1a. St. Hubert's Church: Harvest Festival Gambling Permit.w
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CITY of 1
CHANHASSEN
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690 COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317
(612) 937 -1900 • FAX (612) 937 -5739
MEMORANDUM
TO: Mayor
City Council
Don Ashworth, City Manager
FROM: Scott Harr, Public Safety Director 1� pJ
DATE: June 4, 1996
SUBJ: Gambling Application from St. Hubert's Church
Action by cry A1ni0i!tfby6
Lt
L 5et'!te% ;i Ca."1 8100
This memo is to respond to the license application for gambling from St. Hubert's
Church. The background investigation I have conducted reveals no reason that the
license should be denied. The application does meet the requirements of our city
ordinance regarding gambling within Chanhassen.
Attached is a resolution approving the permit. It is the recommendation of staff that this
permit be approved.
g\safety \gambsthu
R ECLIVE D
MAY 3 01996
06�
Re Minnesota Lawful'AaW A09 SAHTY
Application for Authorization for an
Exemption from Lawful Gambling License
i For Board Use Only
Fee Paid
Check #
Initals
Date Recd
Check the box or boxes which indicate the type of gambling activity your organization will be conducting
® Bingo ® Raffles ® Paddlewheels ® Pull -tabs ® Tipboards
Be sure the Local Unit of Government and the CEO of your organization sign
the reverse side of this application.
For Board Use Only
Date & Initials of Specialist '
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Local Unit of Government Jurisdiction
Is this gambling premises located within city limits?
If Yes, write the name of the City:
City Name CHANHASSEN
If No, write the name of the County and the Township:
County Name Township Name _
- heck the appropriate status of the t ownstup: Llorgaruzed L unincorporated
Local Unit Of Government Acknowledgment
1. The city must sign this application if the gambling 3. DO NOT submit this application to the Gambling Control
premises is within city limits. Board if it is denied by the local unit of government.
2. The county and township must sign this applica- 4. NOTE: A Township may not deny an application.
tion if the gambling premises is not within city limits.
' Upon submission of this application to the Gambling Control Board, the exemption will be issued not
more than 30 days (60 days for cities of the 1 st class) from the date the local unit of government
signed the application, provided the application is complete and all necessary information has been
' received, unless the local unit of government passes a resolution to specifically prohibit the activity. A
copy of that resolution must be received by the Gambling Control Board within 30 days of the date
filled in below. Cities of the first class have 60 days in which to disallow the activity.
' City or County Acknowledgment of Receipt of Township Acknowledgment of Awareness of
Application Application
Signature of person receiving application Signature of person acknowledging application
Date Received:
' Title of person receiving application
Date Signed:
Title of person acknowledging application
Oath of Chief Executive Ofce6 ':
I have read this application and all information is true, accu
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to and complete.
Date: S'- a S - 7j
' Submit the application at least 45 days prior to your scheduled date of activity.
Be sure to attach the $25 application fee and a copy of your proof of nonprofit status.
Mail the complete application and attachments to:
' Gambling Control Board
1711 W. County Rd B Suite 300S
Roseville, MN 55113
' This publication will be made available in alternative format (i.e. large print, braille) upon request.
Questions on this form should be directed to the Licensing Section of the Gambling Control Board at
(612)639 -4000.
Hearing impaired individuals using a TDD may call the Minnesota Relay Service at 1- 800 - 627 -3529 in the
Greater Minnesota Area or 297 -5353 in the Metro Area.
' The information requested on this form will be used by the Gambling Control Board (GCB) to determine your
compliance with Minnesota Statues and rules governing lawful gambling activities. All of the information
that you supply on this form will become public information when received by the GCB.
Yes 0 No
Form ST Minnesota t?epartrnent of Revenue
(Rev. 1.1.74) Sales and Use Tax Division
CERTIFICATE OF EXEMPTION
I, the undersigned purchaser, hereby certify that I am engaged in the business of.
CHURCH AND REL " GI'OUS EDUCATION
(Describo nature of business activity) '
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and that the tangible personal property described herain which I shall purchase, lease or rent from
Name of Seller '
Acores$
is exempt for the following reason:
The purchaser is an organization organized and operated exclusively for educational or religious purposes.
❑ The property is intended for use or consumption in .agricultural or industrial production of property intended to be sold'
ultimately at retail. This exemption does riot pertain to machinery, equipment, implements, tools (except qualifying detachable
accessory tools), accessories, appliances, contrivances, furniture and fixtures, neither does it apply to purchases exceeding
S100,000 in any calendar year of paper and ink products by a publisher for use in an exempt publication.
[ The p:'operty will be shipped or transported outside Winesota by the purchaser without any intermediate use, will be used in a
trade o. business outside Minnesota, and will not be returned to Minnesota except in the course of interstate commerce.' This'
exemption includes packing materials used to pack ana ship household goods to destinations outside Minnesota, and material
designed to advertise and promote the sale of merchandise or services, which material is purchased and stored for the purpose of
subsequently shipping or otherwise transferring outside the state by the purchaser for use thereafter solely outside the state. of
Minnesota.
❑ The property is rolling stock purchased by a railroad, taconite railroad, freight line, sleeping car or express company, taxed on
gross earning under Minnesota Statutes Chapters 294 and 295. trolling stock includes engines, cars, tenders, coaches, sleeping
c , r . r c xcs;r°'r fc; .. �rirr ,ry_,. :�ira e,,.+, t.i such roiling stock.-
The property is telephone central office telephone eilut,pment used in furnishing intrastate and interstate telephone service to the
public. 1 r
❑ The property., is mill liners grinding rods and gnndlnV balls purchased by a company taxed under the in lieu provisions of
Minnesota 5talutes Chaptc* 29II'and is substantially cbnsumed in the production of taconite, the material of which primarily is'
added to and becomes apart of the material being,processed.
Tlie,property is airflight equipment purchasedby'an airline company taxed under Minnesota Statutes, Sections 270.071 through
270.079. Air flight equipmerii iricS&des aiipfanes and parts necessary for the repair and maintenance of such air flight equipment'
and flight shpulators. '
Cetai'ed description of property on`which'ex'emption'is claimed:._._
7707 Great Pla.i ns Boulevar„d aar 1 ! 308 W. 78th St reet '
Check applicable box: ❑ Singfe i5orchasu certificate ® Blanket certificate
If blanket certificate is checked, this certificate continues in force until cancelled by the purchaser. If the purchaser le
uses the property described herein. for other than ex(Impt purposes and sul)selllmnlly, with t 1 intent to evade; I
tax, fails to file a sales or use tax return declaring t11, taxable use of sucl property, the purchaser will be subject to
the full penalty of the law. -k-
ST. HUBERT CHURCH AND SCHOOL
Purchaser's Business Name Sipnawro of Autiwri =ed F'urscr ljr
7707 GREAT PLAINS BOULEVARD PASTO
Title -�
CHANHAS,SEN MINNESOTA _ 5. _
0rty State Zip Coda Date
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Purchaser's Sales and Us. Tax If no number —
Account Numb►r state reason — - - --
27069
NOTE: Sellers must keep t91. certificate as a part of their records:
Incomplete cortifica:'•s cannot be accepted in good faith 1 '