87-1651 WHITE - CITV CLERK
PINK - FINANCE GITY OF AINT PALTL Council /
CANARV - DEPARTMENT (�
BLUE - MAVOR File�� NO. � /`���
,
ouncil esolution
Presented By �'�`"�
Referred T Committee: Date-
Out of C mittee By Date
RESOLVED: That Application (I.D.#g191� for a St. Paul Gambling Permit
(Bingo Only) by Maria Hilf S ciety at 548 Lafond on November 15, 1987,
between the hours of t�-��-:-0A-R,.D4-. be and the same is hereby
approved. 1:00 P. to 5s00 P.M.
COUNCILMEIV Requested by Department of:
Yeas � Nays
Nicosia _� (n Favor
Retttt�an
Scheibel Q Against BY
Sonnen
Weida
WilsOri NOU 1 ? 1987 Form Appr d by City Attorn y
Adopted by Council: Date
Certified Pa:•ed by Council Se etary BY
gy, -I'7'�./
A►pprov y Mavor: Date ��Q4/ 1 6 �7 Approved by yor for Submission to Council
B BY
}`.r�.' `''�'�..:. .. , , _ ...
, . ����5�
UIVISION OF LICENSE ANI) PERMIT ADMINISTRA ION DATE Il �_ / ll Z �(�
INTERDF.PARTMENTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant �(;�,_rIl , �- Home Address � �� `� ��,,,�ww� �..t� ,
Rusiness Name , � Home Phone
Business Address ��� ��,,�, Type of License(s) ����„ �
Business Phone �`Zc`, t �'� �
Public Hearing Date License I.D. 1F
at 9:00 a.m, in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �� ln� �
llate Nutice Sent �� Dealer �� � l (k
to Applicant � �.� ������ 1 � 87 � .
Federal Fi_rearms 46 � �
Public Hearing
DATE INSPECTI
REVIEW VERFIED (COMPUT R) CUMMENTS
A proved Not A roved
�
Bldg I & D �
� �(�- !
Health Divn. '
�n �� '
�
Fire Dept. � �
i��� I
I
Police Dept. I
Y��,�
License Divn. �
ll� L � � �
City Attorney �
<< �3 �
Date Received:
Site Plan � IA
To Council Research �( � � �"'�
Lease or Letter ate
from Landlord
--��u--�-� �� � l [ 3��
H4W TO USE THE �REEN SHEET h "' � •
__ . - � .. .V .r-.Oi Y ' �.. �
The GREEN SHEET has three PIIRPOSES: .
1. to assist in routing documents and in securing required signatures;
2. to brief the reviexers of documents on the impacts of approval;
3. to help ensure that necessary supporting materials are prepared and. if required,
� attached. .
Providing complete information under the listed headings enables revie�rers to make
decisions on the documents and eliminates follow-up contacts that may delay execution.
Below is the greferred ROUTING �or the five most frequent types of doctuaents: " .
CONTRACTS (asswnes authorized budget exists)
1. Outside Agency 4. Mayor
2. Initiating Department 5. Finance Director
3. City Attorney 6. Finance Accounting
Nota: If a CONTRACT amount is less than $10,000, the Mayor's signature is not required,
if the department director signs. A contract must al�ays be signed by the outside agency
before routing through, City offices.
ADMINISTRATIVE ORDER (Budget Revision) ADMINISTRATIVE ORDER (all others)
1. Activity Manager 1. Initiating Department
2. Department Accountant 2. City Attorney
3. Department Director 3. Mayor/Assistant
4. Budget Director 4. City Clerk � �
5. City Clerk
6. Chief Accountant, Finance and Management Services
COUNCIL RESOLUTION (Budget Amendment/Grant Acceptance) COUNCIL RESOLUTION (all others)
'1. Department Director . 1. Department Director
2. Budget Director 2. City Attorney
3. City Attorney 3. Mayor/Assistant
' 4. Mayor/Assistant 4. City Clerk
' S. Chair, Finance., Mgmt. , and Pers. Cte. 5. City Council
b. City Clerk
7. City Council
8. Chief Accountant, Finance and Management Services
The COST�BENEFIT. BUDGETARY. AND PERSONNEL IMPACTS heading provides spaee to explain the
cost/benefit aspects of the decision. Costs and benefits relate both, to Gity budget
(General Fund and/or Special Funds) and to broader f inancial impacts (cost to users,
homeowners, or other groups affected by the action) . The personnel impact is a description
of change or shift of Full-Time Equivalent (FTE) positions.
The �DMINISTRATIVE PROCEDURES section must be completed to indicate whether additional
adminfstrative procedures, including rules, regulations, or resource proposals are
necessary for implementation of an ordinance or resolution. If yes, the procedures or a
timetable for the completion af procedures must be attached.
SUPPORTING MATERIALS. In the ATTACHMENTS section, identify all attachments. If the Green
Sheet is well done, no letter of transmittal need be included (unless signing such a lettier
is one of the requested actions).
Note: If an agreement requires evidence of insurance/co-insurance, a Certificate of
Insurance should be one of the attach�ents at time of routing.
