HomeMy WebLinkAbout[04d] Gambling Permitcrr- cx+r+r.~i~i~
MEETING DATE:
Council Agenda Item ~~
July 17, 2008
AGENDA ITEM: Gambling Permit -Requested Action: Accept the
Gambling Application of the St. Joseph lions for an event to be held on September 13, 2008 at the St.
Joseph Meat Market.
SUBMITTED BY:
Administration
BOARD/COMMISSION/COMMITTEE RECOMMENDATION:
PREVIOUS COUNCIL ACTION:
BACKGROUND INFORMATION: The City is required to accept all applications for lawful gambling within
the City limits.
BUDGET/FISCAL IMPACT:
ATTACHMENTS:
Gambling Application
REQUESTED COUNCIL ACTION: Accept the application of the St. Joseph Lions for an event to be held
on September 13, 2008 at the St. Joseph Meat Market.
Minnesota Lawful Gambling s/o7
LG230 A lication to Conduct Off-Site Gamblin No Fee
Organization name____ST, ?OSEt~H l.loN.~_______________________ License number _ O ZOZ / _
License expiration date __~__!__3~__l__/O _
Gambling Premises
1. Name of establishment or function where gambling activity will be conducted_~T, ~~~_ M!<~ vlARlaa!~
2. Street address and city _2~___N•u~___Lsr 1~~~__ST So~~FFt___(Y-~ ___~3?4____
• Do not use a post office box.
• If no street address, write in road designations. Example: 3 miles east of Hwy 63 on County Road 42.
3. Does your organization own the gambling premises?
____ Yes If yes, a lease is not required.
No If no, a lease agreement must be attached. Use LG224 Lease for Off-Site Gambling Activity.
A lease is not required for raffles.
Gambling Activity
1. Check ('~) the gambling activity your organization will be conducting.
---putt-tabs -bingo _tipboards ~ raffle --paddlewheel
2. Date of single day event I1 ~ a ` . 4 separate days allowed per calendar year.
3. Dates of up to 12 consecutive days in connection with a county fair, state fair, church festival, or civic
celebration. Begin date _____ End date _~~~_~_ 1 event allowed per calendar year.
Acknowledgment
• The person signing this application must be the CEO of your organization and have their name on file with the
Gambling Control Board.
• If the CEO has changed during the term of your license and the current CEO has not filed a
LG2008 Organization Officers Affidavit with the Gambling Control ard, he or she must do so at this time.
1 have read this application, and all info/rma ~ n is true, accurate, a complete.
Chief executive officer signature _ 1 ____________ Date _7 / ~ l 1~~~''
Print name __~/E•'~//~ETrl A~// ~1~n~~1 ____^___ Daytime phone _.~~~- ~1.~ ^--870
Application and Required Attachments
1. LG230 Application to Conduct Off-Site Gambling. Mail to: Gambling Control Board
There is no application fee. Suite 300 South
2. Resolution of approval from the local unit of 1711 West County Road B
government (city or county) Roseville, MN 55113
3. Copy of the lease agreement. Or, fax to 651-639-4032
No lease is required if only a raffle will be
condu`c~d or your organization owns the premises. Questions? Contact a licensing specialist at
651-639-4000.
This publication will be made available in
alternative format (i.e. large print, Braille) upon
request. The information requested on this form
(and any attachments) will be used by the
Gambling Control Board (Board) to determine
yourqualfications tobeinvolved inlawful gambling
activities in Minnesota, and to assist the Board
in conducting a background investigation of you.
You have the right to refuse to supply the
information requested; however, if you refuse
to supply this information, the Board may not be
able to determine your quaycations and, as a
consequence, may refuse to issue you a permit.
If you supply the information requested, the
Board will be able to process your application.
Your name and address will be public
information when received by the Board. Alt
other information you provide will be private
data about you until the Board issues your
permit. When the Board issues your permft,
all information you provided will become
public exceptforyourSocial Security number,
which remains private. If the Board does not
issue you a permit, all information you
provided remains private, with the exception
of your name and address which will remain
public. Private data about you are available
to following: Board members and staff
whosework requires access totheinfonnation;
Minnesota's Department of Public Safety;
Attorney General; Commissioners of
Administration, Finance, and Revenue;
Legislative Auditor; national and international
gambling regulatory agencies; anyone
pursuant to court order; other individuals and
agencies specifically authorized by state or
federal law to have access to the information;
individuals and agencies for which law or legal
order authorizes a new use or sharing of
information after this Notice was given; and
anyone with your consent.