90-57 WHITE - GTV CLERK
PINK - FINANCE G I TY OF SA I NT PA iT L Council ,/
CANARV - DEPARTMENT .�� �L]
BLUE - MAVOR File NO. D v �
� ��� Council Resolution ���; `
'� � �_
�r..�,,
Presented By
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #91195) for the transfer of a Gambling
Manager's License currently located at Joses' , 825 Jefferson Ave. ,
Susan M. Purvis DBA Highland Area Hockey Association, be and the
same is hereby approved for transfer to Tiffany Lounge,
2051 Ford Parkway.
COUNCIL MEMBERS Requested by Department of:
Yeas •mo Diir oand
g Goswitz � [n Favor
� Long q
Re an
Sch be► Maccabee Against BY
� n Rettman
� on Thune c1
W JAN �7�d Form Approved by City Attorney
Adopted by Council':�'1SOri Date g '
Certified Ya.s o ci ret By ��Z���
g},
Approved by vor: Da ,�� � � 19�� Approved by Mayor for Submission to Council
g /,�t.��e�%�r1',�'a��( _ By
Y
�t�.1SHE0 �A N 2 01994_
J I
-, � � � , 4 �� �
� � , � � �
` �
DEPARTMENTIOFFlCE/COUNCII " DATE INITIATED ��
Fi nance/�i cense GREEN SF��' � � 4 _
� -.,,�.�- �,e.-�,:+�t�e+pt'� --
CONTACT PERSON 8 P►IONE � DEPARTMENT DIRECTOR �GTY COUNpL
Chri sti ne Rozek-298-5056 N�� �GTY ATTORNEY �ciTV c�K
MUST BE ON COUNqL A(�ENDA BY(DA ROUTINO �BUDOET DIRECTOR �FIN.3 MOT.SERVICES DIR.
1-9-90 �Nu►voR coR nssisr,urn ��n.Gi 1
TOTAL#�OF 81GNATURE PA (CLIP ALL LOCATIONS FOR SIONATUR�
ACTION REWESTED: D L�
c7
Approval o an application for transfer of a Gambling Manager's License.
Notificati n Date: 11-29-89 -
REOOMMENDATION3:Approve(A)a Rejsct ) COUNCIL COMMITTEE/RESEARCH REPORT OPTiONAL
_PLANNINO COMMISSION _ L SERVICE COMMI3SION ��YST PIiONE NO.
_GB COIUMITTEE _
_�� _ COMMENT8:
_DISTRICT COURT _ ' .
SUPPORTS WHICH COUNqL OBJECTiVE9
INITIATINO PROBLEM,ISSUE,OPPORTUN (Who,What,Whsn,Whsre,Why):
Susan M. P rvis DBA Highland Area Hockey Association at Tiffany Lounge,
2051 Ford arkway, requests Council approval of her application for the transfer
of a Gambling Manager's License currently located at Joses' , 825 Jefferson.
All fees a d applications have been submitted.
ADVANTAQEB IF APPROVED:
If Council pproval is given, Susan Purvis will manage the pulltab/tipboard
sales for H'ghland Area Hockey Association at Tiffany Lounge.
