87-1584 WHI7E - CITV CLERK
PINK - FINANCE �
CANARV - DEPARTMENT GITY OF SAINT PAUL COUIICl f
� BLUE - MAVOR - Flle NO. ���" ��� �
�
un 'l R solutio �
� 11
Presented By
l �
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D.#63433) for a Qne Day City of St. Paul
Gambling Permit (Raffle Only) applied for by Bethesda Foundation at
75 W. 5th Street (Landmark Center) on November 15, 1987, between
the hours of 3:00 P.M, and 7:00 P.M. be and the same is hereby
approved.
COUNCILMEN • Requested by Department of:
Yeas Dr2W Nays
Nicosia � [n Favor
Rettman
Scheibel � _ Against BY
Sonnen
Weida �
W].180n �QV — J �l Form Ap�rove by Attorney
Adopted by Council: Date \
J t
Certified Pass d y cil Se a BY
By
A►pproved Mav : D — Approved by Mayor for Submission to Council
B� ` BY
PUBtISHED N0V 14 1987
��7 is�
� ti N° 011394 ,
�i � DEPARTMENT , , - - - - - -
CONTACT NAPiE
02�j S�-S US . PHONE
� I C�� �5 _ DATE :
S :N r � F (See revsrse side.)
_ Departm t Director Mayor (or Assistant)
_ Finance nd Management Services Director ,_,3_ C�ty�le�
' _ Budget irector � (%o
� Citq At rney _
(Clip all locations for si,gnaCuyce.)
W ON H T C D T ? (Purpose/Ratianale)
�_ � l u.�F-+..ra� • �n-.�.�� l�.r-�..Q� �� �
y'1ti,_ .�t- 1c.��— � (C,:�� �L..,,—�J�> , ��.C�..�
l�o� �.S- � ow��L- c��o-Q=�.c�:� a�-,
�1
COS N BUD ND CTS D:
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N C N . S C D U . E CTIV Y B R E 0 E :
(Mayor's si ature not required if under $10,000.)
Total Ant t of Trans�ction: �'A. Activity Number: n ,�
Funding S rce: � `�
ATTACHMENTS: (List and number all .atts�chmes�ts.)
_-�1,,�,,`��"h �
�`- �
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AD TI G V��
_Yes No Rules, Regulations, Procedures, or Budget Amendment required?
_Yes No If yes, are they or timetable attached?
DEPARTMENT R VI W CITY ATTORNEY REVZEW
�Yes o Council resolution sequired? Resolution required? ✓Yes _No
Yes � o Insurance required? Insurance �ufficient? `Yes _No
Yes o Insurance attached?
, , .
G,��, ��y
DIVISION OF LICENSE AND PERMIT ADMINISTRATION DATE / s / /(��5� k�
INTERDFPARTMENTAL REVIEW CHECKLIST Appn Processed/Received by
� Lic Enf Aud
Applicant � ,��;l.d r�p� -��,,��c�,t(� Home Address ``rj5"� ��������v� ,
Rusiness Name ��Q� Home Phone a a 1 -o�3� �
fiusiness Address �s Iv.S�= h�.�mc�(kC�,• Type of License(s) Q
Business Phone �� - a3� � �
Public Hearing Date �� License I.D. 4� �3 �3 3
at 9:00 a.m. in the Counci iam ers,
3rd floor City Hall and Courthouse State Tax I.D. 4� ���
�
llate Notice Sent; b 1 ��G � Dealer 4f �1/��/�
to Applicant I
Federal Firearms 46 ✓� �
Public Hearing
DATE INSPECTION
REVtEW VERFIED (COMPUTER) COMMENTS
A proved Not A roved
�
Bldg I & D �
n �� ;
Health Divn. �
� �� �
�
Fire Dept. 'I �
I � ` � I
I
Yolice Dept. I
� I�
License Divn. �
�ol �� �
City Attorney �
�
Date Received:
Site Plan �`I�
To Council Research 1f�I Zb � S�"i
LeaGe or Letter Date
from Landlord � �Z\ � �� ��R,,,.J��L�'V�J..- . �� ��C`�.
� ��w � .., i< • � �3T ' . . - - - l� 0 '—�.Sa �
'•�' Minnesota Ch�Pi�t�le��ambling Control Board LAWFUL GAMBLING EXEMPTION
�'��"� � Room N475 Griggs-Midway Buiiding
' FOR BOARD USE ONIY
;. 1$21 University Avenue -
E - St. Paul,MN 551043383 � - ��
`='" �'����� (612)642-0555 ..
� �f< . q� . �° • - . . `.
; .. r.. . .. : - `�' . : . 1 ,i . ..- '. i�.2.
`"' : INSTRUCTIONS: 1. Submit request tor 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
� :>s=_: - .. ,. 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..
