87-1334 WMITE - C�TV CLERK
PINK - FINANC�E G I TY OF SA I N� PAU L Council
CANARV - DEPARTMENT
BLUE - MAVOR F�Ie NO. '
�
Co ncil Re olution
, , .
Presented By �
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D.#42470) for a One Day City of St. Paul
Gambling Permit (Raffle) applied for by St. Paul Ducks Unlimited
#31 at 180 E. 5th Street on September 17, 1987, between the hours
of 5:00 P.M. � 12:00 Midnight be and the same is hereby approved.
COUNCILMEN Requested by Department of:
Yeas Arew Nays
'�'�'a _� [n Favor
Rettman
Sch2ibel � Against BY
Sonnen
6Jeida
WilsOri SEP 1 5 �87 Form Appro e by City Attorney
Adopted by Council: Date
Certified Pas d by Council Secretary BY
By �
Q.l�I��C. �y`�' �
Approv y Mavor: D SEP 1 7 19V��� Approve b Mayor for Submission to Council
B BY
PUBl1SN�D ��P `' G 1987
, �
l���i33`�
DIVISION OF LICENSE AND PERMIT ADMINISTRATIOId DATE S�— oZ �-g �
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INTERDEPARTMENTAL REVIEW CHECRLIST
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Applicant '?�,,,�} �„��5, ���,,,,,;�& Home Address '� ��o IA-t, "�'Y1rZ,,.�C(�c���h
'r �� �
Business Name `j�� _ Home Phone H.`j C -Cj (�� (
._ ... . . __ .._._
.. . ...
Business Address j �('6 � .�� S.� , Type of License(s) n � " �
Business Phone '�J G -�O3 � , �er�
Public Hearing Date � f/5 � � License I.D. � �a ��D
at 10:00 a.m. in the Council Chambers,
3rd Floor Citq Hall and Courthouse State Tax I.D. # 1� �(ac
REVIEW DATE DATE INSPECTZON
APPN REC'D VERFIED COMPUTER) COMMENTS
roved Not raved
Housing & Bldg 1 �
Code Enforcement � ` � �
I
Public Health _ I
� '� �
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Fire Prevention
-, ►� 1r� �
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Police �
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City Attorney i
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ENS �
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300 Foot Notice n 1 I
(a( i
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License Inspector's Comments:
I HAVE BEEN GIVEN A COPY OF THIS NOTIFICATION AND UNDERSTAND THAT MY ATTENDANCE AT
THE PUBLIC HEARING IS REQUIRID.
' � . City of Saint Paul � �� /��"
Department of Finance and Management Services � O
� License and Permit Division (� a�
203 City Hal1 �
St. Paul, Minnesota 55102- 298-5056
APPLICATION FOR LICENSE
CASH CHECK CI.ASS NO. New Fenew
a Q aa R—� j ��
Oate � 19 � ��
Code No. Titte of License � � + ! l -� 'j O %�1��-'
From 19_To � t9
i
�L� 'v.� ��-�L �?: S j,�:
100 � I • �, . � ��� ( - ' • - �-
- J
Applicant/Company Name
100
� <<��' �' `•� '-�; . � �.:� • . '
_ �
100 eusiness Name l -!'
/ 4 { �i� i� 1 1 ��(.� �.--� �.�
�`j�l L�� L� ✓.�)i�.i r�l � ' .
10�
Business Address Phone No.
100
100 Mail to Address Phone No.
�oa v��� ; !`� �����i�:�
ManagerlOwner-Name
� �J� �
100 \ C y _`
� � � f r�y � t ��_, ,. / . ��-.�. !
. . ( I�.� •' 1 �../
100 AlanageNGwner-Home Address Phone No.
• 4098 Application Fee
2. 50 � I I�' �
Received the Sum of 100 ���� �% )-� Li.,p'}� 7"�C<(`,� ';, i�`? '"!
�
S�,� .� � Manager/Owner--Clty-Slate&Zip Cod ���—�� �,
100 Total 100 j > �
:,
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� 4 � ` \ ,.�, �,
License Inspector �� `— By: �� /�"" � � \ 5,nature o(Applicant
;
'
Bond: �
Company Name Policy Nn.�' Expiration Oate
Insurance:
Company Name Policy No. Expiration�ate
Minnesota State Identification No. Social Security No.
Vehicle Information:
Serial Number P�ate Number
Other:
THIS IS A RECEfPT FOR APPLlCATION
THIS �S NOT A LICENSE TO OPERATE.Your application for license will either be granted or rejected subject to the provisions of the zonin9
ordlnance and completion of the inspections by the Health, Fire, Zoning andlor license Inspectors.