Note: Actions which. require City Council resolutions include contractual relationshtps
with other governmental units; collective bargaining contracts; purchase, sale, or lease of
land; issuance of bonds by City; eminent domain; assumption of 1 iability by City, or
granting by �City of indemnification; agreements with state or fede�al government under
which they are providing funding; budget amendments.
„ �.,a
_ ��7��s�
=' • ..,...�. Minnes�ta Charitable Gambiing Control Bo rd LAWFUL GAMBLING EXEMPTION
- - " �� Room N475 Griggs-Midway Buiiding
.� 1821 University Avenue FOR BOARD USE ONLY
?�"�` St.Paul,MN 551043383
�_;� _
�*' '`� (612)642-0555
:��,��;;"=�
`�'i���' * INSTRUCTIONS: 1. Submit request for exemption at lea t 30 days prior to the occasion.
2. When completing form, do not com lete shaded areas until after the activity.
3. Give the gold copy to the City or Co nty. Send the remaining copies to the Board. The copies will be
�� returned with an exemption number added to the form. When your activity is conciuded; complete
PLEASE TYPE the financial`information, sign and d te the form, and return to the Board within 30 days.
_ Organization Name umber of Members License Number lif currently or previously
.. 1K8=�8 Hilf Socie �92 ��censedl and/or permit number.
Address City State Zip County
548 Laf ond Avenue S t. auI '�1 '.:5 I^3 yaa8ev
Chief Executive Officer's Name Phone Manager's Name Phone Number
, Garaldine tachoWitzer i 612�`�91-75G2 Larry .I. `��anthe pl_ , �S7—t?6�3
Type of Organization If Other Nonprofit Organ�zation ICheck One and attach proof of nonprotit statusl.
�Fraternai ❑ Veterans 0 IRS Designation
,._ ❑ Religion -,-- :❑ Other Nonprofi�O�ganization - � Incorporate with Secretary of State -
Attach proof of three years existence: C�Affiliate of Parent Nonprofit Organization
Name of Premises Where Activity Will Occur Datelsl of Activity,drawmglsl
5t. �gnes Church �a22
Premises Address City State Zip County '-'rove-.aber t�
�48 I.afond �►venue St. Paul ?�''t 551?? Raa�se�
,_. ,_ ,�; . ,
Game Yes No � � ��� �
` ,.. �
Bingo R
Raffles �
Paddlewheels x
Tipboards �
�
Pull-Tabs � �Y
Use of Profit
BOAtATION '*0 SAINT AGI4ES vRADE SCHd :'QR ?P.OGRii:'�'!S
:y_ r
_� , x_ � � � W� �� ��
. � _ :�.; „ ;_ - �,, �. �.
I affirm all information submitted to the Board�is true, accor-
t -�y ��ate, and complete. _
� ... '��I�F' . ,.��9 '�/ lri >yi�<.✓,�� �%
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, �. .. . . , ;._
Chief Executive Officer Signature " ; Date �;��� ,
. ACKNOWLEDGEMENT OF NOTI E 8Y LOCAI GOVERNING BODY
I hereby acknowledge receipt of a copy of this application. By cknowledging receipt, I admit having been served with notice
-- that this appiication will be reviewed by the Charitable Gam ing Control Board and will become effective 30 days from the
date of receipt Inoted below)by the City or County, unless a esolution of the local governing body is passed which specifi-
cally disallows such activity and a copy of that resoiution is eceived 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) Tow�ship Name(Must be notified when County is the approving body)
�� Signature of Person Receiving Application Signature of Person Receiving Application
- � � . t�. . . ' .. . � . ' _� .~'j
.'.' TitIA � Date Received Title Date
1s"
� ` � �—•. . . . � - �
'�,, � CG-00020-01.16/87� White—Board Canary—Board retums to Organization to complete shaded areas.
� P'ink—Organization Gold—City or County
sa;
it
� • ' \i1 1� Qr 1 . �nU L ^
, DEP.4RT?•�idT OF rITjAP�CE 1D PSAt3�C^�IEt?T �i'_�.VICES C��l�izS�
�. , . DIVISIOPI OF LICEIJSc, P"Fi�tIT ADr12Z?IST�A'ITOP�
I2rORMATICN �C,UI:� 1•JITH �.P°ISC�TI02d FOR r'�'_',� T TO CC��IDUCT GAi•�3LI;TG SESSIOP' I:T ST. ?AUI�
1. i�ame oi Organization M�� xILF SOCIE
2. Address where Organization's regular mee ings are held 548 Lafond Avenue
3. Day and time oi meetin�s the 2nd onday of each month at 8:00 p.m.
I�. �ddress where Gambling Session crill he h ld 548 Lafond Avenue, St. Paul, MN 55103
5. Is agplicant owner of propert� where Gam lin� Session will be held' � Yes �?o
6. If leased, who is owner of pro�erty whe Gamblin� Session =rri11 be reld?
7. If leased, attach letter of permission t conduct Gamblin.� Session, signed by lessor.
8. Name of officer maIano appZication Ge aldine Lachowitzer
9. Address of officer ma�.ng at�plication 19 Edmund Avenue Date of birth 6-9-38
10. ,tame of ��anager who will conduct Gambl' Session Larry J. Ma.nthe
11. Address of manager 1244 Ohio Street, St. Paul, MN 55118 Date of birth 12/3/16
I2. In connection with what event is tbis G bling Session being held?
