HomeMy WebLinkAbout4.e. Gambling License for American Legion Post 65�I � ` CITY OF ROSEMOUNT
EXECIITIVE SUb�IARY FOR ACTION
CITY COUNCIL MEETING DATE: APRIL 19, 1994
AGENDA ITEbi: GAMBLING LICENSE APPROVAL AGENDA SECTION:
ROSEMOUNT AMERICAN LEGION POST 65 CONSENT
PREPARED BY: LINDA JENTINK, AGENDA �"�n� � � �
ADMINISTRATIVE SECRETAR.Y ��
ATTACI�IENTS: APPLICATION APPROVED BY:
The American Legion Post 65, Dakota County 40 & 8, Voiture 1457, has
requested approval from the City Council for the Application for
Authorization for Exemption from Lawful Gambling License for the State of
Minnesota.
This approval is given on a yearly basis.
RECOb�iENDED ACTION: MOTION to approve the Gambling Authorization request
for the American Legion Post 65, Dakota County 40 & S, Voiture 1457.
COUNCIL ACTION:
!
. � M�nnesota Lau�ful Gambling ,FOR BOARO USE ON�Y
�� Application for Authorization for i ET o� �
� `""�"�' Eaemption from Laarful Gambling License
Fiq in tha unshaded portions of ti►is application fot enemption and ,
>;
sand d�n at/sast 45 days bafore yourgambimg ecbwiy tor processuig
:, .; :,
11TW116 tuld AddTess O,f OrgacniZtctiott ::
/
_ ;.: _. . _ _
_ _
OrgarNzzatiton Name CurrenV�►evbusilcense rwmber Cunent/prevlous exertpt�wmber
Dakota County 40 & 8, Voiture 1457 � X-19005-94-001
sc�ee� cny s�ace z . coum�r
Box 166 8osemount TJ�T 5�y0�8 Dakota
CHet ExecutNe Olticer Oaytime Phone Nurt�ber Treasurar Daytime Phone Nurti�er
Melvzn Wilken (12) 454-5736 Sarry Boquist �612� 423-2596
_ e c Non ro anizataon '
.
.
�JP. ...f:.. P. .R��9 ::.: ;, ` , ;: <
_ _ ___ __ _ _
Check ths box that incGcates your ptoof of nonprofit
Check the box below which indicatss your type ot organization stabis and attach a copy of the proof to the application.
� ❑ Fratemal �J IRS desigt�ation
� SRS designa.tion and chaxter
• Veterans � Certification of good stancfing irom tha Minnesota
information are on file at Dept.
❑ Re�igious of G Secretary of State�s office
❑ � Oiher non-profit �g � Affit�ate of parant nonprofit organization(chartar)
;
> _;
:
;.
Garribiing.:3ite <> ;> _ ; ;; >:
.
,
Name ot sMe where acWily wiu take place
Rosemount American Legion Post 6;
St►eet Cqy...-•--- --------Township State zip code courny
14590 Burma, Ave. Rosemol;nt �N 55068 Dakota
uate(s>a actlwty(tor ranles.tndCate a,e date a u,e drawing)
s�:� 30 & 31� �994
.T1�jpesofGames ;: ;' ; , . ;: �`Inqricr,aI;Report . ii�a�v.n,tora�� <_
`: Enp.n.�s,�nc�u�ny (tnc�ua�n9,uooatfon�`
Gam�(s) `ii►oss A�cNP� :' _ ;: . :Cost of PriZ�s ;: ,:NaE P►oifi :; and cash) ..
Bingo � ; ; , :' ;
Raffles <: > ,
Paddlewheels ' : ' : � `
Ti boards ;: ;; ; _ '
'Pull-tabs ' : ':
< _:,.: ,.:
_ : ,; ,:,,:
� � i deciare all informafion submifted to the �`°`''°""""°"`�'""g�'�1Afe'�'�
<; ;
, Gambiing Contro!Board is true, accurate, ,�� "
�..< �......
and complete. . : ..: .: .:>
.. : _ .... :
, �dsaare aa�x�naa�inro�na�ro�su��earo ms cam�er,�conua::
eoard is tiue a«�,r.Ne arw s�bca ' '
i, ,,.;..: ;:
; ;; � :
I, : : ,
,� � � g
Chiaf Exacutiw Oflicar's Si9natura Dat� Chiat Ex�ctitfvaOfllcars Signstun:: `Datr
,.
; _ ;> ;..
I:ocal Un�t of Goverrunent:Acknouiiedgment . ' ':
,. ,
.
�have recehrea a c:opy of aus appecatlon. Tnts applkation wid be.eviewea ay u,e Garro�r,g concra soard and wY�ceoome eneanre 90 aays from tne aate a
►eceipt by ihe dry or counry,unless the bcal u�of govemment passes a reaoluUon to spedfically prohibK the adivity. A c�py of that resohitbn must be reoeived
by the Gamb6ng CaMrol 8oard wkhin 30 days of the date OYed in bebw. CRies of the first dass have 60 days In whid►to�saibw the adivily.
qty or CouMy Township Township is
cny o�oo�r,�y� To�c� p organized I,
s�m�.a��«►re�� �„ ❑uno�ganized'
�s�u� s�a�o���«,re�����o� ❑unincorporated' II!,
'Attach letter
Tkle Date reeeived 'TRte Date Received ,
This form will be made available Mail with S25 permit fee end copy of White-Ori inal . II
9
in afternative fom�at(i.e.large proof of nonprofit status to: Yellow-Board retums to
print,braille)upon request. Gambling Control Board Qrganization to complete ''
1711 W.County Rd.B,Ste.300 S. shaded areas
Roseville,MN 55113