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HomeMy WebLinkAbout20110207 - VI-12To: Mayor Hicks & City Councilmembers From: Adeline Schroeder, Deputy City Clerk Date: January 24, 2011 Item: Temporary One -Day Liquor License and Gambling Permit for Hastings Family Service for Hastings Tasting Event on March 1, 2011 Council Action Requested: Approve the attached resolution approving a one day temporary liquor license and gambling permit for the Hastings Family Service for the Hastings Tasting Event at St. Elizabeth Ann Church Social Hall, 2035 15 "' Street West, Hastings on March 1, 2011 Background Information: Hastings Family Service has submitted an application for a one day temporaiv liquor license and gambling permit for the Hastings Tasting Event. Financial Impact: The $20.00 required fees have been paid. Advisory Commission Discussion: N/A Council Committee Discussion: N/A Attachments: • Resolution _ title of 4 t. st rnip,;s. * � ' ..q ° b � t �;a� '� H El"tirir" , � 1N °�' - .S � 1 � � °.* � p:651-49G2350 . C5� ,�1 � 3 „'..��Ja2 ww !. n��-��.�t7� x' x'711. us City Council Memorandum CITY OF HASTINGS DAKOTA COUNTY, MINNESOTA RESOLUTION NO. 02- -11 RESOLUTION APPROVING THE APPLICATION BY HASTINGS FAMILY SERVICE FOR A ONE DAY TEMPORARY ON -SALE LIQUOR LICENSE AND GAMBLING PERMIT WHEREAS, Hastings Family Service has presented an application to the City ofHastings for a one day on -sale liquor license and temporary gambling permit for the Hastings Tasting Event on March 1, 2011 at St. Elizabeth Ann Perish, 2035 W. 15 Street, Hastings; and; WHEREAS, the Minnesota Alcohol and Gambling Enforcement Division requires a resolution be passed to approve the request; and WHEREAS, an application for a one day on -sale liquor license and gambling permit has been presented; and WHEREAS, Hastings Family Service have paid the required fee of $20.00. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City ofHastings that the Mayor and City Clerk are authorized and directed to sign this resolution and forward to the appropriate agency, showing the approval of this application. Ayes: Nays: Absent: Whereupon said resolution was declared duly passed and adopted on the 7 ofFebruary 2011. Melanie Mesko Lee, City Clerk Paul J. Hicks, Mayor (SEAL) �[ OF P r oe M1 Nfinn esota D parlment of Public Safety ALCOHOL AND GAMBLING ENFORCEMENT DMSI N 444 Cedar Str SLdtC 13, St. Paul MN 55101-5133 (651) 201 -7507 Fax (651) 297 -5259 TTY (651) 282 -6555 A PP L ICATION AND P T FOR A 1 TO 4 DAY TEMPORARY ON-SALE LIQUOR LICENSE TYP OR PRINT INF RMATI N 51 k NAME OF ORGANIZATION DATE ORGANIZED TAX EXEMPT NUMBER 7,0 7 3 STREET ADDRESS CITY STATE kA J ZIP CODE TkI 6-,f 4c� 64r, CY s NA E PERSON MAKfNG APPLICATION BUSINESS PHONE HOME PRONE ck+�L� DATE LI WILL BE SOLD --. TYPE O F PROANIZATIQ L 1JARITABI,E TAR ORGANIZATION OFFICER'S NAB ADDRESS -- ce G. c Ck rf S V'00 _P (01 V-1 51--f-'ere+ A'W - -5 so O RGANIZATION OFFICER 'S NAB ADDRESS ORGANIZATION OFFICER'S NAIVE ADDRESS Location license will b e used. If are outdoor area, describe Will the a c ontra t for intoxicat 1ng liq uor ser 1 c e? If s o, give the name an address of the li quor I l c c lls ce providing the scMce. r--C-e A,) PeS-�utfw-e4pif­k 6av —T' 5 Will tho pIicant carry liquor liability insurance? If so, please provide the c artier's name and amount of coverage. APRVAL APPLICATION MUST BE APPROVEi D BY CITY OR COUNTY B F RL SU13MITTING TO ALCOHOL & GAMBLIN E NFORCEMENT CITY /COUNTY DATE APPROVED CITY FEE AMOUNT LICENSE DATES DATE FEE PAID SIGNATURE CITY CLERK OR COUNTY OFFICIAL APPROVED D DII CT R ALCOHOL AND GAM B LING ENFORCEMENT NOTE: ubm!t this form to the city or county 3 0 days prior to event. Forward app]1eation signed b y city and/or e ounty to tine address above. If the application is approved the Alco hoI and amb1iui Enfo� eeme��t Division will return this appli cation to be used a the License for the event P -09079 (05106) 3� s PwJ TH POLICIES OF INSU RANCE ST D BEL HAVE BEEN ISSUED T INSUA D NAME? A BOVE FOR TH OL[ `f PGRIOD INWATED. NOTWITHSTANE)I AN RE QUIWMENL TER OR CONI)fTIt O ANY CChSITRACT OR O THER DOCUM W tT14 FIESPECT TO WWI - r r119 RTIFI T MAY ISSUED O MA PERTAIN THE INSURAACE AFFORDED gy THE - P OUC IE8 tWSCRISED KEREI [S SUaJECT T j TER iS, EXCLUSIONS AND CONDMOIN POLICIES. A GGRE (3ATE LIM ITS HOW14 