$15.00 CHARGE FOR ALL RETURNED CHECKS
�,� t� � � f a���1 �
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� ��-.�.�- � 1�.s' � � c�e�
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CIT� OF ST. P�UL ��� /�3�
- DEP.�T:��idT Or �IId�;CE r1TlD tiAi�t2G utilEl�T jF,�VICLS
DIVISIOil OF LICEIlSc �1VD PERP�T ADNIIT;IST�.ATIOr�i
�M.ATICN �CUI� r;tITH �DLIC�TIOPd rOR PT_'.i2I�ST TO CCP�IDUCT GAi-�3LIiTG SESSIOP' I;; ST. PAUL
, P�ame of Organization St. Paul Ducks Unlimited #31
2. Address where Organization's re�ular meetings are held N/A
3. Day and time of ineetings N/A
The Great Hall, First Trust Center
�.. �ddress where CamblinF Session :�rill he held 180 E. 5th Street St Paul MN 55102
5. Is a.pplicant owner of property where Gambli� Session c,rill be held? Yes g i?o
6. If Ieased, who is owner of pro�erty where Gambli:�e Sessior. T.�rill be held?
Saint Paul BurlinQton - Limited PartnershiA �
f
7. I£ leased, attach letter of permission to conduct Gar�blir.� Session, signed by lessor. �
fi. Name of officer maF;i.ng application Joel W. Brodd
7 Beebe Avenue I
9. Address of officer making application Mendota Hgts. , MN 551 1 8Date of birth 1 1 /07/51 I
I0. �fame of r�anager who will conduct Gambling Session Joel W. Brodd �
11. Address of manager 7 Beebe Ave. , Mendota Hgts. , MN 551 1 8 Date of birth 1 1 /07/51
12. In connection with what event is this Gambling Session being held? Annual banquet
13. :�1hat type of gar.ibling device(s) will be used? Paddlewreel `I�pboard F.,a.ffle X
Il�. Day, dates and hours this application is for and number of sessions.
Day(s)Thursday Dates 09/� �/87 Hours 4 P.m.-1 a.m�;o. of Sessions �
I.S. irJi11 priaes be paid in money or merchandise? merchandise
io. is tne applicanti association organized under tne laws of tre State of �;innesota? no
17. Horrr long has Crganization been in e�dstence? Since 1937
18. 4v'hat is the purpose of the Orgariization? Restore and perpetuate wild ducks
and other wild waterfowl on the North American Continent.
19. Officers of the Organization
�1ame-Title Address Date of birth
Joel W. Brodd _ 7 Beebe Avenu 11 /07/51
(Chairman) Mendota Heights, MN 55118
Lu, i�ive na�es of officers or ar�y other persons paid for services to the Or�anizati
_ i•�ame-Title Address �ate of birth
N/A � ��� (.�
�
21. In whose custody wi11 records of Organization's Gambling Sessions be kept?
:Jame Joel W. Brodd � Beebe Avenue, Mendota Heights, M .
Address 55118
22. Attach a copy of your Organization's membership roster and date each member joined.
23. Attach the Gar,ibling Session i4anager's bond.
2l�. �ttach a copy of the Department of the Treasux�, Internal �evenue Service "RetUrn of
Organization �cempt from Income Tax't, For;n 990.. (Chapter I�19.OI� (1).)
25. Attach a co�y of Department'�of the Treasuzy, Internal Pevenue Service, "�xemut Qr�an-
ization Business Income Tax , Form 990T. (Chapter I�19.01� (2). )
26. Attach the annual report required of chaxitable organizations by i�.innesota Statutes,
Section 309.53. (Chapter 419.0�: (3). )
27. F:ave you read and do you thoroughlv understar,d the prov�sions of all laws, ordinances
and regulations governin� the operation oi Gamblin�* Sessions? Yes
28. Any chances desired by tY:e applicant association may be ma�'e only *,�rith the consent of
the License Committee.
29. Has any person(s) �articipating in the operation of any of the gambling sessions cov-
ered by this license ever been convicted of a felony in the State of i�ii,nnesota or in
ar�y other State or rederal Court? Yes No X . Ii answer is "�es", provide
nances, addresses and birth-dates.
St. PauL-Ducks Un imited #31
'za�io �
� � -���
(Office - ''t
�a i %
�1''�.r�a�.e c�,arge of`'Cambling Session)
State of P4innesota)
)SS
C ounty of Rans ey )
Joel W. Brodd "
being duly sworn saf that -ri� -i s � the petitioner= in the above a�plication; that ; e=- as.�
r�ad the foregoing petition and rmow the contents thereof; that the same is true of his
oc,rn Irnowled�e.
Subscribed anc3 sworn to before me thi.$
�Jr� day of ' � c�_1o� �.�.........,----�-•-----_....,
�(�, l`7 f� � ;::�~''�"�::•, KATHRYN R. BURGER
-- "�'�\� � �.1L�-L'1.0 L. � % '�"�� � NOTARY PUBUC-MINNESOTA
� ^ �� ; '��'� DAKOTA COUNTY
Votary Public, County, :��i.nnesota M
''.i4..:-�
�'� COIIIR1SSlOI1 gXP1T@S i Y Commission Expires Aug. 16. 1988
:w'N'l�s�Ne�`��as�E
Building Depart:�ent Approved Disapproved by
Fire Departnent Approved �isapproved y '
?olice Department Approved--'—Disapproved--�Y i
I
i
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? � � ��7-/33y.�..
