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1o. Chaska Community Hockey Assn: Gambling Permit.CITYOF COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317 (612) 937 -1900 • FAX (612) 937 -5739 TO: Mayor City Council Don Ashworth, City Manager FROM: Scott Harr, Public Safety Director DATE: October 17, 1996 SUBJECT: Chaska Community Hockey Association Action by City AdmthWM Endorse ✓ - DW q Modified Rejected Dat 1 O — Date Submitted to Commissit3il Date Submitted to Council This memo is to respond to the Minnesota Lawful Gambling Premises Permit Application from the Chaska Community Hockey Association. The background investigation conducted reveals no reasons that the license should be denied. Attached is the required resolution. It is the recommendation of staff that this permit be approved. g:\safety\sh \chaskaho MEMORANDUM Attach J emplo hoto here. I Do not glue ptctwe to I regtstration form Size: I -1/4" by LG209 (Rev. I U26193) Minnesota Law,fuI Gambling Registration of New Gambling Employee Receiving Compensation for the Conduct of Gambling Please Print Emp. # organization by whom you will be employed 1. Name of organization Organization license number Address City State Zip code Phone Emnlo information- 2. Last Name Legal First Name Full Middle name Previous or maiden name(s) Name you would like to a ear on the badge Soc. Security Number 3. Home Address City State Zip code t - ' S O '�`►1 I�t r1 C� �.�'� t �c` �'l c� u n tl L r� 5 S �(n Daytime phone ( (,� l'� y L ' '-* °f Evening phone ( i L ) `-E -1 Z - ` Yo: - r_s :icn w;th orcanization (check as many as apply) '❑ Gambling Manager ❑ Bingo Collector (hard cards) Seller —Pull -tab ❑ Bingo Checker ❑ Bingo Caller Seller— Paddlewheels Asst. gambling manager ❑ Bingo Sales paper ❑ Seller — Tipboards ❑ Other — Identity 5. Gamblinct employment record for past 3 years. (Use additional sheets if necessary) j n u Employer Address Position held Dates Reason for Termination L Z 1r' c,C r1► Ei r r- 1..,. t - �. 5� X C�`15i n � �.4GU I�l�S�-t�L���L L. "3 S1��er` i1��3 - �l �•z1�t<�� }:�:5� �.� 11 NONE (If you have na prior gambling employment, c "None ". Acknowledgment I declare that this registration is true, accurate, and complete and all information has been fully disclosed. I understand that false and misleading answers are g rounds for denial of the issuance of a picture identific?tion card. Your signature Date Attach this form to the Organization License application, LG200A or Organization License Renewal application LG210OR OR submit when hiring a new compensated empicyee. Include the employee's picture measuring "1 - 1/4 x 1 -314." Mail to: Gambling Control Board 1711 W. County Road B, Suite 300 S. Roseville, MN 55113 This form will be made available in alternative format (i.e. large print, braille) upon request. j iJ 0 ED 0 ,no C) o ti k 0? Minnesota Lawful Gambling LEASE AGREEMENT FOR PULL -TAB, PADDLEWHEEL, TIPBOARD, AND /OR RAFFLE ACTIVITY AT A PERMITTED PREMISES Property O Information' Name of Legal Owner of Property Street Addres% City 5 O. w '7) sT Name of Lessor e Street Address City (Thi may or may not be the same as the Legal Owner of the Property) Name of Leased Premises Zip Daytime Phone Daytime Phone rl s 53V7 (62) Street Address City Zip Daytime Phone 1 " � ' idf cpA LouAcc ± r _Izo W 79"' Cftr60n 0AJ SS3)7 (RL) g3 Y-91(. Name of Lessee (Name of Organization Leasing the premises) GCB License # of Organization Daytime Phone � ll CWkM clal2) 31 - F63n (moo) Rent Information' ' Type of gambling activity (check all that apply) that will be conducted at this gambling premises. 0 Raffles 0 Paddlewheels "M Pull -tabs 0 Tipboards Total rent cannot exceed 51,000 per month for all non -bingo lease agreements with your organization for this gambling premises. An organization may not pay rent to itself or to any of its affiliates for space used for the conduct of lawful gambling. Rent to be paid per month S ,00C) , C) List dimensions of all areas leased by your organization for the conduct of gambling activity checked above, including storage. The leased areas are: feet by feet for a total of 27 square feet. feet by feet for a total of square feet. feet by feet for a total of square feet. feet by feet for a total of square feet Storage feet by (p feet for a total of 2- square feet. Storage feet by feet for a total of square feet. Combined total square footage Submit a sketch (drawing) of the gambling premises. This must show the location of your organization's leased area(s) for the conduct of lawful gambling, including areas leased for storage of your gambling product on this gambling premises. Be sure to write the dimensions of the leased areas on the sketch. TILE DMIENSIONS ON THE SKETCH MUST BE ME SAIME AS THOSE LISTED ABOVE. MN Statute 349.18 Subd I states that the term of the lease may not begin before the effective date of the premises permit and must expire on the same day that the• premises permit expires. ONLY write an effective date in this area of the lease if this is a renegotiated lease agreement occuring during the tern of your current premises permit. Zip SS317 Effective Date for Amended Lease Agreements F_ __j teach LG209 employee photo I Minnesota Lawful Gambling (Rev. 192v93) � here. I he not glue I Registration of New Gambling Employee Do ' I ptctwe to I Receiving Compensation e istratton i for the Conduct of Gambling ' I Stze: 1 -1/4" by 1-314_ _ _ J Please Print Emp. # Organization by whom you will be employed 1. Name of org anization 1 Or anization license number 0t10sk�l �_ , mwtjq �}ocl(�Y . S�C(a�lrn� E�2�c03 Address City State Zip code Phone ' Po� 