87-1466 �NHITE - CITV CLEdtK
PINK - FINANCE � GITY OF SAINT PAUL Council
CANARV - DEPARTM�NT
BLUE - MAVOR � Flle NO. �� /��
�
�� Cou cil Res lution ��-�
Presented By '
• � - I �7
Referrec� Ta Committee: Date
Out of (�ommittee By Date
RESOLV�D: That Application (I.D.#65520) for a One Day City of St. Paul
Gambling Permit (Bingo) applied for by St. Columba Church at
1327 Lafond Avenue for November 22, 1987, between the hours of
1:00 P.M. and 5:00 P.M, be and the same is hereby approved.
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COUNCILII�[ElV Requested by Department of:
Yeas DreW i Nays
�l� '� � [n Favor
Rettman '
Scheibell, �
� , Against BY
n
Weida
VJilsOn ���" _ ; '�987 Form Ap rove by City Att
Adopted by Counc�l: Date �
Certified Pass o ncil Sec ry BY
By
A►pprove avo : Date '��:�' -- ' '4;� Approved by Mayor for Submission to Council
By BY
�� PUB�.l�4�ED 0 C i i '?� �9�� �
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� ' .N° 911380 ,
'c.+aEPARTMENT � - - - - — -
� �� CONTACT NAME
_ � PHONE �
DATE .
ASS G UT N (See reverse side.) .
_ Departm nt Director _ Maqor (or Assistam�)�. --�L
_ Finance and l�Ianagement Services Director � City Clerk �'� '1 W�-�--�- �`�' �
_ Budget irector _
L City At orney _
(Clip all locations for signature.)
WHA ii C ON I ? (Purpose/Rationale)
� K.SL �J�°'�-�^-^'"<'' �'�"��L � �.s�1�-�-�
,�,�,� �J '� b nc� (c�.k�.� ) w�.5�.l1. .�.c�,
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COST B SONNE TS C P D:
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F N G C T AC V C GE 0 CREDITED:
(Mayor's si ture not required if under $10�000.)
Total t of TransBction: �� � Activity Number: j�Ifl
Funding :So rce: � '(k
ATTACHMENTS: (List and number all attachments.)
�� �
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AD1rI J S 0 F�U,�S � �°i
_Yes o Rules, Regulations, Procedures, or Budget Amendment required?
_Yes o If yes, are they or timetable attached?
DEPARTMENT RE IEW CITY ATTORNEY REVIEW
�Yes N Council resolution required? Resolution required? ✓Yes _No
Yes �N Insurance required? ° Insurance sufficient? _Yes _No
Yes N Insurance attached?
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� DIVISION'IOF LICENSE AND PERMIT ADMINISTRATION� DATE � a S ( �1
INTERDEP�IRTMENTAL REVIEW CHECKLIST
Applicanl� _ ��, _ �,,��bc.`. l�YU.�IC�] Home Address �
� '�c�r l �� �m�i
Business�Name .(,��YV� Home Phone [ Q c.�(D-CQ O Z1
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Business Address 13a'1 � �-c� • 1�pe of License(s) (1-,Q,,,,�,��, `C e.rw�,,��
Business I Phone '�+-['S -�(�1�J �i w-�.O C��
Public H�aring Date ��Q, ,, , �1 License I.D. # (p 5 S�C>
at 10:001a.m. in the Council Chambers,
3rd Floo� Citq Hall and Court ouse State Tax I.D. � ���
,�
"� � � L �fC�
REVIEW � DAT D E IN PE TION
APPN REC'D VERFIID COMPUTER) COrIlrIENTS
�oved Not ed
Housing � Bldg �
Code Enf rcement �'� !j �
Public He�alth � , ,
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Fire Prev�ention �� �� � ri
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Police �� �� � � �
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City Atto�rney �
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300 Foot �iotice I
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License I�spector's Comments:
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I AAVE BE N GIVEN A COPY OF THIS NOTIFICATION AND UNDERSTAND THAT MY ATTENDANCE AT
THE PUBLI HEARING IS REQUIRID.
_ � . . , , .
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
New Officers:
Stockholders:
, ' ���=-I-��%��
. �Vlinnesota Charitable Gambling Control Board LAWFUL GAMBLING E EMPTION
� � �� �ioom N475 Griggs-Midway Building FOR BOARD USE ONLY
�1821 University Avenue
St.Paul,MN 55104-3383
�°°"� �612)642-0555
: INSTRUCTIONSi: 1• Submit request fo�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 Count�Send the remaining copies to the Board. The copies will be
returned with an exemption numberadde�ito 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 . ��'�+^��ff��'a��'��
St. Colu ba Church �ioT LtGo'AJS:J
Address City,Counry,State,Zip Code
1327 LaYqnd Ave. SL. ��aul. ��+sey. ���'�� 3�1t?4
Chief Executive Officer s Name Pho�e Number Manager's Name Phone Number
iisv. ko�jer F. Carr•oll Ei4;i—�i31 `.�179 iiarl -lckercqann o�e�—tiu_'?
