HomeMy WebLinkAbout[04d] Gambling Premise Permit
4(d)
Council Agenda Item
MEETING DATE: November 2, 2015
AGENDA ITEM: Premise Permit – Requested Action: Accept the
Premise Permit application of the St. Joseph Lions to conduct lawful gambling at Sal’s Bar, 109 MN St W.
SUBMITTED BY: Administration
BOARD/COMMISSION/COMMITTEE RECOMMENDATION:
PREVIOUS COUNCIL ACTION:
BACKGROUND INFORMATION: The Council must review and accept gambling permits that will allow
lawful gambling at specific sites. The St. Joseph Lions has submitted a request to conduct pull tab
gambling at Sal’s Bar. Ordinance 62 requires that 10 percent of the net proceeds must be spent within
the trade area.
Staff will monitor the required quarterly contribution reports to assure that the 10% contribution is
satisfied. The St. Joseph lions have historically exceeded the contribution requirement.
BUDGET/FISCAL IMPACT:
ATTACHMENTS: Request for Council Action
Gambling application
REQUESTED COUNCIL ACTION: Accept the premise permit to allow the St. Joseph Lions to operate
lawful gambling at Sal’s Bar, 109 MN St W.
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MINNESOTA LAWFUL GAMBLING 6/�s Page�of z
LG230 Application to Conduct Off-Site Gambling No Fee
ORGANIZATION INFORMATION
Organtzation Name: St.Joseph LIons License Number:02021
Address: 12870 287th st. ��ty; St. ]oseph , MN Zip: 56374
Gambling Manager Name: Scott Bloch Daytime Phone:320-845-7843
Chlef Executive Officer(CEO)Name: Ralph Meyer Daytime Phone:320-363-7905
GAMBLING ACTIVITY
Twelve off�events are allowed each caknda�year not to exceed a total of 36 days.
From�.J-�./�� Lo �..�..�./_.�
Check Uie type of games that will be aonducted: �
�✓ Raffie ✓�PutF-Tabs aBingo ❑llpboaMs �Paddlewheel
GAMBLING PREMISES
Name of location where gamWing activtty will be conduc6ed: ��'s Bar and GHI
Street address and
City(or townshlp):p4 w_ Minnesota St., St. Joseph Z�p; 56374 �nty: Stearns
• Do not use a post oRice box.
• If no street address,wiite in road designadnns(example: 3 miles east of Hwy.63 on County Road 42).
Dces your organization own the gambling premises?
aY�s If yes,a lease ls not required. ,
�No If no,the lease agreement below must be complebed,and signed by the lessor. �
LEASE AGREEMEHT FOR OFF-SITE ACTIV=TY (a lease agreerr�ent Is not requlred br raf'fles)
Rent to be paid for tfie leased area: �0 (if none,write"0')
All obligations and agreements between the orgaNzatlon and the lessor are Ilsted below or attached.
• My attachments must be dabed a�d signed by bath the lessor and iessee.
• This lease and any attachmer�ts Is the Lotal and only agreement between the lessor and the organizatlon coixiuding lawful
gambling activities.
• Other terms,If any:
L�w�'s Signature: � Date: � Z
Print Lessor's Name:
coNrtNUE'ro nw�2
LG230 Application to Conduct Off-Site Gambling 6/15 ��z�z
Acknowledgment by Local Unit of Government: Approval by Resolution
CITY APPROVAL COUNTY APPROVAL
for a gambling premises fo�a gambling premises
located within city limits located in a township
City Name: ST, 30$Et�F1 County Name:
/
Date Approved by City Council:_ Date Approved by County Board:
Resolution Num6er: � Resolution Number:
(If none,attath meeting minutes.) (If none,attach meeting minutes,)
Signature of City Pe ne• Signature of County Personnel:
Tfde. (�l/',Q.t�- Date Signed: �O � Tltle: Date Signed:
TOWNSHIP NAME:
Complete below only H requlred by the oour�ty.
Local unit of yovernment On behalf of the bownship,I acknowledge that the organization(s
must sign. applying to co�duct gambling adivity within the township limits.
(A township has no statutory authority to approve or de�y an
applicatlon, per Min�esota Statutes 349.213,Subd.2.)
Print Township Name:
Signature of Township Officer:
Title: Date Signed:
CHIEF EXECUTIVE OFFICER (CEO) ACKNOWLEDGMENT
The person signing this appliption must be your o�gan[zatlon's CEO and have tt�eir name on flle with the Gambling Control Board.
If the CEO has changed and Me curt�ent CEO has not filed a LG200B Organization Officers Affidavit with the Gambling Corrtrol
Board, he or she must do so at thts time.
I have read this applicatlon,and all information is true,accurate,and wmplete and,if appitcable,agree to the lease terms as
stated in applkatlon.
/� /o l9 Q,�
StpnaLuro of CEO(must M CEO's sipn�ro;de�iqn�s�nsY not sbn) D e
Mal{or fax to: No attachmenb required.
Gambling Control Board
Sufte 300 South Questions? Contact a Ucensing Speclalist at 651-539-1900.
1711 West County Road B
Roseville,MN 55113
Fax: 6Si-639-�032
This publtcaUon wtll be made avaNable in alternaUve fortnat(I.e. large print,brailk)upon request.
Data privacy notioe: The info�madon requesced p�thls I�orm(and any If the Board does not fasue a partnit,all Infortnadon provlded remains
attachmants)will be used by the Gambling Control BoaM(Board)to pHvate,wRh the�xoeption of Your organhatlon's name and addross whld�
detertnine your orgenizatfon's qualMcatlons to be involv�in lawful wNl remain pubik.
gambling activRfes in Minnesota. Your oryanizatlon has the riqht bo rofuse
to supply the inforn�etion;however,If your organization rePuses to suppfy ��ete data about your organizaUon ere availabk to: Bosrd mamb�rs,
tl�ls Informatbn,the Board may not be able to determine your �►ti������uires aacess to the information;Minnesota's
organlzatlon s qualiflcations and,as a oonsaquence,may refuse to iswe a ���ent of Publk Safety;Attomey General;comml�loners of
pertnit, If your organhcation supplles the Infortnation requested,the Board �mintsdation,Minnesota Managemerrt 5�Budget,and Revenue; .
will be abk to process your organizadon's application. �-e9�s�adve Auditor;natlonal and internatlonal gambling regulatory
agendes;anyone pursuant to court order;other Indhriduals and agencia
Your organizatbn's name and address will be publk lnformatbn whe� specitically authorized by state or federal Isw to fiave atcesa ha the
recelved by the Board. All other inlbrmatbn provided will be private data information;lndividuals and agencks for whkh law or legal order
about you�orgenlzation untll the Board Issues the permit. Whcn the authorizes a new use or shaNng ot Infortnatbn after thts�otice was given;
Board Issues the permR,ail informatfon provided wlll become publk. and anyone wlth your wrAten conser�t.