HomeMy Public PortalAbout1995-044Member Ann Thies introduced the following resolution and moved its
adoption:
CITY OF MEDINA
RESOLUTION NO. 95-44
RESOLUTION APPROVING THE RENEWAL OF A
PREMISES PERMIT TO THE LORETTO FIRE RELIEF
ASSOCIATION TO CONDUCT LAWFUL GAMBLING
WHEREAS, the Loretto Fire Relief Association ("Applicant") has made application to
the City of Medina for a "Premises Permit Renewal" to conduct Class B charitable gambling
activities under authority and regulation of Minnesota Statute 349.16; and
WHEREAS, said premise permit will be for charitable gambling activities to be
conducted at Big Woods Saloon located at 4445 Highway 55 within the City; and
WHEREAS, Applicant understands that this license prohibits conducting charitable
gambling activities at any other location than above mentioned.
NOW, THEREFORE, BE IT RESOLVED by the City Council of Medina, Minnesota that
the Applicant's request for the Premise Permit Renewal be granted, effective January 1, 1996
through December 31, 1997.
Anne E. Theis, Mayor
ATTEST:
Je y . K on, City Clerk -Treasurer
The motion for the adoption of the foregoing resolution was duly seconded by member
Anne Theis and upon vote being taken thereon, the following voted in favor
thereof: John Ferris, James Johnson, Thies, and Mayor Theis.
and the following voted against: None.
and the following were absent: Philip Zietlow.
Whereupon said resolution was declared duly passed and adopted this 3rd day of
October, 1995.
ACKNOWLEDGMENT
GAMBLING PREMISES AUTHORIZATION
I HEREBY GIVE CONSENT TO LOCAL LAW ENFORCEMENT OFFICERS, THE GAMBLING CONTROL BOARD, OR AGENTS
'HE BOARD, OR THE COMMISSIONER OF REVENUE OR PUBLIC SAFETY, OR AGENTS OF THE COMMISSIONERS,
;NTER THE PREMISES TO ENFORCE THE LAW.
BANK RECORDS INFORMATION
THE GAMBLING CONTROL BOARD IS AUTHORIZED TO INSPECT THE BANK RECORDS OF THE GAMBLING ACCOUNT
WHENEVER NECESSARY TO FULFILL REQUIREMENTS OF CURRENT GAMBLING RULES AND STATUTES.
I DECLARE THAT:
• I HAVE READ THIS APPLICATION AND ALL INFORMATION SUBMITTED TO THE GAMBLING CONTROL BOARD;
• ALL 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 LAWFUL GAMBLING AND RULES
OF THE GAMBLING CONTROL BOARD AND AGREE, IF ISSUED A PREMISES pEnmIT, TO ABIDE THOSE LAWS
AND RULES, INCLUDING AMENDMENTS TO THEM;
• ANY CHANGES IN APPLICATION INFORMATION WILL BE SUBMITTED TO THE GAMBLING CONTROL BOARD AND
LOCAL UNIT OF GOVERNMENT WITHIN TEN DAYS OF THE CHANGE;
• I UNDERSTAND THAT FAILURE TO PROVIDE REQUIRED INFORMATION OR PROVIDING FALSE OR MISLEADING
INFORMATION MAY RESULT IN THE DENIAL OR REVOCATION OF THE PREMISES PERMIT.
SIG
CHIEF EXECUTIVE OFFICER
DA E
kL GOVERNMENT ACKNOWLEDGMENT
THE CITY* MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES IS LOCATED WITHIN CITY
LIMITS.
2. THE COUNTY** AND TOWNSHIP** MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES IS
LOCATED WITHIN A TOWNSHIP.
3. FOR TOWNSHIPS THAT ARE UNORGANIZED OR UNINCORPORATED, THE COUNTY** IS REQUIRED TO ATTACH
A LETTER TO THIS APPLICATION INDICATING THE TOWNSHIPS STATUS.
4. THE LOCAL UNIT OF GOVERNMENT (CITY OR COUNTY) MUST PASS A RESOLUTION SPECIFICALLY
APPROVING OR DENYING THIS APPLICATION.
