90-168 O1 \ � � I N��'' • Council File #� �-�io�
Green Sheet #` �a��
RESOLUTION ��
C F SAINT PAUL, MINNESOTA �j �:
_�
Presented By
Referred To Committee: Date
RESOLVED; That application (ID ��97960) for renewal of a State Class A
Gambling License by Holy Childhood - Cana Club at 408 Main Street,
be and the same is hereby approved/�ri�e�d.
Yg�s� Navs Absent Requested by Department of:
on �
o�� �'_
� acca ee �—
e man �—
une �—
z son �— BY�
�
Adopted by Council: Date JAN 3 0 1990 Form Approved by City Attorney
Adoption ertified by Council Secretary
BY: /`-�fi-
By' Approved by Mayor for Submission to
Approved� by Mayor: Date JA N 3 1 1��0 Council
�
gy; �lh��/,dC'1����i� By:
PI�tISHED ��� 1 � i��d
. � �a��'
DEPARTM[NT/OFFICElCO}I�_ i � f DATE INITIATED ,
Finance%Li �n$e GREEN SHEET No. 5821
CONTACT PERBON d PMONE INITIAU DATE- -- IFIITIAUDATE
�DEPAp7MENT DIRECTOR �CITY COUNCIL
Christine ozek-298-5056 �� �ITy ATTORNEY �CITY CLERK
MU8T BE ON OOUNdL AQENGA BY(DA IIOUTING �BUDOET dRECTOR �FIN.a MOT.SERVtCEB DIR.
1-30-90 ❑tiu►Ya+(o�,�s�srn�m 0 Coun�il R
TOTAL#�OF SKiNATURE PA (CLIP ALL LOCATIONS FOR 81ONATUR�
ACTION REGUE8TED:
Approval o an application for renewal of a State Class A Gambling License.
Hearing Da e: 1-30-90 Notification Date: 1-16-90
pEOOMMENDnnoN :�PP►�W a l� COUNCII. REPORT
_PIANNINO COMMI8SION _ L_""'-�I�QMMI8810N ANALYST PNONE N0.
_q8 OOMMRTEE
— � ..
_STAFF �-
-- -
_DISTRIC'i OOURT _ --�-
---
SUPPORT8 WHICH OOUNqL OBJECTIVE - -
�--_i
fNi7UlTIWG PR09LEM.188UE�OPPORTUN
Jerome B. I
City Counc I � A
Gambling ' i ' n
the houre �
bingo-pu'
ADVMITAOES IF APPROVED:
If Cow � k�ue
to sponsa
j
DISADVANTA(iE81F APPROVED:
REGr IVED
��191990 1
CITY CLERK
D18ADVANTAGES IF NOT APPROVED:
l�ouncil I�esearch Center,
JAN 17199�
TOTAL A�tlNT OF TRANSACTION = C08T/AEVENUE 9UD�TED(CI�E ONE) YES NO
FUNOING SOIIRCE ACTIYITI/NUMBER
FlNANCIAL INFORMATION:(EXPWI�
d(,(/
�' � . . . . . ~ �, ��,. p '
`r _ . . . _
NOTE: COMPLETE DIRECTIONS ARE INd.UDED IN THE t3REENr3HEET IN8TRUCTIONAL _
MANUAL AVAILABLE IN THE PURCHA31N8 OFFICE(PHONE NO.ZN-4225). '
ROUTIN(3 ORDER:
Below ere proferred routinps for th�fivvs m�t frequsnt typss of documeMi:
OONTRACT8 (assurtws authaiz�d COUNGL RESOLUTION (ArrHnd,Bd�tsJ .
budgst sxista) Accept. (3rants)
1. Oubide l�sr�cy 1. Dspartment Director
2. �nni�anp o.percm�n a. eudpM ar.car
3. dty Attorney 9. Gty Mtornsy
4. Mayor 4. MayoNAf�i�tant
5. Flneu�ce d�M�rnt 3vca. Direclor 5. Clly(�ow�dl
6. Flnance/looaiMinQ 6. CMef AocouMaM. Fln�Mpmt 8wa.
ADMINISTRATIVE ORDER �, COIJNqL RE80LUTION �suM ORDINANCE
1. AcNvlty Mer�per 1. IniHating DepertmeM Director
2. A
3. Dep�Atront Oi►�ec.�tornr� 3. Me�Aesistant
4. Budpst Of►ector 4. (�ry.Couhcil
5. qty Clerlt
8. Chief AccounteM� Fln&Mgmt 3vca.
ADMINI3TRATIVE ORDER3 (all othsrs)
1. IMtiatfng DsptRmsnt
2. qty Attomsy
3. Mayor/AssistaM
4. Gty Clsrk
TOTAL NUMBER OF 31(3NATURE PAOES
Indfcato ths N of pegss on whfch sipnaturss mro requirod and pepsrclip
ac�of thees ap�es.