DISADVANTA(iE8 IF APPROVED:
I� -
' �;ouncil Kesearch Center:
RECEIVED
UkC 2� 1989 9,�
�� �
. Cl f Y Cl.EkK
DISADVANTAOE8 IF NOT APPROVED:
�
�
I
TOTAL AMOUNT OF TRAN8ACTION :� WST/REVENUE OUDOETED(CIRCLE ONlj YES NO
I
FUNDIN�i SOURCE ACTIVITY NUMBER
FlNANCIAL INFORMATION:(EXPWN)
� �/Y
r � ��. �
' � ��o-�
DiVISION OF LICENSE ANI) P�RMIT ADMINISTRATION DATE �t � 3 �y/ l� JJr � I
INTERDF.PARTMFNTAL REVIEW CHECKLIST Appn Proce sed/Received by
Lic Enf Aud
�
Applicant �(,(SC�r1 M . �u r(>15 Home Address /(o�� �)Ci.tS(�7
Rus ine s s Name �-�t c�h I cc n� ���- �����ome Phone C� ! v � 5 a��
Business Address ��-1-�irl 5 Type of License(s) �$ G vn ���n�
aDs� or� �li-+�
Business Phone --� � q S r v � CG���
Public Hearing Date
� '�j �� License'I.D. 4F � � ( ��
at 9:00 a.m, in the Council hambers,
3rd floor City Hall and Courthouse State Tax I.D. 4� ��,�
llate I�utice Sent; Dealer 4� � �'
to Applicant � a g 5
Pederal Fi.rearms 4� �
Public Hc-�.iring
DATE IrSPECTIUN
REVIEW VERFIED (COMPUTER} COMMENTS
A roved Not A roved
�
Bldg I & D �
N��
Health Divn.
� ��R �
�
Fire Dept. � �
I � I� �
�
Yolice Dept.
� Sen t� fl �i5 1g 1
i I I j!a � � `7 ���
License Divn. � p ��
►�� n��;
City Attorney ,��Zt,�� i o�
Date Received:
Site Plan �I4' , �� ��
To Council Research
Lea�e or Letter Da e
from Landlord �I�
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond: -
Workers Compensation:
New Officers:
Stockholders:
if , _ -^
. � Ya n S-�e r /�4 n a�e r -
' � .a-p (`1 p cJ L,o c a�dyl
�9a�.�7
CITY OF SAINT PAUL
DEPARTMENT OF FINANCE AND MANAGEMENT SERVICES
DIVISION OF LICENSE AND PERMITS
APPLICATION FOR A CHANGE IN GAI�LING MANAGER
The applicant must return this application form, requested supporting
documents and the required fees in person to Room 203 City Hall. Make
an appointment with Christine Rozek, 298-5056, to bring in your
application and to review City gambling rules.
Date: �OVew�he.�i' 1. 198�j
1) Full and complete name of organization:
iT��N l.A-I�t� �2EA- �tbc_KeL �SSOGt a_.I � r1�n
2) Name of licensed location:
��4�kN��S
CURRENT MANAGER INFORMATION
3) Name �,�,y� �(�� � l,l.trV I S
' - First Middle Last
4) Address l(055 1.��-rso� �ldE - S`I', P,4.u.�_ Mt�l �v5 I l(o
Number Street C ty Zip
5) City of Saint Paul License # "�c�o�7
NEW MANAGER INFORMATION
6) Name
First Middle Last
7) Date of Birth
8) Address /
Number Street Citq Zip
9) Phone � `.� Phone i�
Home ` Work
10) Member of organization since:
l�onth Year
�
11) Fidelity Bond: i
Insurance Companq Bond Number
. . : c�q�--,��
CHAN6E IN GAlrBLING MANAGER
PAGE 2
State of Minnesota)
) ss
County of Ramsey )
� �� and ��d,�. � - .t,u��
being duly sworn y that they are the petitioner(s) in the above
application; that they have read the foregoing petition and know the
contents thereof; that the same is true of their own knowledge.
Subscribed and swom before me this
�3V-l."day o f 1.1 u�-�.n-,la�� 19 8�J ��..,,.:•ti
g /`+J:...Sf .
Q-+t.�a�^�LJ � �� ��3t_'�.'��`
� My Commission E�,;,r_�;�.,:b. ..,. ..:�+ �
Notary Public, Ramsey County, Minnesota • '
My Commis s ion Exp ire s (�t S �
12) Attach a copy of the bond to this application.
3'�9�Attach to this application proof of inembership in the organization
for at least the most recent two (2) years.
14) Gambling Manager applications must be approved by City Council
before managerial duties can begin. Allow 30-60 days for
processing and investigation. This application is not a Iicense
to operate. You will be notified by letter of your hearing date
before the City Council. We suggest that you attend the public
hearing.
15) Attach a letter from the President or CEO of your organization
requesting the gambling manager transfer and explaining the
necessity for such a transfer.
