87-1750 WHI7E - CIT CLERK �
PINK - FI.N NcE GITY OF SA NT PAUL Council r� 3O �
CANARV - DE A�RTMENT �
BI.UE - MA OR File NO.
-Council R solution �5
Presented y
R ferred To Committee: Date
0 t of Committee By Date
RE LVED: That Application (I.D.#24984) for a Class D State Gambling License
(Raffle Only) by the Church o St. James at 496 View Street be
and the same is hereby approv d. .
C UNCILMEN Requested by Department of:
Yeas Nays �
'cosia
ttman [n Favor
heibel
nnen � _ Against gY
eida
� DEC — 8 ��� Form Approve y City Attorney
Adopted y Council: Date
Certifie Pa.se b C ncil Se ry BY
gy.
Approv y lVlavor. Date " � j9a� Approv d y Mayor for Submission to Council
By '1 ' BY
RU���NEIi u�C 1 9 �
, F. & Mana anent Services DE PARTMENT � �T� O�3 O"�
Kr's� i�le� CONfiACT
��� �''7.3�/
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298-5 6 PHONE.
23, 1987 DAl'E ��� ��
ASSIGN N R FOlt ROUTIMG ORDER Cl i Al l Locatio s- for Si na�ure :
Depa � nt Director " nirectOr of Management/Mayor
Finan and Management Services Directar - 3 City, Clerk
Budge D'irector _ 2 C7otuzcil Research
1 City ttorney
I#IAT WILL BE ACHIEVED Y TAKING AG.TION ON THE ATT CHED NU#TERIAi.S? (Purpose/ .
Rationale) :
Caro L: Dcmaghue, on behalf o� th� Church St. �aQries at�486 Vzew, reque�ts that
' (�i Day �lasS� B Sta.te of-1.�.irinesota CTamnb ' T,tcense (raffle`only) be appraved:
s given t�o this event wr11 be used t�1 ar�d cfiurch pnai.•poses. �'he City
1 must regpcu�d to this r�est ari or ore Decenber 9, 1987.
oc: istrict CourLCil 9
COST BEN IT BUDGETARY AND PERSONNEL IMPACTS ANT CIPATED: ; .
N/�
FINANCIN SOURCE AND BUDGET ACTIVITY NUhBER CHAR ED OR CREDITED: (Mayor's signa-
ture not re-
Total Amount of"Transaction: N/A quired if under
_ � �10,000)
Fundi g Source:. N/A
� _
Activ ty Number: N/A .
ATTACHM TS List and Number All Attachments :
t C.�e�kl.ist
lution , _ �
A� -r.o�:+r a,,, _ _
DEPARTM T REVIEW CIT�f ATTE}RNEY REYIEW
�/ Yes No Council Resolution Required? ' Resalution Required? ,�Yes No
Yes No Insurance Required? Insurance Sufficierrt? Yes No
Yes No Insurance Attached: •
($EE •REYERSE SIDE� FOR NSTRUCTIONS)
Revised 12/84
,
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DIVI ION OF LICENSE AND PERMIT ADMINISTRATIO DATE j/ % "� �� ��";�' � �` ,� �� -���:� f�t��
INTE DF.PARTMENTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
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A 'cant/' � � � �� � � ome Address ''`���° ��i t�� �� ��
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Bus' ess Name _�--�`�,�.,,,..,� ome Phone `��� ' �;� I/.�
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Bus ness Address T-�=f �,, '�t �-«; �,���--`' Type of License(s) �' ���,`_� \�,� ��-�.��
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BllS IIeSS Pt10A2 �r� �. ��.� �`"� y'�iliv�s.�li.i�ti_1:.. �l.% S��L. �"1-1 ��.L����
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Pub ic Hearing Date �i_ _� i_�t `,�� License I.D. 4f �,�� '✓�'�C4
at :00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. 4� �13r�
llat Nutice Sent; J'--� J Dealer 4� v� °i (�
to pplicant ��7�z"`"`� �(�L��-�� , / 8/�`� ,
Federal Fi_rearms 4� �'� �
Pub ic Hearing
DATE IICSPECTION
REVIEW VERFIED (COMPUTE ) COMrIENTS
A roved Not A oved
dg I & D r� � I
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�
ealth Divn. � , '
/� I !a' i
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ire Dept. � , �
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olice Dept. 1`I I
°�`� r�
icense Divn. �
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ity Attorney �II �
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Date Received:
S te Plan �� ''�' � I ,
To Council Research �l'�,�-� ! ,.�
L ase or Letter , ,, Date
f om Landlord l/1 D _�- ° � ^
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s�i � �1���.r-!..�'1 ��Y'�1 --'L4� � �
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CURRENT INFORMATION NEW INFORMATION
Current Cor-poration Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
. _ . �7 - �� �
. - • CiCy of Saint Paul
. Department of Finance and Management Services
Division of License and ermit Registration
INFORMA ON RE UIRED WITH APPLICATION FOR .PERMI TO CONDUCT CHARITABLE GAMBLING GAME IN
SAINT P
1. Fu and complete name of orRanization whi h is applying for license
The Church of St. James
2. Ad ess where games will be held 486 Vi w St. St. Paul 55102
Numbe Street City Zip
3. N of manager signir.g this application w o will conduct, operate and manage
Ga ling Games Carole Donaahue Date of Bizth 4-23-42
(a) Length of time manager has been member of applicanc organization 22 yea rs
4. Ad ess of Manager 810 Juno Ave. St. Paul 55102
Numbez St eec Cicy Zip
5. Da , .dates, and hours this application is or January 1, 1988—December 31, 1988
6. Is he applicant or organization organized under the laws o: the State of I�1? ye s
7. Da e of incorporati�n October 4, 1887
8. Da when registered with the State of Mia esota October 11, 1887
9. Ho long has organization been in e:cistenc ? 100 years
10. Ho long has organization been in existenc in St. Paul? 10 0 years
�1. Wh t is the purpose of the ozganization? Religious
12. Of icers of applicant organization
Na e Gilbert Endres Z�1 - `i��� va*ae
496 View Street
Ad ress Address
Ti le Pastor Dpg 10-16-27 Title DOB
Na e Name
Ad ress Address
Ti le DOB Title 70B
13. Gi e names of ofticers, or any oc�:e- pers� s aho ?aid ior services to tne organizat!on.
Na e Vame
Ad ress �ddre:s
Ti le Ti�=e
, (Artach sep•aI'aC2 sne•• . _ ac;i_=_�r.•�: �:..�_:a: . �
. . � ������� ✓
14. Att ched hereto is a list of names and add�esses of all members of the organization.
15. In hose custody will organizatiorc's recor s be kept?
Nam Carole Donaghue Address 486 View Street
16. .Per ons who Will be conducting, assisting n conducting, or operating the games:
ham Carole Donaghue Date of Birth 4-23-42
Add ess 810 Juno Avenue - St. Paul, NIDT 55102
Nam of Spouse David Donaghue Date of Birth �-22-38
� Dat s when such person will conduct, assis , or operate OnCe da ily,
• January 1, 1988-December 31, 1988
Nam Sis�ter Virginia Bieren Date of Birth 6-16-38
� Add ess 4532 Scott Trail, Eagan, 55122
Nan ' of Spouse no ne Date of Birth
Dat s w;�en such person �ai?1 concLCt, ass:s , or ope:ate Once daily,
Januar 1, 1988-December 31, 1 88
17. Hav you read ar.d do pou thar�ughly unders and the provisions of all lavs, ordinances,
and regulatior.s ;overning tae operat'_on oz Char:.tab:e Gamb�:ng games? yes
18. • Att ched hereto on t:�e forT: �ur^.ished bv t. e Cit� o� St. Paul is a Financial Report
whi h ite�izes a11 :ece��cs, e:cpenses, and disbursemencs oi che applicant organization
as e�l as a�i organizat'_ons aho have rece�ve� funds ior tae DT°_C2G�f:lg calendar year
whi n has been s:;�ne�, p;epared, and veri:�ed by
N�A ►�ame
dddr ss '
who is che of the applicant Organization.