ACTION REGUE3TED
Ds�crfbs what ths p►oNct/nquMt assks to�ccompll�in sither chronolopi-
cal ordsr or ordsr of imporfar�.whichsyer is most appropriate for the
i�ue. Do not wHte�mplete sentenc�s. Bspin each It�em fn your Iist with
a verb.
REOOMMENDATIONS
Complets if the isws jn qu�tion has bsen pressMed bsfae any body� W+blic
or prNMa.
SUPPORT3 WHICH COIJNCIL OBJEGTIVE?
�ndic�e whicn cound�objectl�re(s)rour�lrequs�supports by�isUr�g
tlis ksY word(s)(�'�OUSIN(i. RECREATION.NEK3HBORHOOD3, Et'ONOMIC DEVELOPMENT,
BUD(iET.SEWER 3EPARATiON).(3EE(:OMPLETE UST IN INSTRUCTIONAL MANUAL.)
COUNqL OOMMITTEE/RE3EARCH REPORT-OPTtONAL AS RECIUE8TED BY COUNCIL
INITIATINCi PROBLEM, ISSUE,OPPORTUNITY
Explain the situation or conditbns thart croated a need tor your proJsct
w roqusst.
ADVANTA(3ES IF APPROVED •
Indkxte whether this is dmpyr an snnual bud�st proc�duro roquired by lew/
ch�rter a wheth�r thsrs aro tp�ciNc In wh�h tM�r of 3eint Paul .
arM its dtizer�a will b�fk irom this pro�Ueictfon.
DISADVANTAOES IF APPROVED
What nsyative sffects or major chsn�s to sxisting or past procesees migM
this proJecUrequsst produce if It is pa�sd(e.g.,trafHcc delays, noi�,
tax increasea or aueaments)?To Whom?Whan? For tww long? �
DISADVANTAC3ES IF NOT APPROVED
What will bs th�rNpldiw oo�ssquenc�s N the promi�d action is not
approvpd?Inabiliry b dNiver s�Mce?ConUnued hi�h trafNc, noiae,
soddent'idsT La�e of��venus9
FlNANpAL IMPACT
Alfhough you must teilor the infonnation yau provide h�re to the issue you
are add�sing, in pensral you mu�ensNrer Mro questfona: How much is it
going to cost?Who fs going to pay?
. � (,F�a -���
UiVISION OF I.ICEI�SE AND P�RMIT ADMINISTRATION DATE �a � �� / (`�' /� o �
INTERDF.PARTMENTAL KEVIEW CHECKLIST A.ppn ro essed/Received y
Lic Enf Aud
�vo vr�-Q. � r Z Yn 4 r Z�c,�.
Applicant , I�.►�,,�d_ ��r 111.�C[�j Home Address 13 g � �']C ��n(�
Rusiness Name Home Phone � ��o - a 3 y�
Business Address ' '-t'� /�GttY} c�.� Type of License(s) �G-SS � ' _
Business Phone _��Vy1� ��VID(.l)Cti�
Public Hearing Date I 30 Cj � License I.D. 41 ql ��OC7
at 9:00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. 4t {�IA-
llate rutice Sentr ` Dealer �� �I�-
to Applicant l� l�
I'ederal Firearms �� ��
Public He.aring
I DATE II�SPECTIUN
REVIEW VERFIED (COMPUTER) COMMENTS
A roved Not A roved
�
Bldg I & D �
�,�
Health Divn. �
, '
���
,.