' - Minnesota Charitable Gambling Control Board LAWFUL GAMBLING EXEMPTION
' �'��, Room N4Z5 Griggs-Midway Building
1827 University Avenue FOR BOARD USE ONLY
����' St. Paul,MN 55104-3383
���"� (612)642-0555
�STRUCTIONS: 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.
Organization Name LiCense Number(M cunently or previously licensed)
. �.�3t• �_3L.'.� �?2C:_3 '..��'2.�ii•,•i��-,t�' �-+'�
� _..1.^.:,;.� �-f�
Address City,County,State,Zip Code
- � .. . �.�8� ;�7:ii.�i�:.:^. j¢. � �='..�,�L i.:i :��, �q ;r� _.'� 1 . f _ .".":�� . . .}
Chief Executive Officer's Name t�--�+��-=��:���3 phone Number Manager's Name . V �L T
� .� ,.� > r., ,, ._ Phone Number
��..�:.. a.: • st.L2:G::a::' �=i���3+::i: " :�. =♦ '`'.�'.:.`._._ � ��-�
v i.:: . t �
Type of Organization If Other Nonprofit Organization ICheck Onel
❑ Fraternal 0 Veterans ❑ IRS Designation
❑ Religion � Other Nonprofit Organization ❑ Incorporated with Secretary of State
� Affiliate of Parent Nonprofit Organization
Name of Premises Where Activity WiII Occ,jur Datels)of Activity
. 1�=: ���i�t� .:C.��� i�.{.�:^� ���'j.�..a. f:,.y,�„t_,
�.1__ e..�. t L ..;t.. t.-<�t,:..��
Pre4mises Address
. 1i3�� _.,r.S:_i%. �'�i.? �s�..w`�"� ;4" �.`�.�.?� '�: ' �{ .
♦ . ..• .p ..._ �::�� �;,, '� i J ��� /
_ Games Yes No Gross Receipts Value of Prizes Expenses Profit `
Bingo '
�
Raffles .�
Paddlewheels
:;
Tipboards „
��
Pull-Tabs ,,
ttsaotProfir '
'��'�[�' �E�:�i�.�� �i$i����k� I�'c�3� q �� ���a�
OistributorFrom Whom Gambfi�g Equipment Acquired Distributor's Ucense No.
':��� #��+��
I affirm all information submitted to the Board is true, accu- t affirm all financiaG information submitted to the Board is
rate, and complete. � true,.accurate,and complete.
� � ` '' ____—�' �' `, ,f t e �,. �� � � � ��...{1 ��'�..
,' � � °,.�' - �, _ • .,,�„ r ,.,,�Y � ,,°? -,
Ch�ef Execunve Officer Signature Date ChietExecutiveOfficerSignature - Date
ACKNOWLEDGMENT 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 notice
that this application will be reviewed by the Charitable Gambling Control Bo�ard and will become effective 30 days from the
date of receipt (noted below) by the City or County, unless a resolution of 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 of Local Governing Body(City or County) Township Name(Must be notitied when County is the approving bodyl
Signature of Person Receiving Application Signature of Person Receiving Application
. ,
Title Date Received Title Date
:z�,i, CG-00020-01 14/86) White—Board Ca�ary—Board retums to Organization to keep
- Pink—Organization P'��`, Gold—City or County
�-���33F
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9�:"0� CITY OF SAINT PAUL
�e'�� '�� DEPARTMENT OF FINANCE AND MANAGEMENT SERVICES
��� =ii�ii 1° e�
DIVISION OF LICENSE AND PERMIT ADMINISTRATION
�'�n ,���' Room 203, City Hail
Saint Paul, Minnesota 55102
George Latimer
Mayor
August 28, 1987
St. Paul Ducks Unlimited
7 Beebe Avenue
Mendota Heights, MN 55118
Dear St. Paul Ducks Unlimited i�31:
Your application for a City Gambling Permit has been received in this
office.
A hearing on your application for a One Day City of St. Paul Gambling
Permit (Raffle) ID ��(s) 42470 wi11 be held before the St. Paul City
Council on September 15, 1987 at 9:00 A.M. , Third Floor of the City and
County Court Aouse. This date may be changed without the License &
Permit Division`s consent and/or knowledge. Therefore, it is suggested
that you call the City Clerk's Office at 298-4231 to confirm this
hearing date.
You are hereby notified that your attendance is required at this
meeting. Failure to appear may result in denial of your application.
Very truly yours,
.( �-I/ �
���'/��7�—
J eph E! Carchedi
License Inspector
JFC/lk