87-1462 WHITE - C�TY CLERK
PINK - FINANCE COURCII �j�� /j�`
CANARV - DEPARTMENT G I TY OF SA I NT PA LT L /� �
BLUE - MAVOR �. F�le NY. d /itrf
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Cou il Re lution --
: � , ��
Presented By -
Referred To Committee: Date
Out of Cmmmittee By Date
RESOLVED: That Application (I.D.#72673) for a St. Paul Gambling Permit
(Tipboards and Raffles) applied for by Frogtown Festival Inc. at
685 W. Minnehaha on October 17, 1987, between the hours of 12:00
Noon and 4:00 P.M, be and the same is hereby approved.
COUNCILMEN Requested by Department of:
Yeas DL'�� Nays ` '�"`
C.,
Rettman �'� [n Favor
Scheibel � _ Against BY
S�e�
Weida
Wilson
Adopted by Council: Date �C'T - 7 1987 Form App ved by. ity t r
Certified Pas e cil S ary BY
By
A►pprov y iVla or: D � '};'°'°' Approved by Mayor for Submission to Council
B BY
PW1.�Si��7 �.)l/T i .:l� 1.7U�
_ _. _ _ _
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� ' lU.° �11377 ,
` DEPARTMENT . - - - - -
' � � , CONTACT NA�IE
- �S PHONE ■ : �
� � DATE
A S G 0 G (See reverse side.)
_ Departmen Director _ Maqor (or Assistant) !
_ Finance a d Zdanagement Services Director � City Clerk Gc�Q• '"l. ����-
_ Budget Di ector _
� City Atto ey _
G (Clip all locations for signature.)
I C 7 (Purpose/Rationale}
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COST B G ND S E S C
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INANC G S CT G D 0 D:
(Mayor's sig ature not �required if under $10,000.)
Total Am t of Transg¢tion: �,� Activity Number: '� l�}-
Funding-S rce: n���
ATTACHMENTS: (List and number alI attachments.)
-a� �
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ADMI I V ROC
_Yes No Rules, Regulations, Procedures, or Budget Amendment required?
_Yes No If yes, are they or timetable attached?
DEP T VI,�W CITY ATTORNEY REVIEW
�Yes No Council resoln�ion required? Resolution required? ✓Yes _Na
_Yes No Insurance required� Insurance sufficient? '_Yes No.
Yes No Insurance attached? ,
I ��l��
DIVISION OFj LICENSE AND PERMIT ADMINISTRATION DATE �' 2'S 1`d�
INTERDEPART�ENTAL REVIEW CHECRLIST
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Applicant ��((��,�h �►� . ��.�_• Home Addressl�,Uq ��Q�„��,�- �-�Q�(dG .
Business Nafine Scti.w� Home Phone Z�{ - 3'��'�
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Business A�dress �„�5 l�} 1 ��.v��t�� Type of License(s) �-��
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Business Pl�one Z"7� - 3'"�¢� �,� SL.Q� •
Public Hea�ing Date �Z�,_1� S�"1 License I.D. # �a( ,'1
at 10:00 a}m. in the Council Chambers,
3rd F1 or ity Hall and Courthouse , State Tax I.D. #� � �(�-
;
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I DA E = DATE INSPECTION
APPN REC'D VERFIED COMPUTER CO�NTS
j ved Not raved
Housing & jBldg �
Code Enf o�cement �/� [ I - `
,7 � �
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Public He�lth � � .
1 1 � � � � . .
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Fire Prev�ntion �
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Police � ` �
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City Attc�rney �
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300 Footj Notice I
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License Inspector's Comments:
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I HAVE $EEN GIVEN A COPY OF TIiIS NOTIFICATION AND UNDERSTAND THAT MY ATTENDANCE AT
THE PUB�IC HEARING IS REQUIRID.
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� „ � � . .. .. . , _ . . . ...... . . . . , c �' F_, � �.. . . . . '- . . .. �- . . � .
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
New Officers:
Stockholders:
�'� .;'����~ f Mirjnesota Charitable Gambling Control Board LAWFUL GAMBLIN�EX�MPTIVN�
� Ro�m N475 Griggs-Midway Building FOR BOARD USE ONLY
18�1 University Avenue
St.iPaul,MN 551043383
'•"""' (612)642-0555
INSTRUCTIONS:� �. Submit request for exemption at least 30 days prior to the occasion. ,
: Q. When completing form,do not complete shaded areas.