Fire Dept. � �U�� �
i
I �
! S-eh�� �a� i a g�
Police Dept. I
la-l '`t �� ���
License Divn. �
1 �3� � /C�
City Attorney �
� r c� q(�, � l�
Date Received:
Site Plan � c`l
To Council Research / L v
Lease or Letter Date
from Landlord � g
CURRENT INFORMATION NEW INFOKMATION
Ciirrent Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond:
.._
�v'or ers Compensation: -
New Officers:
Stockholders:
� City of $aint Paul
Finance and Kanagement Servicesiticense � Permit Divisioa ��Q���
INFORMATION REQUIRED WITH �PPLIC�TION FOR PER*iIT TO COND(ICT CHARITABLE G�IMBLISG G�►.`4E IY
' SAI:iT PAUL (To be used with the following: ,1ew a b C applicatioa, renew � � C
Licenses, and new and renew B in Private Clubs.)
1. F 11 and com lete name of orgaaization which is a lying for license
, ��Q�1��
2. Ad ress where games will be held t , . � t�cr D�
Number Street City ip
3. Name of manager si g this application who will coaduct, operate and manage
Gambling Games � Date of Birth �� �c����1�
(a) Length of ine manager has been mem er of applicant organization
4. Address of Manager �� � . ��0 �
Number reet . City j. �LiAO��O��
�
S. Day, dates, and hours this application is for � c��s� � 9 9l
6. Is the applicant or organiza 'on organized under the laws of the State of MN? ��,y
• � ��-
7. Date of incorporation ��-
8. Date when registered with the State of Minaesota c:� .
9. How I.ong has organization been in existence? . �
10. How Iong has organization been in existence in St. Paul? 3
11. What is the purpose of the organization?
12. fficers of applicant orgaaization:
Name Name �i2?�� ��•L��
� , /� 6 9�l ��,��'�
Address Address .-
Title � DOB �2 Title � B ���7`L7 �7�
.
Name Name
Address 3 Address
Titl�� � B — � , Title �B
13. Give names of officers, or any other persons who are paid for ServiCes to the
organizatioa.
Name Name -
Address � Address
Title Title
(Attach separate sheet for additional aames.)
� � .�.i �!�' , � . .�
/ � • . .
14. a'ttached hereto is a Iist f names and addresses of all me rs ot cte or iza _c� /� a
�� � X
15. In w e custody will organization's records be kept? /�
,
Na � Address .
16. st a perso with the authoritq to siga checks for dispersal of gambling proceeds:
�
'Name • Name
?,dd�ss� I �', Address
y� Mem er o Member of
DOB�� O ��3 Organization? ���14 , DOB Organizatioa?
.
Name Name
A ress �3O '��.�A�ress
/� i Mem of Member of
DOB � c9° Organization? _� DOB Organization?
17. a) Does your or nization pay or intend [o pay accounting fees out of gambling funds?
yes no
b) If u do pay accounting fees, to whom will such fees be paid?
.3� '
Nam � . ' Addres� � �
�c��B�
�� . Member of Organization? .
c) How are the ;accounting fees charged out? � at fee hourly, etc.)
� o� �
18. Have you r d and do you thoroughly understand t e provisions of all laws, ordinances,
aad regulations governing the operation of Charitable Gambling games? .
19. Attached hereto on the form furnished by the city of Saint Paul is a Financial Report
which it .emizes all receipts, expenses, aad disbursements of the applicant organiza—
tion, as well as all organizations who have received fu for the preceding calendar
/
year which has been signed, prepazed, and verified b
3 ' �' o p �
Address
who is the ^ of the applicant organization.
am
20. Operator of premises where games wi11 b held:
, , /
Name
Business Address d • � �� Do".
.
Home Address
�. :
. _ . . ' /S' u�-� , � � �
=. r��'! L��"�� ��' � /O
� ��. 7�s.-- �9�'—/���
���'���
21. Amount rent paid b applicant ganization fo�eq��thg ha : '
' , .�ll
�� �� � .
. t�
.
22. The proceeds f the games will be dis6u sed after deductirtg prize lalyout costs
and o erating expenses for the fol wing purposes and� uses: � �
� �. � � .
. . : :
. �-
. �
�.��.
. .
ny changes desired by the ppli ant association be made o
the City Council .
Y y with the con nt of
� �4���
Organization Name �
Date: ��'r /—� , gy: �
Manager in Charg f Gam
y � � ,,
,
Orga ization President or 0
X�
�.
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' � City of Saiat Paul Page L
Departmene of Finaace u�d ?ianagemeat Ssrriees ��'/� ('/
' Divialon of Lieenaa and Permit Adaiaiscratioa � 15
ITNIf'ORlt CHAaI'UBLE CJI!lDLINC FINANCIAL REPOIt2
�. a- �'�'
. ��
� 1 11aM oi Orgaaisation �
� � 2 Adds�sa vh�s� Chariesbl� is e�daetad 0 • � �����.
