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Home My WebLink AboutResolution 6129 . . . RESOLUTION 6129 CITY OF MOUNDS VIEW COUNTY OF RAMSEY STATE OF MINNESOTA APPROVING PREMISE PERMITS FOR THE LION'S CLUB TO PERMIT CHARITABLE GAMBLING AT THE MERMAID AND ROBERT'S OFF 10 IN THE CITY OF MOUNDS VIEW WHEREAS, the Mounds View Lion's Club presently holds a charitable gambling premise permit approved by the City of Mounds View for two locations within the City; and WHEREAS, the Mounds View Lion's Club is requesting renewal of its charitable gambling premise permits for these locations' and WHERAS, State Law requires the Mounds View Lion's Club to obtain premise permits to allow charitable gambling at the following locations: Mermaid 2200 Highway 10 Robert's Off 10 2400 County Road H2 NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Mounds View hereby approves the renewal of the charitable gambling premise permits for the locations listed in this resolution for the Mounds View Lion's Club. Adopted this 24th day of November, 2003. ATTEST: ~'6~0- K'urt Ulrich, City Administrator (SEAL) i . I ~ 1 I . OCT-28-2003 15:19 FROM:MARY RUE SCHUTTR CPR 7637841729 TO:651 483 8520 P.002 Board Use Only Lawful Gambling License Renewal Application LG200R > ',:" :.' ;'; )Ann'tici'tOrganizaflon License {Fee'$'j;SOJ~:<'" '" ~'. .', ;..... : .~.. .> ,". ".' .,', ;:". ..;..,..~i'... :~'.:~l .:.:...;:-:~:.., ':~'_:', }", ..', "," ...... , ',License #: Expiration Date: 1/31/2004 1816 Organization: Mounds View Lions Club Business Address: 1458 85th Ave NE, Spring Lake Park, MN Phone: (763) 784-2908 County: Anoka 55432 , .~, "::".::~:' ; :'N" '\/~'~ \~:'. '. '. .,O~ , ',:",:::J ~'i ;',;~ '""'II, :.:';',S:L "..:,:;3., .\~,::; ~::I :',' :' .::; Organization Treasurer: John Robert Wharton ,;,' ,;';' ,j Home Address: 7462 Spring Lake Rd, Mounds View, MN 55112 '~~';~:),f;: -Phone: - (763) 784-5040 ,..'.. Date of Birth: 10/12/1941 ~.>':t '; Social Security #: 483~46-4838 ,~~'!:r/ ;}. ':t::~"~ <.':Li1f::1~2~e:t\~t~mj~~~::~:~rP.1f~t:(~~~~~f~,q~~:~~f;~~~~~::~it~i~ ,:W~:jQ:fl~>.> ,': ','" . " ..' ., i >.: ;:f: ;,:;r~f:~[r~~I~;~~!~~~~.~~~,Bef3th~J.o~rb,~1~t~f,~:#t'.~Z:a:~~~-;~ti~~Y.'9~ ,~~/#I!'~t~f!~~.~pqt!~~~:)~~,thfda.YS an~ hours .\ ,;':" ',., I",,, :"'" :: ," . ;', ", '," "..,. ":;0,, e. In!ojlO occasions ::ltlse'Separatesllee ,1 ,neoessary.,t.;: )"" ',,':' '.. ,,,' , I ;~~::..:.-...::=.:..{:...~::.. .~.. ........" _n........ ...".."' ,". ." .' ~~...,. '" ..'...,'"4...~.~.....,.._..... ......~._...."' i::'W;!~f 1 Site #" Org Owns Site: N @ ~e-will notberenewing-this $ite- i ;.,::' ,,'cn"! . --- -----~- ---- ;.:':,;';~) 3 Site Name: Mermaid Entertainment & Event Lef\..+er i;:", ',S!/ Street Address: 2200 Hwy 10, Mounds View, MN 55112 ::;:f/:~' County: Ramsey ;t3::;3: 1 Bank Name: Western Bank ~7~)~"~:J Address: 2711 NE Hwy 10, Mounds View, MN 55112 .;/~~';,::1 Gambling Acct #: 9003013 !f!,,1 Si~#: ~::~:::: ~~~~:=2,s~~~~::!E"::;!sS::f:~~_i i:~:'::','i.~j County: Ramsey 'Jj)~!l ;~:;::~ #: ~~~~: 10, MoundS ~ew, MN 55112 Chief Executive Officer: Home Address: Phone: Date of Birth: Social Security #: Jerome Wayne Linke 2319 Knoll Dr, Mounds View, MN 55112 (763) 786-4696 3/4/1949 471-50-2427 OCT-28-21211213 15:19 FROM:MRRY RUE SCHUTTR CPR 7637841729 TO:551 483 862121 P.02l3 . . . :.,; - ',- .. . ~. '::';-: ". '. \!.'./;~ .r.. ;.' ~ . ,,':.,' "I'" ~: ; .~: ~::';' .: ~: . \" . ~. :\,~: :: . ::.~ : ~: r.; J;; . .' i.~.;' .. ?." ~;,'~~'" . .. , : ..: .' .' ~: 0' . .; ~.~. ~~. ~ :. :'"! :{c:J. ' en: ~;II ':;':;,:~' ::,'~' ..C' ,01:-.: ~: :.:~" '" 'cWo .. ,. 'Ie" 'c.:' '''(l):' :.' ::t .. ::~: I." :T::i:."~1'~ :i'\'~;i~r .:.:.:~;: ~~":~- ~'.: .:' .,.