� � OrganizationName ,.,,'w�' . Lic�seMnwerpfarronuy«pevioudyRcensedl
...rr l�� r V W lriCi�..�l ' .
a Address City,County,State,Zip Code
.` ��9 Capiuol Blvd. �`""''` St. Paul, . .�isu�sota S�I03
Chief Executive Officer's Name . Phone Number Manager's Name Phone Number
� =5=�9 221-239? � _^ q
;,�„ Type of Organization If Othe �profit Organization(Check Onel
❑ Fraternal � Veterans RS Designation
��-•_fl �ieligion....-.- .: ,�]_Othe€�NorlpGOfit�Orgaflizatio�::-r.�-,.;:��-lncocporated-wifh�Secretar.y-of-�t�t�- -�.•-.---�--�_ . - -=.:
❑ Affiliate of Parent Nonprofit Organization -
Name of Premises Where Activity Will Occur Datels)of Activity
I�.�t:�ar!� Ca.�:.e�C ; .�- �
t�avr�:�er 23 Sy �P
Premises Address _ � �
7� W. 3t�h Street, St. Pa�l, -i�.inr�sota 1987
_ Games Yes No P Gross Receipts Value of Prizes Expenses Profit
- , � ,
Bingo Y
,
p . .
.�.-- Raffles >:_: X- . ti- - . _:�,. .. ._ ..., -�„-,-.� :_. ,
=_',- ` _ . . ..__�.� .
Paddlewheels X -� -- . _
� Tipboards � �
�;
�" .
�`" , Pull-Tabs X
Use af Profit
. Distributor From Whom Gambling Equipment Acquired Distributor's License No.
; `. � I affirm all information submitted to the Board is true, accu- 1 affirm all financial information submitted to the Board is
`.�'L.--rate,and complete•; r._.'_. . : .. •,4 ,_, __,,,.-; .. �; ^ .true;aceurats�►andcomplete._ �- ,�i.�__ —__ . _ _ . , _ _
_ , �
;
� ', , r. ��- . ;
Chief Executive Officer Signaturer, Date Chief Executive Officer Sig�ature 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 Bcrard 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.
4� CITY OR COUNTY TOWNSHIP
Name of Local Governing Body ICity or Countyl Township Name(Must be notitied when County is the approving body)
? �-+- "r•
� `' Signat e of erson F�ei p c ion �G�' Signature of Person Receiving Applicatio�
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Title (� --�+ -�-�-�.— Oate Title Date
�r= ,[ , . , .` ���'-•.•' !{.• ��`'
�iw.•--_.,CG 00020-01 14/861 i White—Board ` � Canary—Board returns to Organization to keep
��i ° Pink—Organization Gold—City or Counry,� _ ;, ""
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. ir�l+.11'��11 va - l'h..v� :L t .: v`�:7 VLJ . � . _ �'l IJ�/�
" DI'JISIO:i Qr �I�a:+S:; �.iv�i P:�:u�T :�IIIi;I�"_'��i".'IOPT
" Il'�QR!:A'1'ICN �'�.'rUI�.� ':�ilTii a??T�C�iICP1 ^CF? ??;P��i TO CC";L'UCT Gh:;E'�"G Si�S�IOA' I:1 S?'. :=14UL
� . Bethesda Foundation
�. :;arae oi .�r�:n�zai�on
2. �d�ress where �:garazation's re��ar meetings a:� ;;eld 559 Capitol Blvd St. Paul 55103
3. Day rr:d ti�?e oi *�,eetin�s N/A
1�. �lddress where (:amblin� Session c,r�.11 he r�eid Landmark Center
5. Is a�r.?�ca.*�z ow-ner oi arcr,e�t� -.r:^,�re sa,-:b1iZ� Sessien ��ril? '�e �e'c? ves X 'To
�J. T� '1�8SE�:� ;•ii O 1S o•�ner 02 LZ'C.^,@?'ty *rir9T`P, Gamblin�- �PSS10T: ?h^��� �2 !"�B�(1':
Minnesota Landmarks
7. If lea:ed, attach letter .oi perr^.ission ta cor.duct Gar�blir_� Session, s=gned by ie�sor.
�. :�are of oi��cer .*�a.�ng applica�ie:� Arlene Olson
9. �,ddress oi cf�icer maIfl.r� a�Lcation 6345 .I:eswick Avenue Data of birth _4/17/28
ti water , N
10. :iame of :�a.na.ger who wi.��l cond�.ict Qambling Sessior_ Amy Bragg
. �
�1. nddress ofl r:.anager 559 Capitol Blvd. St. Paul 55103 �aLe of birth 10/2/62
12. in connection with what event is t�s Gambling Session be=r:g held?
Festival of Trees
13. 's�,'Y:at type cf gar.ibling de•rice(s) will be used? Paddlewreel "_Ypboard ?.a_ffle x
?'�. Day, da�es anC nours this arn�l_cation is 'or ?r_d number ai sessions.
Ba;;(s) Sunday �ates 11-15-87 `iou.Ts 3-7 pm ��o. of �essio:�s 1
1S. `�di?i prizes be �aid in mor.e� or �erc^a.ndise? Merchandise
15. is�vY:e a�pi�cant association or�a�zea t:.*!der the �a�as o` Lre State oi :'innesota? ves
�� —
17. `-=.�:c�r-�or_g ::as �rEanization been in eY�sie^c�? t� yPars
� �
� � � �� � � a hilanthro ic or anization to su o
��=.=��r.acc;is �..e pu.�aose o� ..he Gr�ar.izat�on. P P� g pp rt
u_:��
-...