Type of Organization 'I If Other Nonprafit Organization(Check Onel
� Fratemal ❑ Veterans ❑ IRS Designation
� Religion ❑ Other Nonprofit Organization 0 Incorporated with Secretary of State
' 0 Affiliate of Parent Nonprofit Organization
Name of Premises Whefe Activity wIl Occur Datelsl of Activity
tit. Col ba School ^_ �,
�
PremisesAddress ' �"7�• "" ' �' j
:
1327 La�iond �ve.
�: ._ . �;,.�
Games ' Yes No �,fac�R`e�� `g� �� �� �pe�°� �a#c�.;,:
�A'*`'s%' P,"„�s+�g X.�c.
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� Raffles .�� '�"` � �+,��� �.^ ��a�u>'✓f� � H �. d� ��,w�s�r ��•:, s ;5:. � �S ��€:
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- Paddlewheels XY V�w '� � � ' s ,,�������� ��,�� �` �� f R ; ������� ai^�� �� � ' �*s
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Tipboards ` �����..�..�. ��� ; � ,; �c�,�, ��� .��# �.; �
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Pull-Tabs XX �`������ ��� f:���'���:��� � ` ,
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I affirm all infor ation submitted to the Board is true, accu- ��a �fia�aus�i�i��tio�sntic�ti�tec�tc�-fi��.Boa�c.�is
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� rate, and comple�te. � ����`������t�� `
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_ Chief.Executive Officer ignature Date 'f�ei��i�-t3�lTcerSegexatru� -= �at�`
� ACKNOWLEDGMENT OF NOTICE BY LOCAL GOVERNING BODY
I hereby acknow�edge receipt of a copy of this application.By acknowledging receipt, I admit having been served with notice
that this applica�ion will be reviewed by the Charitable Gambling Control Board and will become effective 30 days from the
date of receipt 1 oted below) by the City or County, unless a resoiution of the local governing body is passed which specifi-
cally disallows s�ch activity and a copy of that resolution is received by the Charitable Gambling Control Board within 30
days of the belovl�noted date.
' CITY OR COUNTY TOWNSHIP
Name of Local Governin Body ICity or Cou�tyl Township Name(Must be notified when County is the approving body)
City of $t. Paul
Signature of Person Rec iving Application Signature of Person Receiving Application
Joseph Ca chedi - .
Tic�e oace Recaivea. .. Tic�e oete
L9cense I soector 9/1�/�7
CG-00020-01 (4/86) White—Board Canary—Board retums to Organization to keep
j Pink—Organization Gold—City or County
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L?�'QF?�ATIC�I �C.UI� :�Z'�3 Ac?LIC:?TI�.1 rOR P"���ST TQ CC?�;DtCT G��LL'G Sc,SSICt' r; ST. ?4'JL
?. ..3�'::8 {JI' �ro?T'.1Z^at::JII c��. . �L��/I G�r] t/� ' ��l�l'T
2. �dc'.x�e�s urhere �ani.zation's re�•il.� nestings are r.e?d �.�''t�oLuMB,4 c�{�dOL
' 13a7 L,q-foND ,Q-vC.
3. ua� ax:d ti..�e of :�eetin€s SUA/D,q No� 1pM—.�'
t:. �dcL-��s ,�here �ambLnP Sessioa Tzii? hs he?d /.3�7 LA�uD AvE,
5. �s ���.c�.t oTar.er o.i propert� c�sTer� �2..�bL:r. Sessicn 1•ril? re �e?�'�_°es '.To
5. I� ls$sec, c•;Y:o _s owner of property ar'r.�re Ga�,blin�- Sessior. ��r�_I �e .":e'd' �
' Gl4-u,2.c,H- tR.s�PE22�'
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7. If le�sed, attac� letter of per,aission to conduct Gar�blir� Session, s�g�ed by lessor.
�. P+ame of oi��cer ^��� agplica�icn �E�/, �O�t`� � �R�oLL
9. Addre�s of ofiicer maia.ng a�lication �3 v27 L A��� �✓E - 7ate oi birth
I.O. �:ane pf nanaFer who caill conduct Camblir� Session {�/#-RL ��/I�fA/�i�
I1.. �ddre�s o£ r�a.r�ger �32 � �i(��LELcl00� �i/C. �ate of birth�
I2. In co�.^�ction with what event is th:.s Gambling Sessioa be�� neld?
.; .; FA L L Tu�;e�y f3/�4't3 �SE.�/io2 Cc-ri��-�s)
I3. �e'hat type oi gambl.ing device(s) �ri.1.l be used? PaddZewr�el N� ":_S.pboard � Paff'le /�e
1l1. Day, 4iates and hours this appLcation is =or and nur.iber of sess�ons.
