02-11-1987 Council Agenda - Laserfiche WebLink

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/ r' Minnesota Char. J1le 7mbling Control Board 904 Summit State Bank Building 310 4th Avenue South Minneapolis, MN 55415 (612) 341' -7676 INSTRUCTIONS: 1. Form must be completed by owner of site. 2. Submit to above address at least 60 days prior to date of occasion. 3. PRINT or TYPE. Name of Owner of Site Movers Warehouse, Inc. Business Address 2233 No. Hamline Suite # 220 City, State, Zip Roseville, Minnesota Business Telephone Number ( 6;2 ) 636 -4468 Owner of Site License Number (if applicable) N/A --rYaaek REQUEST FOR 6 MORE THAN FOUR BINGO OCCASIONS Address of Site (for which waiver is requested) • , I 11 • . . Address — City, State, Zip City, State, Zip - 51-1 County :.0 • Is Site Located within City /Town Limit? ❑ Yes ❑ No Number of Additional Bingo Occasions Requested Per Week 20, Organizatiqn(s)ior which Additonal Occasions are Required s:!; Official, Legal Name Address -- City, State, Zip License No. Mn. Registry of the Interpreters of the Deaf. 108 East 7th St. St.Paul MN. 55110 applied _fc North Suburban Developemental Achieiement 1393 Garden Ave. St Paul Lions Club of Little Canada 2814 Rice St. Little Canada MN. 01878 At John's Church of Little Canada 380 E.-- t4ttl.e_Caflada- .&oadrtt Organization(s) Presently, Leasing Site't ut II all II 110.115-cL Official, Legal Name Address — City, State, Zip License No. . ,�: . servants of Mary, Inc. sea a ..�.a ..�.... .,...w.. ..• . 1079 Rice Street. St Paul, MN 55111 1079 Rice Street, St.Paul MN 55113 1115 Bevlah Lane, St Paul MN 5510R 00393 00465 O1ase �t. Joseph's Society Ramsey County Humane Society ver as nsf rt enec ssityofmorethanfourbingooccasionsperweek. Due to anticipated cut backs to City Government �y �oih Fe�era�l and State, certain charitable organizations have indicated a desire to use a portion of their profits from lawful gambling for lessening the burdens borne by Little Canada by initiating, performing and fostering worthy public works and augmenting/supple- menting services normally rendered. The balance of the funds shall be for lawful charitable. prposes. State why allowing additional bingo occasions is consistent with: a. Preventing commercialization of gambling; b. Insuring the integrity of operations; c. Providing for the use of the net profits only for lawful purposes. a. The lessor of premises shall not, in any manner whatsoever, be involved in the conduct of charitable gambling. b. The lessor shall insure the integrity of operations by not being involved in any gambling operations ar,d by maintaining a safe and secure premise. c. The lessor shall not in any way interfere with the organizationsab 1 to donate their proceeds to charitable purposes. Name of Representative for Gambling License Applicant (serving nojic,a) C Sign ner of Site ACKNOWLEDGEMENT OF NOTICE BY OCAL GOVERNING BODY I hereby acknowledge receipt of a copy of this application for request for more than four Bingo occasions per week. By acki wledging receipt, I having been served with notice that this application will be reviewed by the Charitable Gambling Control Board and if approved by .-Soatdrw. ecorne )effective 60 days from the date of receipt (noted below), unless a resolution of the local governing body is passed which specifically disallows such activity and a copy of that resolution is received by the Charitable Gambling Control Board within 60 days of the below noted date. Name of Local Governing Body Signature of Person Receiving Application 2 Date Received (This is date from which the 60 day approval begins) CG 00009 01 (12 041 White Board Canary • Applicant Pink Gov rmm9 Body