96-534'���Glfl�A�.
RESOLUTION
�INT P9lJi.-M
Presented
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Referred To
Green Sheet $ 34955
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Committee: Date
RESOLVED: That application, ID B-04819, for a new State CLass S Gamblinq Premise Perntit
by Minnesota Youth Athletic Services at over-The-Rainbow, 249 W. 7th Street,
be and the same is hereby approved.
Requested by Department o£:
BY= \ \ �,.._.__ c� . �
Approved by Mayor: Date � Z` �p
Council File $ 9�- 5 3 y
ordinance #
Office of License inspections and
Environmental Protection
i
♦^M n�f
Form Approved by City Attorney
BY � .�% Yo� -H � � � - g �—_
Approved by Mayor for Submission to
BY: rC council
By:
Adopted by Council: Date � j
Adoption Certified by Council Secretary
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FOR
9�-53y
GREEN SHEET _N° 34955
INITIAVOATE iNmaware
DEPAHTMEMDIRECTOq OCff'�CAUNCIL
qSY ATTORNEY O CRY GLEFK
BUDGEf DIPECfOfl � FlN. & MGT. SERVICES DIR.
MAYOR (Ofi ASSISTAHn �
TOTAL # OP SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
Daniel Klinkhammer on behalf of Minnesota Youth Athletic Services requests
Council approval of their application for a new State Class B Gambling Premise Permit at
Over-The-Rainbow, 244 W. 7th Street. (ID 46B-04819)
a
_PLeWNINGCAMMISSION � _qVILSERVICECOMMISSiON
_ CIB CAMMITTEE _
_ sraFC _
_ DISTR�CTGOURT _
SUPPORTS WHICH fAUNqL OB.IECTIVE?
PERSONAL SERVICE CONTHACTS MUST ANSWEH SHE FOLLOWING �UESTIONS:
t. Has this person/firm ever worKed under a coMract for this department? -
YES NO
2. Has this person)firm ever been a ciry empioyee?
YES NO
3. Oaes this Derso�ttirm possess a skill nut narmally possessed hy any Gurtent city employee?
YES NO
Explein sll yes answers on separate sheet and ettae� to green sheet
�+�;i�3���: ..'.`'.,'.'fii^'s p .�+".�.��`C�+i
i.ts�i�, � � 4���
TOTAL AMOUNT OF iRANSAC710N S
COSi/REVENUE BUDGETED (CIRCLE ONE)
YES NO
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FUNOIfdG SOURCE ACTIVI7Y NUMBER
FINANCIAL INFORMATIDN' (EXPLAIN)
Greensneet # 34955 L.LE,P. REVIEW CHECKLfS7 Date: / GI ` -5 3 y
in Trackei'? .h 3-9f� t,�a'n aecetvea l ApP'n Processed
License ID # B-04819 State license Type: State Class B Gambling Premise Perm� t
Company Name:. Minnesota Youth Athletic Service� DBA: Minnesota Yo �th A hl S YVi(�PC
Business Addresss: 249 W. 7th St. (over-The-Rainbow) Business Phone: 78 -2220
Contact Name/Address: Daniel Klinkhammer (CEO) Home Phone: 781-222�
Date to Councit Research: 4111 Central Ave. NE �I208
Public Hearing Date: Labels Ordered:
Notice Sent to Applicant:�� 9kb Disirict Council #: 09
Notice Sent to Public:
Ward
Department/ Date Inspections Camments
Ciry Attorney
Environmental
Heaith
Fire
License Site Plan Received:_
Lease Received:
Police /��,���l�� S Ct-tTrLL ���/� l�lt�G,t_.,
�� ��cor� t'J��°ck.. �Ojj�GjS'
Zoning
LG214
nrns,�
❑
Li�
, .:.�: r ,
�Tf, f
Name
Idirtnesota Lms�fict Gam.bling
Premises Permit Application - Part Z of 2
Renewai
Urgan¢ation base license number
New
Piemises permit number
FOR BOARD 11SE QNL'
BASE #
PP #
FEE
CHECK
INIT1AlS
DATE
Liass of premises permit "
(eheck one)
� A(5400) Puil-ubs, tipboards, paddiewheeis, 2ffles, bingo
� B($250) Puil-tabs, tpboards, paddlewheels, raifles
Q C (5200) 8ingo oniy
❑ D ($550) Raffies onty
- svee[ or r. v iiox cuo not use
to
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If bingo will not b� conducted, cfieck here �
owner a
�'�L2 ri
�`-'.C�ree S�. Pa�� j�+J _
ion own the Dwlding where ffie gambling witl be wnducted? p YES ,�. NO -
If no. attacfi the tot{owing: -
' a copy of the lease (hxm LG202) with mrms for at least ene year.
