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HomeMy WebLinkAbout18-05-19 RESOLUTION 18-05-19 CITY OF OAK PARK HEIGHTS WASHINGTON COUNTY, MINNESOTA RESOLUTION GRANTING THE APPLICATION OF GREATER STILLWATER CHAMBER OF COMMERCE TO CONDUCT A ONE-DAY BINGO EVENT AT STILLWATER AREA HIGH SCHOOL ON JUNE 16, 2018 WHEREAS, Robin Anthony, on behalf of Ducks Unlimited St. Croix Valley, has applied with the State of Minnesota Gambling Control Board for a permit to conduct a one-day raffle on June 16, 2018 at the site of Stillwater Area High School, 5701 Stillwater Boulevard North; and WHEREAS, the City of Oak Park heights has reviewed the application and finds that its purposes meet the necessary community standards; and WHEREAS, the City of Oak Park Heights has solicited the input of the public and there have been no objections to the granting of the application for the bingo permit as applied for by Greater Stillwater Chamber of Commerce with the State of Minnesota Gambling Control Board. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL FOR THE CITY OF OAK PARK HEIGHTS AS FOLLOWS: That the application of Greater Stillwater Chamber of Commerce with the State of Minnesota Gambling Control Board to conduct a one-day bingo event on June 16, 2018 at the site of Stillwater Area High School, 5701 Stillwater Boulevard North, within the City of Oak.Park Heights is hereby approved with no waiting period. Passed by the City Council of Oak Park Heights this 22"d day of May, 2018. 1 Mar<<,.McComber frnis M�yca�or MINNESOTA LAWFUL GAMBLING LG240B Application to Conduct Excluded Bingo No Fee Page i oftz ORGANIZATION INFORMATION Organization y r� �p�^ revious Gam ling Name: Permit Number: Minnesota Tax ID Federal Employer ID Number, if any: Number(FEIN), if any: Mailing Address; -Za_� City: 1 I` State: IVA] Zip:_��County: Name of Chief Executive Officer (CEO): CEO Daytime Phone: I'q3q, CEO Email: (permit will be emailed to this email address unless otherwise indicated below) Email permit to (if other than the CEO); NONPROFIT STATUS Type of Nonprofit Organization (check one): Fraternal ❑Religious Veterans �Other Nonprofit Organization Attach a copy of at least one of the following showing proof of nonprofit status: (DO NOT attach a sales tax exempt status or federal employer ID number, as they are not proof of nonprofit status.) Current calendar year Certificate of Good Standing Don't have a copy? This certificate must be obtained each year from: MN Secretary of State, Business Services Division Secretary of State website, phone numbers: 60 Empire Drive, Suite 100 www.sos.state.mn.us St. Paul, MN 55103 651-296-2803, or toll free 1-877-551-6767 Internal Revenue Service-YRS income tax exemption 501(c) letter in your organization's name Don't have a copy? Obtain a copy of your federal income tax exempt letter by having an organization officer contact the IRS at 877-829-5500. Internal Revenue Service-Affiliate of national,statewide, or international parent nonprofit organization (charter) If your organization falls under a parent organization, attach copies of both of the following: 1. IRS letter showing your parent organization is a nonprofit 501(c) organization with a group ruling; and 2. the charter or letter from your parent organization recognizing your organization as a subordinate. EXCLUDED BINGO ACTIVITY Has your organization held a bingo event in the current calendar year? ©Yes 17 No If yes, list the dates when bingo was conducted: 12--7 The proposed bingo event will be: �./ one of four or fewer bingo events held this year. Dates: 11 2nd Ann(k I FOa TJ'UL- cOR- �� !( conducted on up to 12 consecutive days in connection with a: county fair Dates: Ecivic celebration Dates: Minnesota State Fair Dates: Person in charge of bingo event: Daytime Phone: Name of premises where bingo will be conducted: Premises street address: Vt City: soJ /!L _ , If township, township name: County: ~ LG240B Application to Conduct Excluded Bingopae 11f12 9 LOCAL UNIT OF GOVERNMENT ACKNOWLEDGMENT (required before submitting application to the Minnesota Gambling Control Board) CITY APPROVAL COUNTY APPROVAL for a gambling premises for a gambling premises located within city limits located in a township On behalf of the city, I approve this application for excluded On behalf of the county, I approve this application for excluded bingo activity at the premises located within the city's bingo activity at the premises located within the county's jurisdiction. jurisdiction. Print City Name: ani 5 Print County Name: Signature of City P I: Signature of County Personnel: Title: �1'I vl CiA L Date: S 2-619 Title: Date: TOWNSHIP (if required by the county) On behalf of the township, I acknowledge that the organization is applying for excluded bingo activity within the township limits. The city or county must sign before (A township has no statutory authority to approve or deny an submitting application to the application, per Minnesota Statutes, Section 349.213.) Gambling Control Board. Print Township Name: Signature of Township Officer: Title: Date: CHIEF EXECUTIVE OFFICER'S SIGNATURE (required) The information provided in this application is p ete d accurate to the best of my knowledge. Chief Executive Officer's Signature: Date: (Si nature must be CEO's signature; designee may not sign) Print Name: MAIL OR FAX APPLICATION &ATTACHMENTS Mail or fax application and a copy of your proof of nonprofit Bingo hard cards and bingo number selection devices may status to: be borrowed from another organization authorized to conduct Minnesota Gambling Control Board bingo. Otherwise, bingo hard cards, bingo paper, and bingo 1711 West County Road B, Suite 300 South number selection devices must be obtained from a distributor Roseville, MN 55113 licensed by the Minnesota Gambling Control Board. To find Fax: 651-639-4032 a licensed distributor, go to www.mn.gov/gcb and click An excluded bingo permit wilt be mailed to your organization, on Distributors under the LIST OF LXCENSEES tab, or call 651-539-1900. Your organization must keep its bingo records for 3-1/2 years. Questions? This form will be made available in alternative format Call a Licensing Specialist at 651-539-1900. (i.e. large print, braille) upon request. Data privacy notice: The information requested will be able to process the application. Your members,Board staff whose work requires on this form (and any attachments)will be used organization's name and address will be public access to the information; Minnesota's Depart- by the Gambling Control Board (Board)to deter- information when received by the Board. All ment of Public Safety;Attorney General; Corn- mine your organization's qualifications to be in- other information provided will be private data missioners of Administration, Minnesota Manage- volved in lawful gambling activities in Minnesota. about your organization until the Board issues ment&Budget, and Revenue; Legislative Audi- Your organization has the right to refuse to sup- the permit. When the Board issues the permit, tor,national and international gambling regula- ply the information; however, if your organiza- all information provided will become public. If tory agencies; anyone pursuant to court order; tion refuses to supply this information,the Board the Board does not issue a permit, all infor- other individuals and agencies specifically may not be able to determine your organiza- mation provided remains private, with the ex- authorized by state or federal law to have access tion's qualifications and,as a consequence,may ception of your organization's name and address to the information; individuals and agencies for refuse to issue a permit. If your organization which will remain public. Private data about which law or legal order authorizes a new use or supplies the information requested,the Board your organization are available to Board sharing of information after this notice was given; and anyone with your written consent. An equal opportunity employer