~ '. . ~:. ,,; ~. :'~: ;~:.: .:' ':..: ~". ".. .~ ( . ~~:-. ;;; . ,=~:..~ - . : '.~' I ',.". .~. . . ~~ f~: ;~: . .~. : . :: "./" :-:.~ ,,', .'.',' . ,,)..;:...:..,:: \~.'t~,1 r;:j.;: ~i ~::..~}:'~~::.~ t.~~: t~~.:::;\. .... J ...... H:..i"; _.~: ~ ~':". ~ . .:..-':,'"." :::.:: .: ~: ... . . ..... ... ..=. ~ ~! ~;..::~.:.~ >,,'~'i2 :I; ;;~~'::. .. ,.;' '. ~., ':i,:<'~?~.~al: ~a~~~in9.,;Man~~~r,:~~c~nse{F~e.'$~OO) GM License #: 01816-005 :~: . . . ~ Gambling Manager: Home Address: Phone: Date of Birth: Social Security #: Bonding Insurance Co: Bond #: Most Recent Education: John Dennis Deppa 2056 129th Ct NE, Blaine, MN 55449 (763) 767-4981 2/28/1944 477~48-8320 United Fire & Casualty 51072998 6/25/2003 ~!. I----------------------------------------~ IfD We will not be renewing this person as gambling manager. Enclosed is a separate LG212 application Note: A new gambling manager may not assume duties until licensed by the Gambling Control Board. -----_..----- .. .'.. ". ~:;", ~:.. .. '. .r,' oj ',: Affidavit-iir1d"Consenf.statemetit;li;: . ,;.":. ;~>, ,. . ,: j -. ..:.~':':-"~:'. ~.... .~~.:~:::.';:' r~:.~,.:; ..-~;"":~:. .:;::;.::IJ.~::'::~;':"5.. :':J,:;.:" -':<~.....,'.'.~:~::\<:::.l:;:":::':::~- L I have never been convicted of a felony or a crime Involving gambling. 2. I have never committed a violation of law or Board rule that resulted in the revocation of a license issued by the Board within five years before the date of the license application, 3. I have never been convicted of a criminal violation involving fraud, theft, tox evasion, misrepresentation, Or gambling. 4. I have never been convicted of (i) assault, (ii) a criminal violation involving the use of a firearm, or (iii) making terroristic threats. 5. I have never been, or am I now, connected with or engaged in an illegal business. 5. I have never had a sales and use tax permit revoked by the commissioner of revenue within the past two years. 7. I have neller, after demand, failed to file tax returns reouired bv the commissioner of revenue. 8. I do not owe $500 or more in delinquent taxes as defined in section 270.72. 9. I have been an active member of the organization. 10. I am not a gambling manager or an assistant gambling manager for another organization. 11. I am not a lessor, a member of the immediate family, or an employee of a lessor of a premises where this organization has a permit issued from the Board to conduct lawful gambling. 12. r am not involved directly or indirectly as a bingo hall owner, manufacturer, Or distributor. 13. I am not the chief executive officer of this organization. 14. I am not the treasu~cr of this organization. Background Check. By signature of this document, the undersigned authorizes the Departments of Public Safety and Revenue to conduct a criminal and tax background check or review and tp share the results with the Gambling Control Board. Further, I understand, agree, and hereby irrevocably consent that suits and actions relating to the subject matter of this gambling manager license application, or acts or omissions arising from such application, may be commenced against me or my organization and I will accept the seT\lice of process 11'1 any court of competent jurisdiction in Minnesota by service on the Minnesota Secretary of State of any summons, process, or pleading authorized by the laws of Minnesota. Failure to provide required information or providing false or misleading information may result in the denial or revocation of the license. Notary .. OCT-28-2003 15:20 FROM:MRRY RUE SCHUTTR CPA 7637841729 10:551 483 8520 P.004 . . ~ I r ' . I . . " " L~':" . - n ,:;r ;-: ""1\' m' >< ,m, 'n~ 'C' M' c:', ~,>"~, ~' ",0 "'3 ..... .:_' "n, '(1) , ;~~~ l: . . "_ ~.' 