�. 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 � Li�e Pk+�er IH ciurorMV u v�^�v��+�1
�ro town F stivaZ Inc �
A ress i City,County,State,Zip Code _
�i33 Univers t Ave � ^ - �* "' -i ��
Chief Executive OffiCer Phor,na umb anager's Name� Phone Number
;7r . ,� . � eI^f�am Sands �., �����a - 137 -;�s , � � an� �. ir��rtcn ;� i _1 '::' -�`� : ;
Type of Organization i If Other Nonprofit Organization ICheck One)
❑ Fraternat � ❑ Veterans ❑ IRS Designation
�� � ❑ Religion i` I� Other Nonprofit Organization (�: Incorporated with Secretary of State
❑ Affiliate of Parent Nonprofit Organization
Nam p� emises iN cti.i �II O.c u
Datelsl of Activity
,�'_�'� : � i��'���M�� ����rea t f ort Cen t,r
, � Pre��S�addre� �ihn�hah� ::v�!nue a � . °au1 :�`; _�,; 13,,
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Games � Yes No � :ta�rs��`e�ae� �° �f�+�fl��� �c�en�, .`z Profi�;;'
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,- Bingo X ����� � �� ���»��� '��'k � � � �, �
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Raffles I J{ Y��� ���� �°`dy`�s�§� ������'�'`�z7 °a � a � 3 � �`��`«� � � �
-- - ' - ' - ��o Y"� ,'f ;�.,�`d.,?.-��. _.Uc
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. � �'�rrz '� �'^� `��e`-.�e �w.� � .� -g� �F",,,�.,�,���r„t��„ .� _ �`.�„f q.`� ; "^ "" ��,��'r � ��, s',(�,��: _
1 Paddlewheels � *�'��,����������`�� � ���.�����-���,� �ry �} ����� �� � �`� `� �
. �a 4;� : ,>.?v�*�s z" �a�" ,* # * t � & .� _. , .'.�- ,.%� r;,:�.
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p ' �`":�-. �' >.,zt' "'"z�� y����xt�� ���8�'��°�°�� ¢'�.�� �,'_�
Ti boards � , � ���� ��'�� � } � �� � �:,f
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Pull-Tabs i w�" � �r , �-r� ���s� ,;�y��� �*�'°x� ``°* �'�r ;., t
� . '" �'" 3{ %£,�,�''� �.. .:�v
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`� � : -�y' "tanP�� ���1� 2 $y� t .' R�'y. �'��� ��`b.�yi a�r �p.
.>s.��� �e- �° ,a�f.a �.'.4-i,,..-.r� .�:. ,�'t :�.
�� ' 3 ��,�^���,-� � , ���� �� a ��� � "�q a EIIst��EjC8�as6,t�i�
w s'�y, �x� ��'�".�-., ��!r,��'"�7 r x�h �r�`.`� ������a�`�,� a�_ z� ..t�� �5_. .�� � � %� '' r x '
,»-��r��� i���.a_a,�3.s '�?F. _�,a». ! �.,a-u, t ;;rt rrm
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. . :I affirm all inforrfnation submitted to the.Board is true, accu- �a�ic�at��a�eia#��rtfoc,ma�i�sr.►��ai�tec�°:t�.th�:8�za�e�is
rate, and compl�te. ���ac���a�t�ca�p�fet� t;
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Chief Executive Offic 'r Signature Date A� S`ig�ure�:'''- '��' -'
; . • -I ACKNOWLEDGMENT OF NOTICE BY LOCAL GOVERNING BODY
I hereby acknovNiedge receipt of a copy of this application.By acknowledging receipt, I admit having been served with notice
, that,this applic�tion will be reviewed by the Charitable Gambling Contro� Bo�ard and will become effective 30 days from the
date of receipt knoted below)by the City or County, unless a resolution of the local governing body is passed which specifi-
cally disallowsisuch activity and a copy of that resolution is received by the Charitable Gambling Control Board within 30
days.of the bel�w noted date.
CITY OR COUNTY TOWNSHIP
Name af Local Gover ing Body(City or County) Township Name(Must be notified when County is the approving body)
..i y�QZ `�t.��U�� �;
Signatureipt Person I ceiYnngApplication � ' � Signature of Person Receiving Application
_ ` ��--. _�t�'� 0�s���O ,� �,�,��`�+*ia✓sA►s✓�o+.,� �, f,f � r
�C!�y/„t7
Title. _�,, �_ � Date Received Title Date .
• l }�_- ...y-.- �._-�
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CG-00020-01 14l8 1 White—Board Canary—Board returns to Organization to keep
- � Pink—Organization Gold—City or County _-�-
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`�1r�s �.��-SoS� ; CITY OF ST. PAUL 53. '1 �" ��,..�
• DEP.�T:•�.�itT OF rI?dAP;CE AAID i1A��1AG��tTT SE3VICES a,�'`�- `-�'f'Y�
DIVISIO:i OF LICENSL �1D PE�4IT ADMIP?IST�Ztorr '/
, 7 �l �GZ���, y� ���
2 d .�(J �''��L�
I2drORMATION P:�UI� 1•,ZTH P�DLIC:�TIOP1 rOR �iZMST TO CCr•IDUCT GA:��IS=1G SESSICP�i _.•? ST. ?AUZ ='-=�.�
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1. tlame of O�rganization Froutown Festival, Inc., a Minnesota non-profit corporation �
2. Address w�ere Qrganization's regular meetings are held 633 University avenue, St. Paul MN 5510�
3. Day and �i.me of ineetin�s as n eeded
�.. Address c�here Gamblin� Session :�rill t�e held West Minnehaha Recreation Center, 685 West
Minneh�ha Avenue, St. Paul, MN �
5. Is agpli�ant owner of propert,� �rhere Gambling Session taill be held' °es XX �10
6. If lease�, who is owner of property rrhere Gamblin€ Session saill be held? City of St. Paul/
Depart�nent of Community Services Division of Parks and Recreation
7. if leaseli, attach letter of permission to conduct Gar.�blir.g Session, signed by lessor.
