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HomeMy WebLinkAbout1991-01-14 Approved MN Gambling Premise Permit • `. 'M _.-t /-mac �l FOR BOARD USE ONLY ;flit J� FEE CHECK INITIALS LG214 DATE Minnesota Lawful Gambling i9/5/901 Premise Permit Application - Part 1 ..,.:':2}}}}-::.:::.,:,.:,sss:n,...ny,;.,...,!},y„}y,}s}?yy»s}:.....:•?yms?y}»r?ry>:.ss».r.??}. ..xn wys?:?:,:,, : ..... .... „„ ,:::•.•rn•.,•n,•.,,. ......x2»?!•:4ssssr}}}}}?:.yys?}rs.�r?sssv:}?s?rr};4;.yys..,;:.}:.y.:iyyss:-•-?•a:.?,.:2,sy,•.,,,,,n;,.,•:.,,+v,-.�:.,-:::.::..:•: :-}:•}}r:::::Y}}':•t2}}?i:...:::!-ii:}:{v}SS:<•:2:{:.:..:........n::.v:::::::::r:::::::::x::::::w::::::::::::::::::::::::::::.v::::::::w:..:.:...:-..::.:....:::. a o �fo Legal Name of Organ n G�'f 45/ -g/A).05-° C p i(—ra A>sr 31'3 Business Address of Organization-Street or P. Box(Do not use address of gambling manager) y4 Seto 0/ (4 41/‘. A. City State Zip Code County Business phone number 5 C.Lcr./Air Q, "I AI 53°Z: l•1.4r5h1 pI6'7-00V (6/t1 'St3o Name of chief executive officer(cannot be gambling manager) Tide Business phone number D,t Jc9 rotapeY post Address of chief executive officer-Street or P.O. 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Status of Premise Permit-check one: ❑ New premise—Fill in Ian organization premise permit number g Renewal of existing premise permit—Fill in complete premise permit number A 00330-60/ • ❑ Previously expired premise permit—Fill in complete premise permit number • LG214 • Minnesota Lawful Gambling Premise Permit Application • Part 2 uamminit•••:••••• -,:T:-t •x:x::.•. -nvatw::xin vv.•.:x x••n•.w:x:xvm::.vvvxv:..v::.:.•: ?i:•}'}}%?::v} .. .. }}f.......... ...Y.?T.....Y.. ..nv......................... .::!4v.r{.}:!-i}X{?r•:•}%:{;:;.}:^;-:{^}W..-}}::i-x vr{{{nv:ygT}}:•:t?v:4}}is i??t 5}X.t4}:?!T vT:?•}:•:{T:?T!:SM}:?{t4..+}':?:/.{:!.%4:•}:n rwm ......::• .:�-._:.:.:.............vw-.T-.r'b.-^Y.'v:.;r:.vr:r........ ..- /.+f..............................}...:::......-..-..-......:....:-....:...:.......:-+rf..n...vw..........n...................-.............-.........."'i./.....'.�-......:r:.: :......... .....�--: :::::•.:.:.:. 4.:- ::::. r::� ;.v.::.:.;:.,..... v::v::::::;::w:r'.?v:�-:v::::.v:::::::::.::.v:::::w:nv::r.n::::::::::::::::::::::::hw:::.v:�:v:::::.:v::::::.v:::-::::::•:•:::.v::.v::::::v.v-:•n:{--.:..: istti�'u-'{'{r-'-v-i�.}':•i}:T':.v:Y4}}}}i:'T}}i}�rv`:-`}:?4}iY.• ?re:-'r:W}:•�:}:•:•r•'i.>.4:iti{:'ir::r•i::T}:`t`4'Ti}Y:}}: Name of establish�"t where gambling will be conducted Street Address(do not use a post office box number) ,J f*' VF LA) 34-3 3710 o Af4. /4 PVC. n/. S?u•c✓rt f AM/.1314-x_ Is the premises located within dry limits? ❑yes Brno I/4($ is W177J/sJ .L)4((/ iew ifewstrys Cf iy r.dowrs City and County where gambling premises is located OR Township and County where gambling premises is located if outside of city limits 0441( 441/l h'E7 ,qis,4450/A/Cro ll Name and Address of Legal Owner of Premises City State Zip Code VFW As T 3)-3 , ..ajb o'1#il4t. 4vekr. �1 STyc,c, M, -troi Does the organization own the building where the gambling will be conducted?ArYES ❑NO NOTE:Organizations may not pay themselves rent if they own the building or have a holding company. A letter must be sub- mitted showing rent payments as zero from gambling funds if the organization's holding company owns the premises. The letter must be signed by the chief executive officer.) If NO, attach the following: • * a copy of the lease with terms for one year. ' a copy of a sketch of the floor plan with dimensions, showing what portion is being leased. A lease and sketch are not required for Class D applicantions. Rent: For gambling with bingo $ Total square footage leased For gambling without bingo $ Total square footage leased Address of storage space of gambling equipment Address City State Zip code AS ,4(.30✓fc • Bank.