'r:' :': ;:':. ~ "'.~? .~\~ , :_",,~Gr .','"n ~.)i , ";'3"'- ',-::";",~< ~:U~}j:~~ ~. : -: -. :;~:~I: , 'A~kn~wled~~merit an~;,qath: :: ,:::: .. . .. . .. '. . '". ~ [ DECLA.RE THAT: " :. I have read this application and all information submitted to the Gambling Control Board; All the 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 operation of all gambling activities to be conducted; I will familiarize myself with the laws of Minnesota governing gambling and rules of the Gambling Control Board and agree, if to abide by those laws and rules, including amendments to them; Any changes in application information will be submitted to the Gambling Control Board within 10 days of the change; I understand that failure to provide required information or providing false or misleading Information may result in denial or revocation of the license. I have read this application and dcdare that all information submitted is true, accurate, and complete. Notary Public Seal must be current and correct; seal may not be altered. Subscribed rmd sworn to before me this -"ww RUE SCHUITA NOTARY PUBLIC. MINNeSOTA -'. ............. Mail comolete renewal aoolication by: 12/2(2003 to: I':~,on~~cil ~~~rd::I.711. W'Co Rd B : "",~30~~~~()$ieville, MN SSl13. \ t '- .. -, - - - .... OrQanization license 1816 licensing Contact: Phone: Fax # Email: Roxie Rolph (651) 639-4079 (651) 639-4073 roxie. rol ph@gcb.state.mn.us .." ..,-." ';"~I . I' .( < :~;~:/ The infonnation requested on this form (and any attachmen~) will be used by the Gambllng Control Board (Board) b:J determine your ,.~':" 1i~;", Qualifications to be Involved In lawful gambling activities In r-1innesota, and to assist the Board in conductIng a background investi~i:ltlon of ~,. ",:;:!( you. You have the right to refuse to supply \he Information requested; however, If you refuse In supply this informaUon, the Board mi!lY r"i :i;/:ji, not be able to detennine your qualifications and, as a consequence, may refuse to Issue you a license. If you supply the Information i, :; ::,' :< 7:; ~ requested, the Board will be able to pro~ess your application, '~, , :'~ oJ': Your name and address will be public Information when received by the Board. All the ctJ1er information that you provide will be prl~te ',' " ?, .:. ; data about you until the Board issues your license. When the Board iSSUes your license, an of the information that you haye provided to <, ' " '. ;<;.~; the Board in the process of applying for your license will bewme pUblic except for your Social Security number, which reml'lins priYalle, If ;;;':: ";.:< the Board does not Issue you a license, afllnformation you have provIded In the process of applying for a license remains prIvate, wIth the .. : ';)';-:: Cl:ceptlon of your name and address which will remain public, 0' y,>:,.:. T Private data about you are available only to the following: Board members, staff of the f3.:;lGlrd whose work assignment requires that they <,,.~; \':: have access In the information; the Minnesota Department of Public Safety; the Minnesota Attorney General; the Minnesota :';'" ;..j,;' Commissioners of Administration, Finance, and Revenue; the Mlnnesata Legislative Auditor, national and International gtlmbling regul~tory :':,',: ", L ,( agencies; anyone pursuant In court order; other individuals and agendes that are specifically authorizeCl by st'Ite or federal law to have , ' ",~,,:,. a:cess In the information; individuals and agencies for which law or legal order C1UthOriZes a new use or sharing of informatIon all:er this " ::' Notice wes given; and anyone with your written consent