• a copy of a skeich of the ftoor p{an with dimensions, showing w}iat portion is being leased.
A Iease and skeuh are rwt requ'aed fa Class 0 appGcations.
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aY 9 LUC1 �" J� ,��e S1' Pt�w_P ubnJ 3S! o z
If applying for a cIass A or C per.nit, fill in days 2_•id beginni g& ending hours of bingo ocrasions: .
No more than seven bingo occasions may be conducted by your �gar_izati�n per week.
Dzy BeginningfEndtng Hours Day BegtsuiingJEnding Hours Day Beginning JEnding Houre
�s t�e premise, located wiffiin city Gmitt? �Yes C7 No It no, is township � organized � unorganized p uni+icorporated
Ciry and Coumy vrhere g�mbling premises is tocated OR Townshi� and Counry where gambGng premises is luat2d if outside of city Lmrts
.<-T: n�.. � �,�.�... �
lf3innesofa Lasqfut Gambling d/
Premise Permit Application - Part 2 of 2 - l b�� �
S`�� t 3ii� Ca..+<<i hwe N� r�t��s r�N ss4,�� �F..,ar,,: !'�.,�pr
JQn �-t kk.� w�w�¢! �� R�O vGnc...a .S �`rY2-1- N� �-ft< l t /t'V�7 5$31�-I CKPCtw,�i^P
, � /v4! �
1 hereby co�sent that bcal law enforcement officers, the
board or agents ot the board, or the commissio�er of
revenue ot pub{ic satety, or agenls ot the commissioners,
may enter the premises to enforce the law.
Bank Records Information
The board is authorized to inspect the bank records of the
gambling accourtt whenever necessary to fuKill
requirements of currsnt gamblirtg rules and 1aw.
oath
I declare that:
•I have read this appiication and all information submitted
to tne board is true, accurate and mmptete;
•aN other requ{red intormation fias been tu!!y disdosed;
1. The city'must sign this application 'rf the gambling prem-
ises is bcated within city limits.
2. The county •'AND tcwnship" must sign this application ft
ihe gambling premises is Iocated within a township.
3. 'ihe bcal unh govecnment (city or county) must pass a
resolution specilically approving or denying this appl'ication.
Ciry o f unty N
Signa re oi pers r
/ d � �
r f �
��Z���GGLr
Reter tp the msWc
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for iequired attachments.
Maii to: Gambling Conirol Board
Rosewood Ptaza Soulh, 3rd Floor
�711 W. County Road B
Rotovllle, MN 55113
•I am the chief executive o�cer of the organization;
•i assume fuli responsibility for the tair and lawful opera-
tion of aH adivdies to be conduded;
•I will familiarize myself wiih the laws of Minnesota
governing lawful gambling and rules of the board and
agree, 'rf iicensed, to abide by those laws and rules,
inciuding amandments to them;
�any changes in appiication intormation will be submitt=d
fo the board and bcai unit of government within 10 days
of the change; and
•t understand that faifure to provide required information
or providing talsa or misieading intormation may result in
tfie deniat or revocaticn of the license.
4. A cro�v of tha local unit of aovernmeM's resolution ao-
pr vinn this aoolication must be attached to this �ppfication.
S. If this appti�cation is denied by the bca! unit of government,
it shouid not be submitted to the Gambling Contraf 8oard.
Township: By signature bebw, the township acknowledges
that the otganization is applying for a premises permit within
township 4im+ts.
Township Name
Signa7ure of person receiving app�ieation
rn�
I Date Received
CG214(Part 2)
(Pev72D91)
8ank Name _ Bank AccouM Number
1 �o,nlc �-�'t`7"�-�Ry9�/
Bznk Address City Staie p Code