16) 1989 Gambling Manager transfer fees are: � 3 �, $ g
7/89
� ' .. . � . _ — . ts � " _.- . -
� �, _ i I �
' City of Saint Paul
� Department of Finance and Management Services
, License•and Permit Division �Q—,57
203 City Hall
. . St. Paul, Minnesota 55102-29&5056
: ,. � APPLICATION FOR UCENSE �
'.��CASH CHECK . CLASS NO. . New . Renevr ....,.; ., . . . . � . ;� �'
� 0 � � � �:..:-Q� Q ° - _ � :,��
�ca .. . . . . . _
,� . . o�t. �� ,C3 ,9�
.. __ . �
.' ;�'. . . . . -� - j '.... ..,.:,
� Code No. . Tttle of License � � - From. '� 19�To — � 18�
a b '' ' � /,,�� .
.
., ,00 ��;a,�,t, m �9' .
- AppliwnUComparry Nam� '��
--- '°° �� GGa�c�
• 100 siMSS Name '
. " . �_ ,� , � -D- ' � �6
,r .Businesa Address Phoo�Na
,� 690-,S,2�G
� .�.. � /��� / �;��J�•�
100 Mail to Address PhOns No.
. �
to0 �i���.J /�'I �.L��aJ . ..
� Ma�apedOwne�•Nam� '
100
. 100 AtanagedGwner-Mom�Address Pnon�No.
4pg8 AppQeatfon Fee 2 gp
Fieceived the Sum of 1� �
ManaqedOwner•City,State d Dp Cod�.
100 Totai 100
.
Ueense Inspector � �'`� gy; S►ynsture oi App�ieant
�BOnd• .
Company Name Policy No. Expintion Oat�
Insurance• �� �
Company Name Polley No. Expintlon Date .
�Minnesota State Identificatfon No Social Secuuty No _
Vehicle Informatiom
S�rialNUmb�r - aMN�NnD�r
Other �
THIS IS A RECEIPT FOR APPLICATION . J. - '
THIS IS NOT A UCENSE TO OPERATE.Your appllcation for Itcsnse wili either be granted or rejectad sub�act b the proviaions of the zonlnq .
ordinanes and completfon ot the inapectiona by the H�a1th, Fin.Zoniny and/or Lies�se Insp�ctors.
. , ,`.` . _ ; _._. _
� . .. - . , z f_ � ' � .. . -- ,
� . � . , .- ,%I - . �1�.00.CNARG� FOR �AtL: RETIIRNEQ�'CHECKS �:,, � - : �
. .� .� . � . , . ,:� �qaa� . _ ;
, � •
; � .
.��te.� /�/l S�9 � �
� � � � � y�_��
HIGHLAND AREA HOCKEY ASSOCIATION
�lOVE.'lll�`�l" ? y i`3��
r:ir��J�.. .�� ��L'���
......:.� ... �`'�... . ;'�aU.�
�z�e�'."±'�1lC:-�... O'� , l�iun.�� :�nr�
Mana�eiTl�i�t Serv�.C;@8
G�v�.Si��t� �: ` �_c�^5E', anc� Per-^itS
Oea�r Mrs . r�oz�k =
;,::�n'�a�d ^��a .-;oc:�ey Assoc:,aticn requests a trans��r of ����e Gambling
�lar�ager :.icens� of Susan M . Purvis from �oses , 825 Je�ferson A�e , St .
�aui , "iN 55�.02 �0 7i`fany "� 3ar �rd uril:. at 20�:. F�rd Par !<way , St .
Paui , MN 5511� .
'"nis request i� made due to a termir.at:.cn ��f �us���es� ac�ivi���s at
Joses effective October 31 , 1989 anc! the resuin�tion of ac�ivit;�.es on
or abo�!t February 1 , 1990 at 7':�fa,,y '� ,
Thantc you .
2es�;�ctfuilY ,
�.J�.
Davia r�oz��
Pr?si�aent
Higriand Are� Fioci<ey Association