87-1751 WHITE - CIT CIERK �
PINK - FIN NCE COl1�IC1I
CANARV - DE RTMENT G I TY OF SA NT PAUL � 7�/
BLUE - MAV R FIIe NO•
1
Council R solution �b
Presented
Re erred To Committee: ..Date
Ou of Committee By Date
RES LVED: That Application (I.D.#26717) or a One Day Gambling Permit (Raffle
Only) by St. Paul Civic Sympho y Association at 75 W. 5th Street
(Landmark Center) on December 1, 1987, between the hours of
9:00 P.M, and 1:00 A.M. be and the same is hereby approved.
CO NCILMEN Requested by Department of:
Yeas Nays �
N cosia ln Favor
R ttman
S heibel � Against BY
S nnen
W ida
�EC — � h7U1 Form Approv by City At orne
Adopted b Council: Date
Certified a s y ouncil Secre BY
By
Appro Mavor. Date � " ' � Approved y Mayor E Submission to Council
By
1�`�;r`a�'��f _ �_ _ � ? i���'
a,,�- •�,�:.�
�E' � & Man.a e�nt Services D�PARTMENT �� � '/�/ N° _ 0'7296
.� � a2 ✓
Itx�i.�� �' ex' � y CONTACT
298-5 6 - PHONE . _
13, 1987 DATE : .��n Q, Qi
�
ASSIGN N . ER FQR ROUTING ORDER Cli All Location for Si nature ; �
Depar nt Director Director of Management/Nlayor `
� Finan and Management .Services Director - 3 City Clerk.
-.
Budge airecto.r � �
. � Cauncil Research
1 Ci ty torney;. , :
WHAT WILL E ACHIEVED BY TAKING ACTION ON THE ATT HED MATERIALS? (Purpose/ �
Rationale) :
Ms. 1 Jensen, oaz beha.lf of the Saint Paul ivi-+c SympYioriy Association, is requesti.ng
Counci app�ro�ral of a �e Day Charitable Ga�nbl' License (raffle) t�o be held on
31, 1987 at the 7�ar�maxk Center, 75 st 5th 5treet. Tl�e monies will be
used fin�ance pn�blic c�certs by the Symp Orchestra.
COST BENEF T BUDGETARY AND PERSONNEL IMPACTS ANTI IPATED:
N/A
FINANCING OURCE AND BUDGET ACTIVITY NUMBER CHARGE OR CREDITED: (Mayor's signa-
ture not re-
Total ou�t of T.ransaction: N/A quired if under
Fundi�g Source: � �iJA � �10,000) �
Activit Number: N/A
ATTACHMENT List and Number All Attachments :
t Crieak:List � _
R,esolu 'on .; - .
*'��"l: +i w�,
DEPARTMENT EVIEW CITY ATTORNEY REVIEW
✓Yes Council Resolution Required? � ' Resolution Required? �-Yes No
Yes Insurance Required? 'Insur�ance Sufficient? Yes No
Yes Insurance Attached:
. . , . .
, .
(SEE •REVERSE SIDE FOR INS UCTIONS)
Revised 12 4
� . �'� i 7s'�
✓
UIV SION OF LICENSE AND PERMIT ADMINISTRATI N DATE 1L � i�14S1 � 1 t � t c.� ��'r1
INT RDF.PARTMENTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
App icant �„��,�,�� �A�,���Uh� Home Address �5��-� �}� � '__. ,cL�.I '.� .
r. r .�s+.,..
Bus ess Name �� ��
�;v,c,,,�,., (���5`n Hotne Phone
Bus ness Address �S�l�J 5 t= �{,., , Type of License(s) ;�wu� ��,�,,�c "�Q�,
,m
Bus ess Phone �'l�( - 35 IC�
Pub ic Hearing Date �>�;=~=����� License I.D. 4� a(,Q�1 I�1
at :00 a.m. in the Council Grhambers,
3rd floor City Hall and Courthouse State Tax I.D. �� �(� �A�
llat notice Sent• �,� ealer �l � ��
to pplicant Ssy� �o��3/$
7 Federal Firearms 4P ��PS-
Pub ic Hearing
DATE I1cSPECTION
REVIEW VERFIED (COMPUTE ) CUNIl�4ENTS
A roved Not A ved
B g I & D �
n1�
�
H lth Divn. '
��Y11� i
— i
F' e Dept. � (
� •,� 1� �
(
P ice Dept.