8. Name of !officer maF�ng application A. William Sands
9. Address 'of officer maIang application 633 University Avenue Date of birth 10/27/38
10. Ptame of 'manager who will conduct Gambling Session Diane Cindrich
1.1. address i of manager 595 Arundel Street, St. Paul, MN 55103 Date of birth 12/26/41
12. In conn�ction with what event is this Gambling Session being held? Frogtown Festival
�
Octob�er 16, 17 and 18, 1987
13• ti�Jhat e of gamblin� device(s) will be used? Paddlewheel 2�pboard XX Paffle
and P illtabs
11�. Day, dattes and hours this application is for and number of sessions.
Day(s ) � Sat., �7ates 10 — 17 Hours� ia�ov- y'UU�iy>, of Ses sions I
15. frJill pitizes be Aaid in money or merchandise? Cas� '� '
L�� A'���
16. rs the �ap�licant association organized under the laws of the State oi t�Iinnes�a7 ,':-�es
�-� .
17. How lo�g has Cr�anization been in existence? In excess of three years '��' " -�•�%
" ,
18. 6dhat i� the ouroose of the Organization? Civic ="; �'
. .
r
� ,J
19. Officeirs of the Organization
' Name-Title Address Date of birth
R:...;_.: .. . .... ..
A. William Sands � ,.---. Fi33.U�ii`ver.sity�Avenue, St. Paul 10/27/38
1 1'D::::ti'�i.�;:c�ti9'!NAI�:f �,.� {
Don�ld A. Evans � ,.,,� ����J����Avenue, St. Paul 2/17/33
�
• r
Joh�r F. Bannigan, Jr. 409 Midwest Federal Bldg, St. Paul 10/26/36
�
� � �y7-�Y��
20. Give na�:es o�' of�icers or a�p other persons paid for ser�rices to the Or�anization. -
' ' Na}ne-Title �cidress �ate of birth
--�-�---�---
None
21. In whose cus7tcdy will records oi Organization's Gambling Sessions be kept?
v�e Diane C�indrich Address 595 Arundel Street, St. Pau1,M N 55103
22. Attach a co�y of your Organization'.s membersr.ip roster and date each member joined.
23. Attach the �ambling Session Manager's bond.
2l�. Attacr a co�y of the Department of the '"reasuxy, Internal ?evenue Service "Return of
Organizatio� �cemnt from Income '"ax", Form 990.. (Chapter 1�19.0l� (I)•)
25. Attach a c y of Department of the Treasury, Internal Pevenue Service, °1Fxemnt Or�an-
ization Bus�'�.ness Income Tax'r, Form 990T. (Chapter l�19.04 (2).} /�/�.
26. Attach the iannual report requi.red of charitable organizations by i�.innesota Statutes,
Section 30�'.�3. (Chapter Lt19.0l� (3). ) /�f'�'
27. F?ave fou r�ad and do you thorou�hly understand the provisions of all laws, ordinances
and re�ulatiions governin� the operation of Gamhling Sessions? Yes
28. Ar�y cr,an.ce� desired by the applicant association may be made only *,aith the consent of
the Licens� Committee.
29. Has any pe son(s) participating in the operation of any of the gambla.ng sessions cov-
ered by th�s l�cense ever been convicted of a felony in the Sta.te of I`linnesota or in
an,y other $tate or Federal Court? Yes PJo XX If answer is "yes", provide
names, add�esses and birth-dates.
' Org t' n
..... _. _._._. B� - ' �
' (Offi er-Title A. William Sands, President
� �
� and
(I�lanager in c �ar e of GamblinF Session
State of ?�inne�ota) Diane Cindrich
)SS
County of Rans�y )
A S s and Diane Cindrich
being duly swo sa� that they are the petitioners in the above a�plication; that �hey have
rsad the foreg�ing petition and Tmow the contents thereof; that the same is true of treir
own ?rnowledge. !
Subscribed andi swo to before me thi� ,�
��*-�- dag of 1°� • ANNETTE E. NIEARY
� I '�'' MO�AAY PUBLlC-1�
i� ���y��� RAIABE1f COlIN1Y
Notarg Public,~ r tv, i�linneso �������
;�13r co�mission �xpires
Buildir� Depa.rt:�ent Approved Disapproved by
Fire Depart,;�erut Approved ?isa�proved by
Police Departmlent Approned-�isapproved-�oy
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