Da�(s� �} �ates 0�/ uAUrs �PM -SPlVr °:o. of Sessicns o'��
.15', '.��ii? �rizes be� paid in *�one� or �erc�.an�::se? .iYJP�!/Fy .-
16. Is tY_� 3DD�.icant association o�an:�zed under t;�e laws o` Lt�.e Staie of �:inr.ssota? ES
i7. i�oFr l�ng ras Cr�anizatior. been ir� exiszer.ce? 702 ��s
lE. t,7�at is t.e pi:x�ose of the Or�3,nization? ����� C(r� ZC�tI �,U�'�Io,(�'
19.� Of1�.C�TS� OI l+he Orgaaization
�Iame-Title �ddr�ss �aie oP birth
�R� /�-�����A�/��, �Zcs. t 3� � �,��'��� �/�s��9
r,�� i,r/2�C l��r- �!�. � 7 �' S.�t o�✓ �� � 7
�Y1 R t� �'"�o t�s�/v �c y � 7� ¢ {�1�cJ� TT t 9' � �
G u C �i 7—��' �'��s /�6 a �,rl,�-s l � -�T'/
� C'.r-��-����
?.. ::ive :�:.es o_' oi��.cers or ar.,; othe� persors ?a:-? _or sz�ces �o �he �TM'�T'�ZuLiOI�. .
� ' i 1'i2�'1@ i�tiB :�G�"835 'ate O? �1_��':
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• Zi. i� ��GO�° C12StCG�,',.' L�7�111. :'00O2'�S O.L' OI'�8L'1Z2.;i,iCI1�S '��L1�.^.�_.F. .SQSS�OLL �° :°D��
:�ame + �L �-r E+2N i A :dc�.ress. J 7.�"9 .��/A/ZAP ?�C. �i9��-
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22. �ttac�� a copy oi �our Crgarization's membersr.ip roster and date each nember ,joine�.
23. A�tacnl t:7e GacibZi*ig Session :•fana�°r's 'noad.
Z. iat�2.C�, 3 coP3' Oi �:e ';epaTt.;.ETlt OZ t.B `�'�3S1L"�� In�eS'.^_al .'.ener.ue .2T't%_�° rr'..B�UT'^ O_T'
Crgan.i�atica :xe�t �_o�, �r.co�^.e '"ax", r o_*�^t 9cn. (Chz���r L19.�L ;i i.i
25. �t�achl a co�� oi :epart�!ent oi �:�e ^'T�asw.�, In�ernal =e��er_ue :,e:�c�, ''�.:,e:�rot CrQan-
izatio� �usi.ness Income ?'ax", rorza 9°0�. (CY�apier !�l?.0!� (2).}
20. �ttach. the a�*�u� reDOrt rscu:�red of cY�.aritable or�an-�zations by �Ti�nesota ;,�a�utes,
Sec�ioh 3�9.53. (Ch�.�ter 419.OL (3). )
27. Fiave Tbu read and do ?ou tho�ou�hl� understar.d the -�rov'_sior.s o�' aIl Ia*as, ordiaances
and re�ulation� �overr.in� the ope:ation oi Ganhi=� Sessions? ���
�
28. �� cr$n�es des�.red by tre anpl�car_t asseci�t:or_ �a� �e mace only :•r th the corsent oi
� tr.e Li�ense Co�rm�ittee. -
� .
Zg: iias an�r oerson(s) pa.�ticipat;�:g in the operation of any o� t,�:e ga_�bL� sessions cov-
ered by this Lc�nse ener been convicted oi a °elon in tt-e State of �iir.nesoza or i.n
��� � `� ar� oty�er State or _�ederai Cou.�t? Yes :�o�. Ii ar:swer is "�es", provide
r.ames, addresses and birth-dates.
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i �Gr�aaiza�ion)
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(1!an�ar �n c:ar�.e of �ambli^.� Session)
��+6 VP. c� :�Lz�eso�a) .
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��unt,-r of ?�:ses )
��'V- ��<x'E�R �-�KR��-C.. and --�-R�- f�k�E"R/yl�'9�N
being dulv orn sa� that t.",e�r a:,� the pet�t�.oners in �he abo�e a�pLcation; �:�at �Fev havs
�s�� t:�e *o��oin€ pet�tion and '•�c•a �he contents. t.ereof; Ll1a�. ..�.e same is =:se or :`�ir
o:•rzi. ?�o«led�e..
Subscx~'_bed alnd swox�*a �o bei�re ;�e �:'15 anM.An/tiVNn.^.',n.MN,hti^.:l^.',.,.1,NV�AAhs
/S� d3� Of sE7�'°�/1'18 glZ �a �f 2• ,�;�lr. �LIZABETii M. IYELIS
' - <�.�j� NOTARY PUBUC—MINNESOTA
� t a�� RAMSEY COUNTY
� !!�'� �.� MY�OMM.EXPIRES AUG.28, 1990
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:iota...-J- u��= , �x�v� ;,ouat�, :•Lr.nesota -�' '
:•:� cc�missiopn �.�cQi�es� s�, /9 yd
�tildir.� ^ep'��ent :�p�roved Lisaaproved by �
�ire �eoar�t��nt �pproved �isanp�ved r4
Po�.ce �eoartaer_i nD�roc�ed-'Jisagproved-�;y