Vame o= Oi�:ce '
19. Ope ator of pre�ises where zames �r�1= �e h id:
Nam The Church of St. James
Bus ness �ddress 496 View Street
Hom Address
20. Amo nt of rent pa�d by app�",anc Organi�ac�on tor rer.c o= che hall; specify amounc
pai per 4-hour se��;on none
! �- 7 i y�u
. - . . - ,�
21.� Th proceeds oi the games will be disburs�d after deducting prize lavout costs and
op rating e:cpenses for the following purpc�ses and uses: '
School operation expensles - part of budget
22. Na the premises where che games are to b held been certified for occupanc}• by the
Ci y of Saint Paul? ye s
23. Ha your orgar.izat:on �iled :ederal form 90—T' yes IL answer is yes, please attach
a opy wit;� this applicac:on. I: answer s no, explain why:
i
Any cha ges desired by tae ap�1_c�:�c �ssociaci n maj be �ade onl;r wich t:;e consent oi the
City Co i��c;1. �
The Church of St. James
Orga:�:zation
Date June 2, 1987 g�; �_-'Z��?����-�.. .c.c..� _
Manaae: in rge of game
Carole L. Donaghue
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��=� '��� Charitable Gamblin Control Board
,�,,o._ ��o;:?�: 9 �� FOR BOARD USE ONLY
°�''•�,' Room N-475 Griggs-Midway Building
- :� 1821 University Avenue LicenseNumbsr
' ��=� St. Paul, Minnesota 55104-3383
(612) 642-0555 MT
, " ��'t*i ..'.��� CHECK#
DATE
GAMBLING LICENSE APPLICATION
INSTRU TIONS:
A. Typ or print in ink.
B. Tak completed application to local governing body,obtain sign ture and date on all copies,and leave 1 copy.Applicant keeps 1
cop and sends original to the above address with a check.
C. Inc plete applications will be returned.
vrx •
Type of pplication:
❑Class — Fee S100.00(Bingo,Raffles,Paddlewheels,Tipboar s,Pull-tabs)
❑Class — Fee S 50.00(Raffles,Paddlewheels,Tipboards,Pull abs) Makecheckspayableto:
❑Class — Fee S 50.00(Bingo only) Minnesota Charitable Gwnbing Co�hol Board
�Class — Fee S 25.00(Raffles only)
❑Yes�7 0 1. Is this application for a renewal? If yes,give co plete license number 0 - 0 - L�J
OYes� 0 2. If this is not an application for a renewal,has or a ization been licensed by the Board before? If yes,give base
license number(middle five digits)
❑Yes� 0 3. Have Internal Controls been submitted previously If no,please attach copy.
4. Ap licant(Official,legal name of o�ganization) . Business Address of Organization
The hurch or St. Jame3 �96 �lizw �tr�et
6. Cit State,Zip . County 8. Business Phone Number
�'f'. c7L12� M2:1r'a'�57�:� S:Z�i' Rdmsey ( �3 c�. ) ��7—!n�`_�
9. Ty of organization: OFraternal ❑Veterans QFteligious ❑Other nonprofit"
'If rganization is an"other nonprofit"organization,answer question 10 through 13.If not,go to question 14."Other nonprofit"organizations
m st document its tax-exempt status.
C�Yes No 10. Is organization incor orated as a nonprofit orga ization�If yes,give number assigned to Articles or page and
book number: �• •`j `�` �9Attach co y of certificate.
GdYes No 11. Are articles filed with the Secretary of State?
�Yes No 12. Are articles filed with the County?
DYes No 13. Is organization exempt from Minnesota or Feder I income tax?If yes,please attach letter from IRS or Department of
Revenue declaring exemption or copy of 990 or 990T.
❑Yes No 14. Has license ever been denied,suspended or rev ked?If yes,check all that a ly:
❑Denied ❑Suspended ❑Revoked ivedate: -
15. N mber of active members 16. Number of years in exi tence Note: If less than four years,attach
1, 10 G I�p � e 3 rg evidence of three years
l _. existence.
; 17. N me of Chief Executive Officer - 18. Name of treasurer or person who accounts for other revenues
F ._z�r t�i?mert ��.�.:���s Carol.a9��nag.hue
�e Title
P stor Bookiceepc�r
siness Phone Number Business Phone Number
� 6I^ � 227-?(�^r � 61� � �c?3-9I1^
19. N me of establishment where gambling will be 20. Street address(not P.O.Box Number)
c nducted
S Jame� Sc'�co'_ 436 �Ti��a �t-r�e�
21. C y,Stste,Zip 22. County(where gambling premises is Iocated)
S ?c"tLtl, _'�27.:'1RL'.:Gf'2. `7�.�i'�' :�.cZI"1Sr'i7
CG-00 1-02(8/86) White Copy-Board Canary-Applicant Pink-Local Governing Body
. 4 /
. . _ �k?`77� �%
` Gambli g License Application ' �� Page 2
= Type of pplication: ❑Class A ❑Class B ❑Class C ❑Class D •
. .
"' �Yes❑ 0 23. Is gambling premises located within city limits?