MAY HAVE BEEN REDUCED BY PAID CLAIMS. +D3Y EFl PF_1f1lAt3i' CLADASLMD EilocGUR MAD 604205623 07101/10 07101/11 FEBSONAL&AMMU - -9 20000ro GEM riG #E L �3a� � [ PROMOT 8 • COMPm# #1m .2 r (1 11 A - it Ippm Loc ANYALM ALL OWNEDA VY03 M UJ OS H iRED NON- MMEDrOS � � 1��' ILr ry r i;kNY X B DEDUG-TmE E MPLOYERSILMUTY ZL 40FrMM#MER E,c? 44 ai - . - i COMBINED �r6 UH. , 000-1 u vi) a 110001 07/01/10 0710111 8wLyjNjuRy (rt) 4 I 000 0 o PROPERTY DAHAGE f £$ I 11 AUT ONLY- EAACIOID DTH E19 THM ACC AMONLY: AUG Is EACH COCURFIENCS 1 5 1 000 000 AMBEGA js 07/ 01/10 07101/11 I -L EAC AGE IS so -- 07101/1 07101/11 L >PLO AAA E L DISEASE - POUC Y Lthir3 50 04 00 604205623 G7/01/10 07/01/11 1 1,000,0 00 . DESCRIPTMOFOPEM'nOMILCCATI ]VEHICL ISAUE)E [ L kPor Liability is coverea under all - UtHTIMAJft HOLDER City Of Ha ztin g s 101 l ast 4 gt Hazt ings , M 55 651 - 437 -7082 (fax A ttn C arol CANCELLATION SHO ULD ANY OF 7HE AWV9 DEScmBED FOLICIES 13 C 0MI s LL ED A NTH E 'IAA i 1j TIC JM �. D WREa'4 NOTICE TO Till =MFICATE Hbl.OFFI eel 3y4M - To - TTJE J M BUT FAILURCE TO DG So SliALL AGIRMM OR 1 9 E PRrUMNTATW dal eMATIVE D CORPOR"UN 1988 I'til+ 1 I -%§AF1FJrF1 +3i7r# f�17/V Page 1 of 2 7110 raii117f0 W-/�/%/44+R r%,+arriWU■ �W 4b%aia~as5 a V LG220 Appfor Exempt Perm Appli e vent If app lication ostmarked or received; less than 30 days before the event more than 30 days before the event An exempt permit may be issued to a nonprofit organization that: - conducts lawful gambling on five or fewer days, and awards less than $50,000 in prizes during a calendar year. $100 . o. `G I ATE .'- C T:I O N :. : - _:_ . =.: . : . ..::. .: . :. :::: . : �: _ _ : � : _ = .... h. Organization name Previous gambling permit number' r U i Type o f nonprofit organization. Check one. E] Fraternal Religious lous Veterans nd Other nonprofit organization Mailing address city State Zip Code Counter go &- ,46 - 4 - 15S0313 Name of chief executive officer (CEO) Daytime phone number Email address yi 16W p. _�_._ _ _ _ _ _�_�_ .�.� '_ _ . /}+�� ■ e ■ e s ■ ■/.�� -- ---------- ch" - :-. -. - _ _ . _ _' .-_-_ _- �.+' '1- ;}•�! { [y-�r - �" �.€ - V '.- U `� "_-: c ' -' r� Do not attach a sales tat exempt status or federal ID employer numbers as th y are not proof of nonprofit status. Nonprofit Articles of Incorporation OR a current Certificate of Gen{ Standing. Don't have a copy? This certificate must be obtained each year from. Secretary of State, Business Services Div., 180 State Office Building, St. Paul, MN 55155 Phone: 651-296-2803 IRS income tax a cempti n [501 ] letter in your o rg anlzati nts nerve. Dent have a copy? To obtain a copy of your federal income tat exempt letter, have an organization officer contact the IRS at 877 - 829 -5500. IRS - Affiliate of national, statewide, or internati nal parent nonprofit or ani ation (charter) If your organization falls under a parent organization, attach copies of b oth of the following: a_ IFS letter showing your parent organization is a nonprofit 501(c) organization with a group ruling, and b. the charter or lever from your parent organization recognizing your organization as a subordinate. IRS - p roof previously submitted to Gamblin Control Board If you previously submitted proof of nonprofit status from the IRS, no attachment is required. m e f pr l where gan bl ng ifl onduot dd for_raffle . _list th -' lte` - . h r _th dr v i�ig �l _ tat SJ ; �' �.� -, Hiqn Cam, socty 4a / I Address (do not use PO box) City Zip Code County Date(s) of activity (for raffles, indicate the date of the drawing) Do I C heck the box or bones that indicate the type of gambling activity your organization will conduct: [� Bingo's F affles 0 Paddlewheels* 0 Pull - Tabs` ❑ Tipboards* G ambling e quipment for pull—tabs,, bin pape tipboards, and Also complete paddlewheels must be obtained f rom a dis tributor licensed by the Gar bling Control Bear EXCEPTION: Bingo bard car and bingo Pa ge - of this form. number selection devices may be borrowed from another organization authorized to conduct bingo. To find a licensed distributor, go to www.g b.state.mn.us and click on List of Licensed Distributors, or call 651 -639 -4000. t, LG220 Application for Exempt Permit P 2 of 2 1110 - .Ltd � - L _ . � .l T:� - G ERN. MENT' K : ; -::::: � . M E.. _ .. -. . : :.. .. .... .. :_ . - :.: - -: =: _ =: =: := :._:.:__;.:: _:: .:. = -.....,.