�Iif01I3�atiOli: :.:.:v.::.:{...:.vxxkT....rw....-.:..T.T:}::K...?...r........nr:4•.y::v.x-v..}!?{n:•i}}}}:::}.. v}:}. ?}:rn vx..::}v.-::/...r.-. --r:x..:. iw.:e .::.r. :•mis.:.:..Y.:. }4 %n w:i: : i v4}c : :....::} vr}.n.n..........:........n:...:.v-:.,;•.:.........-.........n.......--:.4:..if?y,?•.T::v}:nv:::xr,W}.:}:::::::v:..:::}::: (each permitted gambling premises must have a separate checking account) Bank Name Bank Account Number cEW1Q■ t. 6d t"XZ "Iv 8 27 Bank Address City State Zip Code S9 l'O('e )1 A Ife. 1t1, S?it c.w,j? � Sfoo4 3 Name,address,and title of persons authorized to sign checks and make deposits and withdrawals. Name Address Title D�JI D . APP (,7y Sc 4kft S CC Ih��. 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Clf oUCw►eeio /D tr tr 45$ 6101134016 NG tivx_f DA-40 CaLise›) /cf90 t 6 0I4 '.ST '4 r' r r r r 64 ,,,A1 4C4. • LG214 Minnesota Lawful Gambling Premise Permit Application - Part 3 }Y.---.?"4v cry::::7::}:.:i:::K::?:.;:?•:n.vx?xr.}'{. ry:::::: ::??4Y ..... {rr{ir;rxy}:.;?r:ry:?.yi}IMY.^'{:u}}i}}:??^}}}?;?:::..:v:::::w::r ::.•ev r::n••.vx• •rn:v..:rrv:x ::::::x•.:vvv:x::vrvnxv:xv:vvx•:::::v::x-.vvw.v.x:....... ::...:..$.J::.v:::........................:.......................:.:::.....:.:........v......................:...........?..........:ro$�fY..f..:..{.....H.^:•i...........:{.v..:......r...r:...........................:.......:.....:....n.f..r....::h:n.. .......... .....:::. : ........:.:::w:::.�::...-..f:....... .............r......................n:v:::::::::::::: ::..........:::�.:::iv::M1?v::::::..:::. :.:::::.:?.:.:v:rv::.:-.:�:-:- ::::-:}:v::::::v.::..:.v............:.:J rn.vx:v{ry v:{..:...........:...•:...........-v::v:.r.:n• .:{.v.::v.:-.v:::}.:n::v.:.... ... ........::........:...:....:......::.::.n:::::n.}:::::...: ..... ........ ........ ... ..5../.......................:::r::::vv:::rn}::.:.vx.:n::::.•::::?.::::::::.y::::::::::::::::::.:::•::-:.v..::::?tn::iv}:i???^}}'•}i}:v"?�:�:{???4}}}?:}::?:i•::::::.v w:i}}}: :?v.}:.;.:•}:..;?^:}.p}}?}:.{.?vL:•}:?•?i?}}:?i.?:i4}}i:'}}:•?:-i}} :'.h A'4}}Y.-}:•}-i:?•}?R i}i}}}i:6}}}:4}}?T:?}i}r •.n:..... ~:�:+:<=:: ti::riry�::��i:�iiiiii?::::"f.'>i�'::}�:>.i?�:v�$i:t::iti4??}Y..:ti^}:?`.}?}Y-i?•}:4:•}?}::ti??W}:?4}:C?•i::•}}}i:._:-}}iX:•:r:}}i:}}::�:•:i}ii}}}}i•}:v?:LX?•}'^:r?vjSi�i}:i:.4::?::.:i. Ackna��ec� emen�� <:��<:v .......v...........:.r.. ..:..... . ....... ....... . . Gambling Site Authorization I hearby consent that local law enforcement officers,the board or agents of the board,or the commissioner of revenue or public safety,or agents of the commissioners, may enter the premises to enforce the law. Bank Records Information The board is authorized to inspect the bank records of the gambling account whenever necessary to fulfill requirements of current gambling rules and law. I declare that: I have read this application and all information submitted to the board; All information is true,accurate and complete; All other required information has been fully disclosed; I am the chief executive officer of the organization; I