��I-is��
���: �i*fA :3T:@S O� ^v2'i�C@T'S O: '..`7� C�:�i persor.s ^31� _0� S2?"V_CES �O �rB �T'��,.*'.i,_8i.:.0I:. .
- ' ;1ame�i;,le iddress 7ate of b�:t"
Amy Bragg - Director 3070 W. Owasso Blvd St. Paul 55113 . 10-2-62
21. ir_ wt�s� custcd�r ,�ri�l :��oras oi �€anizat�on's Gambli^� Sessions be kepi?
'd�r►e �y Bragg �1d�ess 559 Capitol Blvd St, Paul, MN 55103
22. �ttach a copy of �our Organization's membersaip roster and date eac:� member joined.
23. :���a.ch the G2rih�in� Sessi�n ".ana.�er's bond.
2L. ���ac� a copy o� t::e ::e��rt.,.ent of t::e Treas��, lnterr.�.? �e��enue Serv-yce ''R..�tu?-r: o�
C��ani.zation :�czrut iror.. �::ccrLe ,ax", Form 99C. �CY?2^,�P.Y' !;19.�! �l). )
��. n;,tacn 2. COD� OF Depart:-lent O? L.�'12 �''_"°2.SLL�"Y'� I:1LP.*:181 ���e:?ue Service, ��r.;iE.:^.'J� :.�='?3I1-
ization 3usiness Incame ^_'ax", F'orm 9°G'". (Crapter �:19.0� (2).)
26. Attach the annual report requ:red oi charitable organizat�ons bv i4ir:r.esota Statutes,
Section 309.53. (Chapter l�19.CL ;3). }
27. :iave �rou read and do �ou thorou�'r1v understand the -�rov�sior.s o�' all larrs, crdir.ar:ces
and �sr�.�?atiions Qovernir.� the cneration of Ga�-�bli�* �essions? �P�
�
2�. �n� cha.�:�es desi:zd b;r �'r.e app�=cant associatior. ^�a3T he mace only -•,�t?� �he cor_ser_t oi
the Lic°nse Cocc�niLtee.
29. iias an� person(s) partic�.pating ;n �he operat�en oi ans oi the gambling sessior.s cov-
ered 'oy this Lcense ever been convicted oi a feiony in tre State of i�iinneso�a cr in
an� other State or Fecera.:� Co�.�t? Fes `3o X Ii �^s*.aer is "�res", �rcvi�e
narr.es, addresses and 'oirth-dates.
GrranizaLion;
R� � ,�o�, C� �
(Offic�r-'"itie)
ar_d .
;i•L3na�er ' c:ar�e o_� , l�.n� Sessionl
Sta�e of :i�n.nesota;
)SS
C ount f of ��� )
AR l-�nr b G . o L s o .v and A rl y r,, l i 2 �4 G-G
C2172F. �.111y �WOTII S2;j L�:3't i,r@� 3"° �.e aeti��oners 1*� t;?8 zDOVP 3T:L'Z�C2.t1Ori� ':?aL �i:2�T �2,z'i@
:°8C �`.:B �ore�oin� pe��.�iOII 3LSu T'S:OLd �:18 contents t�er=of� L1:2+ Lri2 52.I'!e '_S `:a° 0_ ���,I'
o:�n. ?rnotlled?e.
��.:�scr�be� .,n.� staorn �o bef�rs �e �'rs.s
/�'� �'a� o� i o�'7 .
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d '�'�_ Mcir�._r:
:iQt� �t1D._1C� .4�.-�.„,��,,;,, vOL121�V� i'f:i.AA25C 2 :^�.'! Mvcommi.sw,.=x,�.�. Y-i7•Y3
:�fy cocr.r►ission a:c;,ire`� 7_ /7-9�i
3i;:i.ldir� �eparvnent �lpproved Disa��roved by
�i�e �ep�rt:Zent ADproved ?i52D,'L'�oved by
_?o'ice ;e�art�:�ent Agproveci-�isarproved--�;y
-------------------------------- AGENDA ITEMS -------------------------------- ��7-/S�/
------------------------ --------------------------------
.ID#: j373 ] DATE REC: [10/20/87] AGENDA DATE: [00/00/00] ITEM #: [ ]
SUBJECT: [GAS STATION (3 PUMPS) APPLICATION - EXPRESS GAS - 430 S. ROBERT ]
STAFF ASSIGNED: [NONE ] SIG:[RETTMAN ] OUT-[X] TO CLERK [�@f�/00] /4 �,Z/
ORIGINATOR:[LICENSE DIV. ] CONTACT:[SCHWEINLER - 5056 ]
ACTION:[ ]
C ]
C.F.# [ ] ORD.# [ ] FILE COMPLETE="X" [ ]
� � � r � � � � � � � �
FILE INFO: [RESOLUTION/CHECKLIST/APPLICATION ]
C 7
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