- .. ... .......... .............. .- ... - ..-- ..- ..- ...... -. - -. ... f t g m - tiling premises is rithin city limits, . -...., - .--- .- .-- ........ -.- ..- ...- .-- ,.- .....- -.--------..-..-.-.-...---------------------------- - - - - -- - - - - - - - - - - - - - - . It the gamblin premises is located in a township, a a city official must check the action that the city is county official must check the action that the county is taking taki on this application and sign th application. on this application and sign the application. township official is not required to sig n the application. _The application is acknowledged with no waiting period. The application is acknowledged with no waiting period. The application is acknowledged with a 30 day waiting The application is acknowledged with a 30 day waiting period, and a llows the Board to issue a permit after 30 period, and allows the Board to issue a permit after 30 days o days for a 1 st class city). days. The application is denied. The application is denied. 1 Print county name Print city name ## f be t1� ur�iy ! ac t a On behalf off city, 1 a this a Signature of county official receiving application Signature o off=icial receiving application Title Date (optional) TOWNSHIP: n behalf of the township, I Title b t# .Date acknowledge that the organization is applying for exempted gamblin activity within township limi [A township has no statutory authorit to approve or deny an application [Minnesota Statute 349.166)] Print township name Signature of township official ackn6wledging application Title Date �. F- -� E EC: -= .::- I = =_ . �-- : F :FI - � : - .. ::_ :-:: = :l: -ICI T - : ti- . : :: . . . . . : :. :. . . .::::: - _ : _:- : -:_ _ _._::::_ :.::_:: - :.:: =:: _:- - =:_: =: =: =_ . =_ -- .= :::= := _= := :== = :_:.: - :: - - =_:- _ : := :::::::_:::_ _::= :::::::.:_ : -: -------------- The information p rovided in this application is complete and accurate t o the best of my knowledge. 1 acknowledge e that the financial report wi ll be c and returned t o the Board within 30 days of the date of our gambfing activity. Chief e office si gnature Date C omplete a separate application for each gambing activity: Financial report and recordkeeping required - one day of gambling activity, financial report form and instructions will be sent with two or more consecutive days of gambling activity, your permit, or use the online fill -in form available at each day a raffle drawing is held uwrwwrv.gcb. state. mn.us. Within 30 days of the activity date, Send application with: complete and return the financial report form to the a copy of your proof of nonprofit status, and Gambling Control Board. ° application fee for each event. Make check payable to "State of Minnesota." To: Garbling Control Board 1711 Vilest County Road B, Suite 300 South Roseville, ille, MN 55 This form will be made available in alternative format (i.e. large print. Braille) upon request. Data privacy noti e:The information requested on #his form (and any attachments) will be used by the Gambling Control Board (Board) to determine your organization's qualifications to be .involved in lawful gambling activities in Minnesota. Youfr organization has the right to refuse to supply the information requested; however, if your organization refuses to supply this information, the Board may not be able to determine your organization's qualifications and, as a consequence, may refuse to issue a permit. If you supply the information requested, the Board will be able to process your organization's application. Your organization's name and address Vill be public information when received by the Board. All other information provided will be private data until the Board issues the permit, when the Board issues the permit all information provided will become public. if the Board does not issue a permit, all information provided remains private, with the exception of your organization's name and address which will remain public. Private data are available to: Board members, Board staff whose work requires access to the information; Minnesota's 'Department of Public Safety; Attorney General; C ommissioners of Administration, Minnesota Management & Budget, 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 written consent.