-Midway Building Fott aoaFS�us�oN�v
1821 University Avenue
St.Paul,MN 55104-3383
� ' (612)642-0555
INSTRUCTIONS: 1. Submit request for exemption at least 30 days prior to the occasion.
2. When completing form,do not complete shaded areas.
3. Give the gold copy to the City or County. Send the remaining copies to the Board. The copies will be
returned with an exemption number added to the form.When your activity is concluded;complete the
PLEASE TYPE financial information,sign and date the form,and return to the Board within 30 days. ��
Organizati Name ��e►�h+r�eerltfc�rrentl�'av�N���d�
o -�' ��,D �� �-�t.c f� lN�,
Address City,Cou�v State,Zip C e
,� "1 b�+� Si-f'A�-L F 1� S`,$�t1''�
C ef Executive Officer's Na Phone Number Manager's Name Phone Number
�RE ����H��l' �f 8�-'t�s � �..oy.� �����.+�
Type of Organization If Other Nonprofit Organization(Check One)
� Fraternal ❑ Veterans � IRS Designation
❑ Religion �Other Nonprofit Organization ❑ Incorporated with Secretary of State
❑ Affiliate of Parent Nonprofit Organization
Name of P►emises Where Activity Witl Occur Date(s)of Activity
Premises Address
Games Yes No
Bingo �
Raffles
Paddlewheels
Tipboards �
Pull-Tabs
I affirm all information submitted to the Board is true, accu-
rate,a complete.
� • �
Chief Executive Offi r gnature Date
ACKNOWLEDGMENT OF NOTICE BY IOCAL GOVERNING BODY
I hereby acknowledge receipt of a copy of#his application.By acknowledging receipt,I admit having been served with notice
that this application will be reviewed by the Charitable Gambling Control Baard and will become effective 30 days from the
date of receipt(noted below)by the City or County, unless a resolution ot the local governing body is passed which specifi-
cally disallows such activity and a copy of that resolution is received by the Charitable Gambling Control Board within 30
days of the below noted date.
CITY OR COUNTY TOWNSHIP
Name o�al Gove�ing Body�ty or C ty) Township Name(Must be notified when County is the approving body►
Signa �e o Person R eivi iCa'on Signature of Person Receiving Application
� !_
ky
Ti e ' Date Received Title Date
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i
CG-00620-01 14/861 V1lfiite—Board Canary—Board returns to Organization to keep
Pink—Organization Gold—City or County
1 , (��.J T �
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� s�'�'o:.R.,, CITY OF SAINT PAUL
�`'� '-�''� DEPARTMENT OF COMMUNITY SERVICES
�J ��
'?,% ""�������' �� DIVISION OF PARKS AND RECREATION
�• -
�'�, ,��� 3(�City Hall Annex, 25 West Fourth Street
otr�"""�9�g",`~`~ � St Paul, Mlnnesota 55102
CEORGE LATIh1tR
MAYOR ,
612•292-7400
Joseph Carchedi , License Inspector
City of Saint Paul �
209 City Hall
Dear Mr. Carchedi :
The Division of Parks and Recreation authorizes the Rice Street
Business Association to use the facilities at Rice-Lawson Recreatlon
on August 1 and 2, 1987 from 8 a'm' to 8 P'm'
date time
The above mentioned organization may sell beer if they are able to obtain
proper_license through your office.
APPROVED:
� ��-l��„�
Division of Parks and tion
� 6/17/87
Date of issue .
Issued to: Greg Sheehan
Phone No. _
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����n�'���`'� C I TY O F SA I N T PA U L
...:������•T �-°-r.
3�• ;-'�', DEPARTMENT OF COMMUNITY SERVICES
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'°� "'������01 �' DIVISION OF PARKS AND RECREATION
�y• -
� „ 100 City Hall Annex, 25 West Fourth Street
'o-n �...
hn:ir..��'%��` ,
CEORGE LATItittR
St Paul. M�nnesota 55102
MAYOR b12•292-7400
Joseph Carchedi , License Inspector
City of Saint Paul
209 City Hall -
Dear Mr. Carchedi :
The Division of Parks and Recreation authorizes the Rice Street
Festival Committee Rice�-Arlington Athletic Field
to use the facilities at
on August 1 and 2, 1987 from 8 a'm" to 8 P'm'
date time
The above mentioned organization may sell beer if they are able to obtain
proper.license through your office.
APPROVEO:
r��..�. ��",-,
Division of Parks Recreation
� �-/f'—& 7
�Date of issue �
Mike Temali
Issued to:
Phone No.
�'� .
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+ CITY OF SAINT PAUL
.¢�oL.ur:,::ri:
`'.`L�T 7,°.��r'�
a`� '-�`'= DEPARTMENT OF COMMUNITY SERVICES
N� � a's
%+ '��������� �� DIVISION OF PARKS AND RECREATION
�.
��0nn, �... 300 City Hall Annex, 25 West fourth Street
'.crcr.ir..�:�:�+�1~. -
GEORGE LATIMER
St Paul, Minnesota 55102
MAYOR
f�i z-zvz-�aoo
Joseph Carchedi , License Inspector
City of Saint Paul
209 City Hall
Dear Mr. Carchedi :
The Division of Parks and Recreation authorizes the
Rice Street
Festival Committee Rice�-Arlington Athletic Field
to use the facilities at
on August 1 and 2, 1987 from 8 a'm' to 8 p'm'
date time
The above mentioned organization may sell beer if they are able to obtain
proper,license through your office.
APPROVED:
1�`'�"` ' ' ���
Division of Parks Recreation
S--/s—� 7
�Date of issue i—i _—
Issued to:
Mike Temali
Phone No.___�! _,_
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A_C _E_lY_A :A_M_A T=E_R=I_A_L_S
COUNCIL ID�� �(� DATE RECEIVED / N
AGENDA DATE AGENDA ITEM ��
SUBJECT � �` �� � ' �
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ORIGINATOR �j
CONTACT � � �
,
RESEARCH STAFF ASSIGNED �/
DATE SENT TO CLERK 7 /;'
COUNCIL ACTION
M�STER FILE INFO AVAILABLE -��o-��:� � � ,�- ,��(�`�
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ORD'/RESOL. �� ' DATE FILE CLOSED
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