Annual Turke Bin o Afternoon
13• 6dhat type of gambling device(s) will be ed? Paddlewheel iipboard Raffle
I.1a. �ay, dates and hours this application is ior and number of sessions.
�po- �i� o�
Da�(s) Sunday Dates November 5 Hours 4 r:o. of' Ses si,�ons 1
•; _ .
� �
15. �Jill prizss be paid in money or mercran se? both
16. Is the applicant association organiaed der the laws oi the State �of, :�innesota? Yes
17. How long has Cr�anization been in existe ce? 81 years '�%
18. T+Jhat is the purpose of the Organization? Fraternal Society - Social��''�-.-„��• � �
19. Officers of the Organization
;dame-Title ddress Date of birth
Blanch Mever, President 595 E. Minnehaha Ave.�l`5,55101 �� — a� -'//
Fraternal
Geraldine Lachowitzer, Secretary 819 E mund Avenue, 55104 6-9-38
Marion Saiko, Recording Sec. 503 G enwood, 55113 7-17-25
Mary Ann Oberg 500 N rth Snelling, 55104 -1902
20. Give na�es of of�ficers or az�y other perso paid for seivices to the Organizati��i. ����
` , , . 1Vame-Title adress �ate of birth '
21. In. whose custody will records oi Qrganizat on's Gambling Sessions be kept?
Name Geraldine Lachowitzer Addre s 819 Edmund AVenue 55104
22.. Attach. a copy of your Qrganization.'s membe sr3p roster and date each member joined.
23. Attach the Gambling Session i�ianager's bond
2lt.. �ttacr a copy of the Depa.rtment oi the Tre ury, Internal ?evenue Servi.ce "Return of
Organi2ation �'...�cempt from Income '"ax", Form 990. (Chapter Lt19.01� (1).)
25. Attach a cony of Department of the Treas , Internal Pevenue Service, �'�'.xemnt Or�an-
ization Business Income Tax", Form 990T. Chapter L�19.01t (2). }
26. Attach the annual report required of chari able organizations by ��.innesota Statutes,
Section 309.53. (Chapter Lt19.01� (3). }
27. Have Tou read and do you thorou�hlv unders and the �rovisions o� all la�rs, ordinances
and re�ulations governing the operation of Gambling Sessions? �P�
28. Any chanF-es desired by the applicant assoc ation may be mac�e only Taith the consent of
the License Committee.
29. iias any person(s ) participating in the ope ation of any of the gambling sessions cov-
ered by this license ever been convicted o a felony in the State of plinnesota or in
any other State or Federal Court? Yes No XX nO If answer is "yes", provi.de
names, addresses and birth-dates.
M ria Hilf Society
; ' ,
Org 'aatian
�.i:..:}::''R:f1 v�;`i'��; � ' � � -
?it::i_i. . _.... ,._....'!'=..'iL'¢t.'.i�7�.�A11. B�
�+:: :...;�:n�-,sa.;��.._•�.�y,�* i�, iGBS, (Off'cer-Title)
, � , �/
.,
. and
,_.
l�•� er in c: g ' �amblin� Session
State of,:fiinneSa*.:a� , ,• �
�i `,,.%ss
C ounty of Rans ey'� )
�a �
being duly sworn sa� that they are the petitione s in the above a�plication; that �hey have
read the foregoing petition and r�ow the content t�ereof; that the same is ti^1e of treir
own ?cno��rledge.
Subscribed and sworn to before me thi�
�day o� ��.�1 1°�
�
Not Public, _ Countv, i�innesota
��fy comma.ssion expires /� �� _ ��
�
Building Depa.rt�nent . Approved Disapproved by -
Fire Depart;aent �pproved ?isanproved by
Police Departnent npproved--'Jisapproved �y
� . �����5�
________________________________ AGENDA ITE S =_______________________________
ID#: [435 ) DATE REC: �11/04/87] AGE DA DATE: f.00/00/00] ITEM #� f. 1
SUBJECT: [ST. PAUL GAMBLING PERMIT - MARIA ILF SOCIETY - 548 LAFOND ]
STAFF ASSIGNED: [NONE ] SIG:[DRE ] OUT-[X] TO CLERK�88-/�OT66� /� /�`�
ORIGINATOR:[LICENSE DIV. ] CONTACT:[SCHWEINLER - 5056 ]
ACTION:[ ]
f 7
C.F.# [ ] ORD.# [ ] FILE COMPLETE="X" [ ]
� � � � � � � � � � � �
FILE INFO: [RESOLUTION/CHECKLIST/APPLICATIO ]
[ 7
C ]
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