�Yes❑ 0 24. Are all gambling activities conducted at the premi es listed in #19 of this application? If not, complete a•separate
" � application for each p�emises lexcept raffles)as a eparate license is required for each premises.
' QYes❑ 0 25. Does organization own the gambling premises?If o,attach copy of the lease with terms of at least one year.
, ❑Yes❑ 0 26. Does the organization lease the entire premises?If no,attach a sketch of 27. Amount of Monthl Rent
� the premises indicating what portion is being leas d.A lease and sketch S
is not required for Class D applications.
❑Yes� 0 28. Do you plan on conducting bingo with this license If yes,give days and times of bingo occasions:
Days Times
��•t� ••�Yes� 0 29. Has the S 10,000 fidelity bond required by Minnes ta Statutes 349.20 been obtained?Attach copy of bond.
30. Ins rance Company Name 31. Bond Number
C tholic Aatual Relief Society -
32. Les or Name 33. Address 34. City,State,Zip
35. Ga bling Manager Name 36. Address '� ' 37. City,State;-Zip
Ca oIe �r:z� .'�.a= k�� Vi�•� Stre�t S` o P�u:i, :�F�f .,°�C�
38. Ga bling Manager Business Phone 39. Date gambling ma ager became
( , �� � �G:_<_l 3 �^ member of organi ation: i�6�
GAMBLING SRE A THORIZATION
By my gnature below;local law enforcement officers or age s of the Board are hereby authorized to enter upon the site,
at any me, gambling is being conducted,to observe the ga bling and to enforce the law for any unauthorized game or
practic .
BANK RECORDS A THORIZATION .
By my gnature below,the Board is hereby authorized to insp ct the bank records of the General Gambling Bank Account
whene er necessary to fulfill requirements of current gambli rules and law.
OA
I hereb declare that:
1. I h ve read this application and all information submitted o the Board;
` 2. All nformation submitted is true,accurate and complete;
3. All ther required information has been fully disclosed
4. I a the chief executive officer of the organization;
5. I a sume full responsibility for the fair and lawful operati �n of all activities to be conducted;
6. I w II familiarize myself with the laws of the State of Minn sota respecting gambling and rules of the Board and agree,
if li ensed,to abide b those laws and rules, includin a endments thereto.
40. O icial,Legal Name of Organization 1. Signatu�(must be signedby Chief�E�cecutive Officer)
Th� C��ur^h �f ��.. .�:rt�s X .. �-'� := ,,.� ..�;:-.--.-�''
Title of igner ate ' � ,,,, .w
Das or ' c;:, f" f
,
ACKNOWLEDGEMENT OF NOTIC BY LOCAL GOVERNING BODY
I hereb acknowledge receipt of a copy of this application. y acknowledging receipt, I admit having been served with
notice hat this application will be reviewed by the Charitabl Gambling Control Board and if approved by the board, will
becom effective 30 days from the date of receipt(noted belo 1,unless a resolution of the local governing body is passed
which pecifically disallows such activity and a copy of tha resolution is received by the Charitable Gambling Control
_ Board ithin 30 da s of the below noted date.
42. Na e of City or County(Local Governing Body) f site is located within a township,item 43 must be completed,in
,; ddition to the county signature.
L�.
Signatu e nf;person.receiving application 3. Name of Township
X i ' .;-.
Title , ' Date received(30 day period ignature of person receiving application
' begins from this date)
!1 � � � ��:
44. Na e of Person delivering application to Local Goveming Body itle
� _.! . ,.f� �... _
CG-000 -02 (8/86) � White Copy-Board Canary-Applicant Pink-Local Governing Body
� 7 , ��
--------- ---------------------- AGENDA ITEMS =__ --------------------________
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ID#: 87-[ 07 J DATE REC: [11/24/87] AGENDA DA E: [UO/00/00] I�TEM #: [ ]
SUBJECT: CLASS D STATE GAMBLING LICENSE - CHURCH OF ST. JAMES - 496 VIEW ST.] �
C.R. STAF : [NONE ] SIG:[SCHEIBEL ] OUT-[ ] CLERK-��67�9�U�7 ///2
ORIGINAT :[LICENSE DIV. ] CONTA T:[SCHWEINLER - 5056 ]
ACTION:[ ]
C ]
C.F.# [ ] ORD.# [ ] FILE COMPLETE="X" [ ]
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FILE INF : [RESOLUTION/CHECKLIST/APPLICATION ]
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[ ]
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��V 2 4 i987
COUNCILMAN
JAMES SCHEIBEL