� �� I
� �-�.`�._� �i�.�..- �r S� :��...�--
L' ense Divn. ��, tc�(�I �v« U����
C�, � b�, : �,o,,w - �52�
C' y Attorney �
f
Date Received:
Sit Plan _�,�(
To Council Research J� I�� K'�
Leas or Letter Date
fro Landlord ������{,'�
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
�
- Workers Compensation:
New Officers:
Stockholders:
.^ .., •�1 . 'J �.� I\ ��Y.♦ ..
r1�! "
L'T 1� l�:" i. :iU� � ;, ;
�-��r��s� 1-=-.-
� �1 rY�T.�R'+�TT (�T •T� T'.T\ {(��i�r T�T1!ff1 �TT�TT T/� /
�L�:1L•1:.�,.11 l.'i �1911..CL .L a�11L'':t.L:.'..i:Ll.� ✓a.�_�G 1CL�+ �
DI�JISIQi1 Or �Cr,I3Si �1; P�P��IIT �MIi?IS'"��TIO?�I
I?1�Q ��':ATICN yC,tJlt�,� �TIi:�: p?°LICr��IC?d FGR P"'i �T TO CCP�IDUC': GAi�'�3IS:'G S�SSICP' I;1 ST. FAUL
1. :�r.e oi Organi.�ai�on St. Paul Civic ymphony Association
2. �ddress where �*anization's re�uZar mee in�s are l:eld MacAlester College,
. au , Minneso�a
3. ay a.-�d ti.�.e of �eetir_�-s every Monda from September to May at 7 :30 p.m.
!�. dc?r=ss w'r.ere Gatr.�lin� �e�sior. :�rill be h ld 75 Fift St. W. , St. Paul, MN 55102
�. s a�p?:�cant ow«er oi prope�t r �ahe^e Ga.n: lin� Session will be helc^ °es X ?To
ti. i leased, �;ho �s owner of pro�erty wher Ganbl�n�- Sessior. will be heZd? Ramsey
County
7. f leased, at�ac: letier of per�ission t conduct Garbl�.r.€ Sessior., s�gned by lesser.
�. lzmz of officer maI�.�:ig application Car 1 Jensen
2530 Madison St. NE
9. �dress of officer maF�.ng application Minnea olis MN 55418 Date of birth 04/26/45
10. tame of manager who will conduct Garibl' Session Carol Jensen
2530 Madison St. NE
Zl. dd:ess of manaeer Minnea olis P�Iinn sota 55418 �ate of birth n4/��, 45
12. n connection with what event is this G bling Session being held' Annual fund
aising charitable ball .
13. �That tyt�e of gar.ibL'.ng device(�) wi.L be ed? Paddlewheel '�pboard Paffle X
�. ay, dates �nd hours this application is for and number of sessions.
12/31/87 9 : 00 p.m. to
ay(S� Thurs ./Fri . �ates O1/O1/88 Hours 1: 00 a.m. p;o. of Sessions 1
15. 1ill prizes be paid in monev or merchandi e? merchandise
16. s the a�plicant association cr_-�anize� er the laws or tr.e State o�' I:in.^.esota? �PG
17. o�r Iong has Crganizatior. been in existen e? 10 years � -
18. 'hat is the pur�ose of t.".e Or�anization? To promote the o eration of the -
St. Paul Civic Orchestra -
I9. f�icers of the Orga.*iizati�n ` '
Pdame-Title A dress �ate of bi:th
2530 P�lad son St. NE
C ol Jensen-President Minneapo is, MN 55418 'j���,��
0 a o St.
Be sy Fritz- St. Paul, MN 55117 td � 14 - S �
orpora e 14 W. yan � Q
Su an Secretary Rosevill , biN 55113 � ' J"1 ' �!�
ou wic 551 Selb �
m i p _ S �; ' l l,� `7 `S
7U• •i';? :�.:���5 ..: O:�_C8�'S OT' L:T vT,;.E'_' �@S'� .S ^.2.?_. i0r se:^''_.ces LJ �:? �:''_'�3i���i.`7J �
n . � _ :2.:.e��tle � �ddress 1atz o= 'r_;�7.h
Mac ester College Music Dept.
uard Forner-Music Director St. aul, NIl�1 04/O1/34
��. . :+I::CS° (`.lIS�:�� rill� �°CO::+� �J� .';i�:.371��, �.i.CI1�S l'�2?:;)�_T1F' J@3S=CT:S ^° TiAJ��
2530 Madison St. NE
;a.cae Carol Jensen �c�: ss Minneapolis, MN 55418
22. ttach a copv or your Crgan:zat�on's memb rs'r.ip ros�er znd cate each r�e*r:ber .ioined.