assume full responsibility for the fair and lawful gambling and rules of the board and agree,if licensed, to abide by those laws and rules, including amendments to them; A membership list of the organization will be available within seven days after it is requested by the board; Any changes in application information will be submitted to the board and local government within 10 days of the change;and A termination plan will be submitted to the board within 15 days of the termination of all premise permits. Failure to provide required information or providing false information may result in the denial or revocation of the I' ns /-- 3- o Signature of chief executivg2i.--i Date :{.::.::.??.?•{.T7:?.:??i'f..:K::::i'vi:::ti}ti:ti: 'i ii::2rti i:iy.}JS'.:i 4:$?i^` r ?�T'?vi:-:'•.:. :4Y{.vr:i:.v.::•r•1.::.? ••is??iii.}'-f .• v'v'" �o �cramea�Ac�naw�ed ement->:,:::<}:>«}::::::::}::$:ri>.?:}:.}:?.>:.<::>:.:::},.:}�}}}::.?.:::�.}}}:::.:::::::..:::::::::}:r:.::::<::>:»_:� :>::: 1. The city'must sign if the gambling premises is located within city limits. 2. The county"AND township"must sign if the gambling premises is located within a township. 3. The local government(city or county)must pass a resolution specifically approving or denying the application. 4. A copy of the resolution approving the application must be attached to the application. 5. Applications which are denied by the local governing body should not be submitted to the Gambling Control Division. Township: By signature below,the township acknowledges that the organization is applying for a premises permit within township limits. City'or County" Township" City or County Name Township Name Name, j< ( E (( fdTS Si re of person ,/ n Signature of person receiving application T Date Received Title Date Received . /9 - j—Y—9/ delivering ap cation to local governing body Date 110 Z. C4- k'1ScJ I I- *--q/ Is township: ❑Organ i zed ❑Unorganized 0 Refer to the instructions for the required attachments Mail to Department of Gaming - Gambling Control Division - Rosewood Plaza South,3rd Floor 1711 W.County Road B ' Roseville, MN 55113 RESOLUTION 91-01-02 CITY OF OAK PARK HEIGHTS WASHINGTON COUNTY, MINNESOTA A RESOLUTION GRANTING APPLICATION FOR GAMBLING LICENSE SUBMITTED BY GREEDER-HINDS-COMFORT COMPANY/VFW POST 323 WHEREAS, the City of Oak Park Heights has received a request for a premises permit to conduct lawful gambling by the Greeder-Hinds-Comfort Company/VFW Post 323; and, WHEREAS, it appears that the applicant has satisfied all other provisions of Minnesota law affecting charitable gambling; and, WHEREAS, Minnesota law requires municipal consent as it affects charitable gambling within the community; and, WHEREAS, it appears that Greeder-Hinds-Comfort Company/ VFW Post 323 has complied with all the statutory requirements as it affects charitable gambling. NOW, THEREFORE, BE IT RESOLVED by the City Council of for the City of Oak Park Heights, Washington County, Minnesota that the City of Oak Park Heights herewith consents to the issuance of a permit for charitable gambling by the State of Minnesota to Greeder-Hinds-Comfort Company/VFW Post 323 within calendar year 1991 for purposes of a Class A Premises Permit allowing the activities of bingo, raffles, paddle wheels, tip boards, and pull tabs. Passed by the City Council of the City of Oak Park (141L Heights this 14th day of Januar , 1991. di. l4k Barbara O'Neal, Mayor Attest: LaVonne Wilson, Administrator/Treasurer