5. A COPY OF THE LOCAL UNIT OF GOVERNMENT'S RESOLUTION APPROVING THIS APPLICATION MUST BE
ATTACHED TO THIS APPLICATION.
6. IF THIS APPLICATION IS DENIED BY THE LOCAL UNIT OF GOVERNMENT, IT SHOULD NOT BE SUBMITTED
TO THE GAMBLING CONTROL BOARD.
TOWNSHIP:
BY SIGNATURE BELOW, THE TOWNSHIP ACKNOWLEDGES THAT THE ORGANIZATION IS APPLYING FOR A
PREMISES PERMIT WITHIN TOWNSHIP LIMITS.
CITY* OR COUNTY** TOWNSHIP**
CITY OR COUNTY NAME
C' �y v/r& old'n
SIGNATURE OF PERSON RECEIVING APPLICATION
;1y elL,/c
DATE RECEIVED
9/s79 s
TOWNSHIP NAME
SIGNATURE OF PERSON RECEIVING APPLICATION
TITLE DATE RECEIVED
REFER TO THE CHECKLIST FOR REQUIRED ATTACHMENTS
MAIL TO: GAMBLING CONTROL BOARD
1711 W COUNTY RD B - SUITE 300 S
ROSEVILLE, MN 55113
'}
Central STATE OF MINNESOTA
GAMBLING CONTROL BOARD
PREMISES PERMIT RENEWAL APPLICATION
LG214PPR PRINTED:07/12/95
FOR BOARD USE ONLY
AMT PAID
CHECK NO.
DATE
LICENSE NUMBER: B-02179-001 EFFECTIVE DATE: 01/01/9X 6 EXPIRATION DATE: 12/31/9)S 7
NAME OF ORGANIZATION: Fire Loretto Dept Relief Assoc
GAMBLING PREMISES INFORMATION
NAME OF ESTABLISHMENT WHERE GAMBLING WILL BE CONDUCTED
Big Woods Saloon
4445 Hwy 55
Medina 55357
COUNTY Hennepin IS THE PREMISES LOCATED WITHIN THE CITY LIMITS?: Y
DOES YOUR ORGANIZATION OWN THIS SITE?: No
IF NO, LIST THE LESSOR:
Larry Thomas
430 Edgewood Dr
Loretto MN 55357
NAME OF PROPERTY OWNER (WHEN NOT LESSOR):
SQUARE FEET PER MONTH:
LESSOR I::^:,.^.MATION
57 AMOUNT PAID FOR RENT PER MONTH: 500
SQUARE FEET PER OCCASION: 0 AMOUNT PAID PER OCCASION: 0
BINGO ACTIVITY
BINGO IS CONDUCTED ON THIS PREMISES: No IF YES, REFER TO INSTRUCTIONS FOR REQUIRED ATTACHMENT
STORAGE ADDRESS
259 N Medina St
Loretto MN 55357
BANK INFORMATION
State Bank Of Loretto
Box 98
Loretto MN 55357
GAMBLING BANK ACCOUNT NUMBER: 800112
4773
ON THE LINES PROVIDED BELOW LIST THE NAME, ADDRESS AND TITLE OF AT LEAST TWO PERSONS
AUTHORIZED TO SIGN CHECKS AND MAKE DEPOSITS AND WITHDRAWALS FOR THE GAMBLING ACCOUNT.
THE ORGANIZATION'S TREASURER MAY NOT HANDLE GAMBLING FUNDS.
Doug Doboszenski President 4035 Belle Rose Lane Loretto, MN 55357
Tom Van Beusekom
Vice president 155 Elsen St. Loretto, MN 55357
Scott Wendland
Gambling Manager 4665 Co. Rd. 11 Loretto, MN 55357
(BE SURE TO COMPLETE THE REVERSE SIDE OF THIS APPLICATION)
THIS FORM WILL BE MADE AVAILABLE IN ALTERNATIVE FORMAT (I.E. LARGE PRINT, BRAILLE) UPON REQUEST