HomeMy Public PortalAbout1996-011Member Ann Thies introduced the following resolution and moved its
adoption:
CITY OF MEDINA
RESOLUTION NO. 96-11
RESOLUTION APPROVING THE RENEWAL OF A
PREMISES PERMIT TO THE HAMEL VOLUNTEER FIRE
DEPARTMENT TO CONDUCT LAWFUL GAMBLING
WHEREAS, the Hamel Volunteer Fire Department ("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 Inn Kahoots located at 45 Hamel Road within the City; and
WHEREAS, Applicant understands that this license prohibits conducting charitable
gambling activities at any other location not stated herein.
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 June 1, 1996
through May 31, 1998.
Dated: March 19, 1996
ATTEST:
AffSy�n, City Clerk -Treasurer
Anne E. Theis, Mayor
The motion for the adoption of the foregoing resolution was duly seconded by member
John Ferris and upon vote being taken thereon, the following voted in favor thereof:
Ferris, Jim Johnson, Thies, and Mayor Anne Theis.
and the following voted against: None.
and the following were absent: Phil Zietlow.
Whereupon said resolution was declared duly passed and adopted.
Central STATE OF MINNESOTA IFOR BOARD USE ONLY'
GAMBLING CONTROL BOARD IAMT PAID
PREMISES PERMIT RENEWAL APPLICATION 'CHECK NO. I
l 4PPR PRINTED:11/30/95 IDATE I
LICENSE NUMBER: B-01926-001
EFFECTIVE DATE: 06/01/1111 EXPIRATION DATE: 05/31/1/0 97
4(.
NAME OF ORGANIZATION: Fire Hamel Vol Dept
GAMBLING PREMISES INFORMATION
NAME OF ESTABLISHMENT WHERE GAMBLING WILL BE CONDUCTED
Inn Kahoots
45 Hamel Rd
Medina 55340
COUNTY Hennepin IS THE PREMISES LOCATED WITHIN THE CITY LIMITS?: Y
DOES YOUR ORGANIZATION OWN THIS SITE?: No
IF NO, LIST THE LESSOR:
4 Ronald Splette
7620 Kalk Rd
Hamel MN 55340
NAME OF PROPERTY OWNER (WHEN NOT LESSOR):
kRE FEET PER MONTH:
LESSOR INFORMATION
70 AMOUNT PAID FOR RENT PER MONTH: 750
1,RE 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
92 Hamel Rd
Hamel MN 55340
BANK INFORMATION
Farmers State Bank Of Hamel
145 Hamel Rd
Hamel MN 55340
GAMBLING BANK ACCOUNT NUMBER: 14680
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.
3 Z Z Co M rm eiN) �� � ► / /11,0
,1.57 t---V kvc..10" l-1-oAST-er 1`�r;�t= l��. ( Ni 6.53(-10 (Pr c_ sccQ��T�
(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
ACKNOWLEDGMENT
GAMBLING PREMISES AUTHORIZATION
I HEREBY GIVE CONSENT TO LOCAL LAW ENFORCEMENT OFFICERS, THE GAMBLING CONTROL BOARD, OR AGENT
OF THE BOARD, OR THE COMMISSIONER OF REVENUE OR PUBLIC SAFETY, OR AGENTS OF THE COMMISSIONERS
TO ENTER 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 PERMIT, 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.
SIGN7 OF CHIEF EXE yTIVE OFFICER
DATB /
LOCAL GOVERNMENT ACKNOWLEDGMENT
1. 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
61,74y /414 d(n a
TOWNSHIP NAME
SIGNATURE OF PERSON RECEIVING APPLICATION I SIGNATURE OF PERSON RECEIVING APPLICATION
TITL
DATE RECEIVED
6.71r Cleo-T/.E4fuAtr 3- /5' - 9L
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