23. ttach t:e ^a...:�lir� Sessior. :•`ar:a�er's c�cr. .
t Required
2�. ►��BC� 3 CJ�,�,,- Ci �:_8 .:eYa.t:,�er.t �f `�.:E �'r 3511.";7� lrlt@:'^.2.1. �eve:.�:e =e*^:�.�e «:'@+U?"!: �•'
�27'��2f."�CP. `..'Cc�'*7}: «CI: T:'1.^,OI12 :':iX't� CQ:-, ��QC. ��}?2.^.�P.Z' �_�a.:�� /� l.�
y j^ ts i c.r� ��o ^rca — -++ � t r ' a - j� r�
2 . t�ac.. a cc�,, oi .,�_,a:�°e:�c oi ., . ._ as �-, �:�;,�:^a� _.e re _�:e ::e��c , _.::��:�t ��a..
zat�cn =us=ness _T:.cc�e ^aY", ?or� ocC'�. (Cha�Ter lsl��"1 (2)� ;
ne filed as the organization has no bu iness inco�re.
ct. ��3.C;'i tr2 2.*1'_"iL'3� �DOI'L T'°�lL�G 02' Cf:2T�t�.�1�P, OT';.3T1Z8LiOT1S �,-,7 ,�:ir_ne�a�a 5��2i.utQS�
ec��on ?0�.�3. �Ch�.�ier !�19.0�� (3).)
ganization is exempt from this filing equirement.
27. ave �ou read and �o vou thorou�hly un�?er tand tre prov,.sions or all laws� crdinances
d re�ulations �over:iin� the operatyon o �ar!bli:� �essions? ves
22. ny cna.*�:�es des�red b� �Y:e app:._ca:.t asso iation na;� �e r�ace only :��zth �::e cor.se^t of
he License Cemmittee.
' 29. ias any person(s) oa.rt�c�pating in tne op ratior_ cf an; or tre �amblin� sessions cov-
red by tr_is 1=cense ever beer. cor.victed f a °elony in tYe State of i°=inneso�a or in
.y ot:�er State cr redera.i. Court? Yes No X . I= anst•rer is ";res", pro�ide
.es, addresses and birth-dates.
St. Paul Civic S m hon Association
��'1Y' 'dZllZ8`t�lO:'i�
Ey �� ��� t.e.��e��..�-
(Of ic�r .�tle,
(C rol Jen en - President)
and
(: ager i: :�e o: !'a.;�tl�n� SCSSIC;'i
Sta�a of :'.:.nr_escta;
)SS .
Cour.t of ?ar.:sey )
C ROL JENSEN an�
beiag duly sworr� sa�• t;.at Lhe s ?-•� t:�e _r.etit'� ers in �:e above arpiicaiio^; �hat t:e�; !:a�r�
i°c� :IS fore�oi.^.� ?2t��lOII 3.'1� T�'lOW L:1@ CO?lt2 tS t�ereof; Liict� �r@ Sa.."12 1S 1T"1� Or �t':P.'Z'
o:�rn *.� o;.r�en�.o.
Subsc ;be� ar.r_ s;,rorn �o be'�re �e t:-.is ��M�.�N'�M.M,.+�W��n.ry,1�Y�.^,.,.,�.,;...
3 ca� oi v�.�-i�B�2 _i?�Z t�1;p�� ����i�, H �cNr��c,v
,..-:`r� i'IOT�^`:' P!;�'iiC l';`�+��
�``.;�;,'i. _ �r�C,..
< "I�i`.,1-i iiJ �,��,!�'���Y
:i 3�'^ ?t�C11C + < �ti C,�ri;r � �t; << c:.�r 5. 1�.;;c:
� LOLL'1,.9� ''i�=II250+2 �� . , � ;,,r,�n.•„v;;,..
co ^iissicn eri:es q�(� �� '
�u�1�'r�- �epa.-v:�e:� �p�roved Disap^rov d by
=ire ��•-t-znt :.p�roved ?isa�p:o� d by
?olic �e�a:t^er_t np�roved�isa�+Trov d nt•
�,' Minnesota Charitable Gambiing Control Board LAWFUL GAMB J G EXEMP ION
�y�a.�o...,:'
��.�� Room N475 Griggs-Midway Building ,�
�� 1821 University Avenue FOR BOARD USE ONLY
��:. St. Paul,MN 55104-3383
�������'�. (612)642-0555 ,
INSTRUC IONS: 1. Submit request for exemption at least 30 days prior to the occasion.
2. When completing form, do not complete haded areas until after the activity.
3. 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 add d to the form. When your activity is concluded; complete
PLEASE PE the financial information, sign and date t e form, and return to the Board within 30 days.
Organization ame Num r of Members License Number lif currently or previously� ' •
,�� — licensedl and/or permit numbec - �
.r� '.: �.i�T�i.. �:.i`0::�! '.�.�.�:�..'.ui�::�:ls :;1:.. -' �+v�_ . :3�i:.
Address City State Zip County . � :
� . _ . , , _ _ _ ?�,21 .. �.Jy.�� •it
Chief Executi e Officer's Name Phone M nager's Name Phone Number
_ ::'Ji . .�2:. '_:1 �^. �1 � '—._ .�� _._ .^.�. _ ?:._ �-- 1� . . � . ., � ..
