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HomeMy WebLinkAbout10-07-24 1 RESOLUTION 10 -07 -24 • CITY OF OAK PARK HEIGHTS WASHINGTON COUNTY, MINNESOTA RESOLUTION GRANTING THE APPLICATION OF THE AMERICAN CANCER SOCIETY TO CONDUCT A ONE -DAY RAFFLE AT THE STILLWATER AREA HIGH SCHOOL ON AUGUST 7, 2010 WHEREAS, Jon Carlson, on behalf of the American Cancer Society has applied with the State of Minnesota Gambling Control Board for a permit to conduct a one -day raffle on August 7, 2010, at the site of the 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 raffle permit as applied for by the American Cancer Society 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 the American Cancer Society with the State of Minnesota Gambling Control Board to conduct a one -day raffle on August 7, 2010, at the site of the Stillwater Area High School, 5701 Stillwater Boulevard North, within the City of Oak Park Heights and the same are hereby approved with no waiting period. Passed by the City Council of Oak Park Heights this 4ageau y of July, 2010. L � 4 ( TTE Mayor Eric . J m on City d ini trator • Minnesota Lawful Gambling Page 1 oft Application fee for each even LG220 Application for Exempt Permit Ifapplication postmarked orreceived: An exempt permit may be issued to a nonprofit organization that: less than 30 days more than 30 days - conducts lawful gambling on five or fewer days, and before the event before the event • - awards less than $50,000 in prizes during a calendar year. $100 $50 ORGANIZATION INFORMATION Check # $ Orqanization name Previous gambling permit number w� i C d t (?at &- C o 1 a. X --3 3-1 7 3— O — 0 v 5 Type of nonprofit organization. Check one. ❑ Fraternal Religious ❑ Veterans ® Other nonprofit organization Mailing address City State Zip Code County 'lu fi 14, o 6 12o dV "s4a s Name of chief executive officer (CEO) Daytime p one number Email address Attach a copy of ONE of the following for proof of nonprofit status. Check one. Do not attach a sales tax exempt status or federal ID employer numbers as they are not proof of nonprofit status. ❑ Nonprofit Articles of Incorporation OR a current Certificate of Good Standing. Don't have a copy? This certificate must be obtained each year from: Secretary of State, Business Services Div., 180 State Office Building, St. Paul, MN 55155 Phone: 651 - 296 -2803 IRS income tax exemption [501(c)] letter in your organization's name. Don't have a copy? To obtain a copy of your federal income tax exempt letter, have an organization officer contact the IRS at 877 - 829 -5500. • IRS - 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: a. IRS letter showing your parent organization is a nonprofit 501(c) organization with a group ruling, and b. the charter or letter from your parent organization recognizing your organization as a subordinate. © IRS - proof previously submitted to Gambling Control Board If you previously submitted proof of nonprofit status from the IRS, no attachment is required. GAMBLING PREMISES INFORMATION Name of premises where gambling activity will be conducted (for raffles, list the site where the drawing will take place) 571 /w or r .9& #1 i a r Wig /r 5�;�4AOI Address (do not use PO box) City Zip Code County O l sn lwac - tr X !v n/ Ala « e /G t 5SUF 3- " 1 K . 0 t w Date(s) of activity (for raffles, indicate the date of the drawing) A , Check thb box or boxes that indicate the type of gambling activity your organization will conduct: Bingo Raffles F� Paddlewheels' F Pull- Tabs* E]Tipboards' * Gambling equipment for pull -tabs, bingo paper, tipboards, and Also complete paddlewheels must be obtained from a distributor licensed by the Gambling Control Board. EXCEPTION: Bingo hard cards and bingo Page 2 of this form. number selection devices may be borrowed from another organization authorized to conduct bingo. Print Form • To find a licensed distributor, go to www.gcb.state.mn.us and click on List Reset Form of Licensed Distributors, or call 651 - 639 -4000. LG220 Application for Exempt Permit Page 2 of 2 1/10 LOCAL UNIT OF GOVERNMENT ACKNOWLEDGMENT If the gambling premises is within city limits, If the gambling premises is located in a township, a a city official must check the action that the city is county official must check the action that the county is taking taking on this application and sign the application. on this application and sign the application. A township official is not required to sign the application. The application is acknowledged with no waiting period. The application is acknowledged with no waiting period. _The application is acknowledged with a 30 day waiting The application is acknowledged with a 30 day waiting period, and allows the Board to issue a permit after 30 period, and allows the Board to issue a permit after 30 days (60 days for a 1 st class city). days. _The application is denied. The application is denied. Print city ame ('i ht �F Oa.K Park Print county name Y On behalf of the county, 1 acknowledge this application. On behalf of the cVJ acknowledge this appli on. Signature of county official receiving application Signature of ci o re ving application Title Date /r /� I (Optional) TOWNSHIP: On behalf of the township, I Title )] j?A U 1 l�ltrk- �/ 2-1 /Iv acknowledge that the organization is applying for exempted gambling activity within township limits. [A township has no statutory authority to approve or deny an application [Minnesota Statute 349.166)] Print township name Signature of township official acknowledging application Title Date CHIEF EXECUTIVE OFFICER'S SIGNATURE The information provided in this application is complete and accurate to the best of my knowledge. / acknowledge that the financial report will be completed and returned to the Board within 30 days of the date of our gambling activity. Chief executive officer's signature Date Complete a separate application for each gambing activity: Financial report and recordkeeping required - one day of gambling activity, A financial report form and instructions will be sent with - two or more consecutive days of gambling activity, your permit, or use the online fill -in form available at - each day a raffle drawing is held www.gcb.state.mn.us. Within 30 days of the activity date, Send application with: complete and return the financial report form to the - a copy of your proof of nonprofit status, and Gambling Control Board. - application fee for each event. Make check payable to "State of Minnesota." To: Gambling Control Board 1711 West County Road B, Suite 300 South Roseville, MN 55113 Print Form Reset Form This form will be made available in alternative the Board will be able to process your information; Minnesota's Department of format (i.e. large print, Braille) upon request. organization's application. Your organization's public Safety; Attorney General; name and address will be public information Commissioners of Administration, Minnesota Data privacy notice:The information requested when received b the Board. All other on this form (and any attachments) will be used y Management & Budget, and Revenue; i nformation provided will be private data until Legislative Auditor, national and international by the Gambling Control Board (Board) the Board issues the permit. When the Board determine your organization's qualifications to p gambling regulatory agencies; anyone pursuant be involved in lawful gambling activities in issues the permit, all information provided will to court order; other individuals and agencies become public. If the Board does not issue a specifically authorized b state or federal law to Minnesota. Your organization has the right to permit, all information provided remains private, p y y refuse to supply the information requested; have access to the information; individuals and with the exception of your organization's name agencies for which law or legal order authorizes however, if your organization refuses to supply and address which will remain public. Private this information, the Board may not be able to anew use or sharing of information after this data are available q Board members, Board Notice was given; and anyone with your written determine your organization's qualifications staff whose work requires access to the and, as a consequence, may refuse to issue a consent. permit. If you supply the information requested,