11 N► LA 0\4' 55311 ( WyM - A 5 Employee Information - 2. ast Name Leg I First Name Fulli Middle name Previous or maiden name(s) Nam�ou w to appear on the badge Soc. Security Number I i zab2trl �l ueJE�L 4T5 -12 - 9-] tt� ' 3. Home A City i date Zip code 1 "�'�a�,lic>cSQti� 1 r1fl \ c JS�t�1 Daytime phone ( �fIZ Evening phone Your position with organization (check as many as apply) ❑ Gambling Manager ❑ Bingo Collector (hard cards) Seller —Pull -tab Bingo Checker ❑ Bingo Caller ❑ Seller— Paddlewheels ' Asst. gambling manager ❑ Bingo Sales paper ❑ Seller — Tipboards ❑ Other— Identify ' S. Gambling employment record for past 3 years. (Use additional sheets if necessary) Employer Address Position held Dates Reason for Termination NONE (If you have bo prior gambling employment, ch "None ".) ' Acknowledgm_ ent_- / declare that this registratiovfis true, accurate, and complete and all information has been fully disclosed. I understand that __false,and mislaaog aAswers are grpunds for denial of the issuance of a picture idenbfic?t card. Your signature � � � �- -� n Date � Attach thislorm to t4`Organiz3tion License application, LG200A or Organization License Renewal application LG2100R ' OR ubmit when hiring a new compensated employee. include the employee's picture measuring "1 -114 x 1 -314." Mail to: ' Gambling Control Board 1711 W. County Road B, Suite 300 S. Roseville, MN 55113 ' This form will be made available in alternative format (i.e. large print, braille) upon request. LG214 (7rz9f91) Minnesota Lawful Gambling Premises Permit Application - Part 1 of 2 Renewal Organization base license number New Premises permit number Orgarc;ezatio � l<r�oFina�a.. FOR BOARD USE ONLY BASE # PP # FEE CHECK INITIALS DATE Class of premises permit (check one) A ($400) Pull -tabs, tipboards, paddlewheels, raffles, bingo B ($250) Pull -tabs, tipboards, paddlewheels, raffles ❑ C ($200) Bingo only D ($150) Raffles only Name of Organization CQ4 Colnrn Busjgess Address of Organza 'on - Street or P. O Box (Do not use the address of your gambling manager) City State i Code County 1 Daytime phone number Mo. 1 Name of chief executive officer (cannot be your gambling manager) Title Daytime phone number �:�UeT . O t t nazi' Bingo Occasions If applying for a class A or C permit. fill in days and beginning & ending hours of bingo occasions: No more than seven bingo occasions may be conducted by your organization per week. Day Beginning/Ending Hours Day Beginning/Ending Hours Day Beginning /Ending Hours to to If bingo will not be conducted, check here Gambling Premises Information Na ,c� of establishment whe gambling will be conducted Street Address (do not use a st off i a box umber) K i 4� PA Lccw( .> 1 FSfi.9 2p�t 53(6 W . q+n �rA C S Mc 5) 3n Is the premises located withiq city limits? � Yes = No If no, is township = organized O unorganized C unincorporated City and County where gambling premises is located OR Township and County where gambling premises is located if outside of city limits CV1Qi1ylQ '!U 0 DX12'�YC� � and of premises City State Zip Code � ? � _ K j.,i= �� c� `7 ��� c��•� c� � v� J1k ,. , 553 Does your rg inn "e building where the gambling will be conducted? = YES NO attach the following: a copy of the lease (form LG202) with terms for at least one year. a copy of a sketch of the floor plan with dimensions, showing what portion is being leased. A lease and sketch are not required for Class D applications Address of storage spa of gambling equipment = oo not 'use a Po � number 1 1 r� Address City State Zip code I c� � , V. _Ck C�c��4��ss� Y�� 553 i-� 1 1 1 1 1 1 1 1 1 1 1 1 AGREEMENT BETWEEN CITY OF CHANHASSEN AND INDEPENDENT SCHOOL DISTRICT NO. 112 RELATING TO TIF REVENUE SHARING AGREEMENT made this day of , 1996, between the CITY OF CHANHASSEN (hereinafter "City ") and INDEPENDENT SCHOOL DISTRICT NO. 112 (hereinafter "School District "). RECITALS • The School District and City have previously discussed the disposition of Tax Increment Financing (hereinafter "TIF ") funds arising out of additional tax levies relating to the issuance of the School District's General Obligation School Building Bonds, Series 1993C in the amount of $15,300,000.00 and bearing a date of original issue of July 1, 1993, and the School District's General Obligation School Building Bonds, Series 1994B in the amount of $31,980,000.00 and bearing a date of original issue of May 1, 1994; and • Certain TIF funds have in the past been transferred by the City to the School District; • The parties desire by this Agreement to formalize the sharing of TIF funds generated as a result of current and future School District referenda and resulting levies; and • The parties recognize that this Agreement is based upon present state law and that the City must retain the ability to modify or terminate this TIF revenue transfer in the event of changes in state law. 43763 NOW, THEREFORE, the parties agree as follows: 1. Commencing with payable 1997 taxes and terminating with payable 2000 taxes, the City will transfer to the School District TIF revenues as calculated according to Exhibit "A" hereto which is incorporated herein by reference. 2. The City will not transfer any TIF revenues to the School District unless and until the City actually receives the TIF revenues. 3. The City shall have the right to terminate this Agreement if changes occur in state law which directly or indirectly effect the amount of TIF revenues received by the City. Dated: Donald J. Chmiel, Mayor And Don Ashworth, City Manager Dated: , 1996. CITY OF CHANHASSEN 1996. INDEPENDENT SCHOOL DISTRICT NO. 112 By: Its: By: Its: 43763 2