Type of Orga zation N Nonprofit Organization(Check One and attach proof of�onprofit statusl.
O Frater I ❑ Veterans - IRS Designation
0 Religio C3 Other Nonprofit Organization Incorporate with Secretary ot State
Attach pr of of three years existence. Affiliate of Parent Nonprofit Organization
Name of Pre ses Where Activity Will Occur Datels)of Activity,drawing�sl
_.�:�•:.... . �„!` '':. ; 3t:.. .�.� _�_ , . _
Premises Add ess City tate Zip County . ?i:. :.� �,• � .
. _ . . L ♦ .. .�. .. . � I�'.�.�i.i ._. ..r.�^ � ....�..�:S:7�f
�� .. .g 2 s�<.: r�a�� �� ��� 3�� g u� '�
G me Yes No ����' �y�e �A�,� �, � � � �rtc+���
, a ,
.�� � r
� , � ��ti��iz,� �_�� �
,-
N . s �, ., �,.
��: � ��;Y ,�, ,' ��_
Bingo .; �� � �,
Raffles �
,, _. � �A,
Paddlew els _. ��;
.� . �: . ` �. . .� r :
�� ��
Tipboard _, � � � ���� ' � �
�
�«� �� �� �,-� w�,���.�;�
� ' � �.� � „��� �: _� E �,� ��� ����.� � �� �
Pull-Tabs , , ,. � .a � = F � �����° �� �.������ �� ��� .;
� � ��
- � ;� .�
�� , - _ s .._ � . ��. � ��.� a . ��� ��� .�� � .. .�
Use of Profit "
�"J ,...:1: Y:.^._' ;i: ;li... ......,:�r::3 �'l`J ..i� ;7:. ���tiIi r_..�; .�_..:i��:�.:�
� .��.� �� � �' - s^���� .�'� �.' '�� ��3 �. S�`���8���
' �Y���� a� �� � ��, . ��� � �}�����` ��, �a`�x���g ,�,� ,���r
. ,. =',
a. . � ,.: ., '�,�.__ ,s'``.'�' �::-. ,;� x� .. „ , �:. F<� .�'�'" ,�..s`�.�; '`����a�f`�, x�r:,��.�
� � �
_. . . _. < � ,:
.. :.,., .._.. .-..;... . � ..:. . .,,.,.<.. �. , .- �_ . .
._ _ . .... .. _. � . . �� .:
I affirm al information submitted to the Board is true, accor- cr2������`��a�t;�'�r�b�nt�+��'�c��'se�8cta���
ate, and mplete. �Krtc�El�ic��� ������`��� ��� � �'������,��� �"�
�-� ��� '�.�, ��� ��n �, n� .��t � ��� �i
��� .�,��§ �' c�� � �� r
��;"���� k�� /Z����. �,�.a�� .,: s+ i�, .�.�C �'�Y ��'Z zi��'w �
?:,.»�:�. ,I. .r`•: ;a' �.->q3. .S»
Chief Executi e Officer Signature Date �tratuta���x ��'�,' �� °;,�„,� . �:��£ '"�`�'!� ?`
ACKNOWLEDGEMENT OF NOTICE BY LOCAL GOVERNING BODY
I hereby a knowledge receipt of a copy of this application. By ac nowledging receipt,I admit having been served with notice
that this pplication will be reviewed by the Charitable Gamblin Control Board and will become effective 30 days from the
date of re eipt(noted below) by the City or County, unless a res lution of the local governing body is passed which specifi-
cally disa ows such activity and a copy of that resolution is re eived by the Charitable Gambling Control Board within 30
days of t below noted date.
CITY OR COUNTY TOWNSHIP
Name of Loc Governing Body(City or County) T nship Name IMust be notified when Cou�ty is the approving bodyl
Signature of rson Receiving Application S' nature of Person Receiving Application
Title Date Received T le Date
CG-00020-0 I6/87) White—Board Canary—Board returns ta Organization to complete shaded areas.
Pink—Organization Gold—City or County
_ � �7 - � ��
----- AGENDA ITEMS = ------------------------------
ID#: [4 ) DATE REC: [11/18/87] AGENDA D TE: [00/00/00] ITEM #� C ]
SUBJEGT: [1-�AY GAMBLIN6 P'ERPIIT - �T. PAI� CIVIC SYMPHl11VY ASSN. - 75 W. STH ]
STAfF AS IGNED: [NONE ] SIG:[SCHEIBEL ] OUT-[X� TO CLERK {�88f86� /1//q
/
llRI6INAT :[LICENSE DIV. ] GONT GT:[Sl..'Ii�IPLER - St156 ]
ACTION:[ ]
[ �
C.F.# [ ] ORD.# [ ] FILE COMPLETE="X" [ ]
� � � � � � � � � � �
FILE INF : [RESOLUTION/CHECKLIST/APPLICATION ]
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