� � ` � �
� � 3 R�post tor pesiod eov�sin= . � 19 tbsou�h • 19 �
� � ��'/.Z�S' „4�.
� ?otal nusb�s of da�s play�d
� ;' .
N � S Gso�a recaipts fos abov� p�riad = `����
0 �
`) � � � Csoas psiza parouts fos abo�� p�siod (ineluda caab a6ost) 3
� � N�t r�caipta - Iin� 5 sinu• lin� 6 � �C�
� 8 Facpana�� iacusred ia eoadueCln; and op�satin; ga�: � a �D� �
� ` A. Crosa vases paid. Attaeh voskae list vieh �t�/�
na'es, addr�sa�a, aso�s vages. n�b�s oE houss S _rr v
vo�ked. and asount paid per hout.
• B. Rent for ��� /� veeks S ���
• T /� /}�
C. Llcense fee ; /D�/`�` v
�� �
D. Insurance �
. '"'`' /D D .d7J
E. Bond �`i� • ����
T. Dishonored ehecks not recovered
: G. Acaounting Facpeaaa = 7 � ���
, r /�,�
H. Fmplcy.r. F.I.c.A. s SGS��
. I. Pnlltab Ta�t Paid to Departa�nt ot Rrrsnua i
' J. tiina. U.C. tax : �
. [. F�d�sal Excisa ?ax i Seasp = + �+
� L. Stata Cmblin; Taa = •D
�� M. Ni�esllanaous Expen�as. Zdtntit� t!u mount
. � . a o,vho� a.
K 1
'� Z. � •
. � : �. :
� ,. : r
. 9. �o�..t �.a... . ror�. : .�3 c7 /
: � 10. N�e Ineos� - liu� 7 ainu• llns 9 ; / • /'
� `11. Cbeekbook balane� ba=iania� ot p�siod i �
t2. Total ot lio� 10 and ll = � •
""� 13. ?otal contsibutioaa (tsoa actached vociuhese) � •
• � 14. Cluekbook balanes ead o! reportinf period - �� /�
� � liaa 12 less lias 13 . : �
� �� ��I�"' �
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�� � �l,�i�6�1� II���
o..� �3 9� 7 � . _
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UfliFaRM (.�yAKiTt�Bl� Gi�1N6lING FI�VA!'IGiAI REt�ORT
� . L�11fUL PURP�SE .CONTRISUTIONS - '+IORKSHE�T �C�Q ��
Line #13 - Total Lawful Purpose Contributions. S �O, eb /.
•. list beiow all checks written from qamblinq funds which are
charitable lariful purpose cantributions. The total dollar
� amounts of these checfcs must match the anrount cla�med in
line �13. Use additional she�ts as necessary.
CHECY � OATE ' PAYEE �CK Al�U � P RPOSE
.
3,s . ,��9 . �o.o , ,��,�
' ir �o 0 o C'
�. � .�6/• �'9•9 � '� • '�„ ' ' „ „ •, .
2. 3 S'd'•� 3 -/°`' " " N ���� .
w . D Od O � i. ♦• ., �• .
3. 3 G o� �./o_ .,
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4. 3��/ ��`� „ ., " u�a o�,� . � -
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5.--�L�9 e��9- •• �• �- �000.o . � , ,, ,�
�i 3� ,, �• 4 3,�5"0 0,0 � ,:
� � � � /- . ' �poo � ^ .,
6 . �� „ y �
3 ` �� ��,��
7. ,�S000 . ., .. N'� � .
a •
�/�,� �. '� i 4 i� '� � •
s.3 �l'� 9� q _ o_ �, y , `s',''o 0 0,0 . •• � .
.3 �,3 0 /o / ,,
• �. �-o 0 0,o '•
9 3�,�s',�. ��_i� 9 ., ,. o 0 0 o a � . ��
• �
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3 � . _ ,, � ', �� G�O
1 �7 v � �_� !f II y /•S+ � I, •
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3 �' —" � ��,z�� ./o.� �
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'2 3 f.3 �; �p_9� , . �; . I►
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13 . fA_��� a i� N '�� I��
TOTAL CHECK A1�UNT S ���
NOTE: These expenditures will be provided to Cauncil Members at your Council hearing.
� Be s that your financial report is complete and accurate.
� Kv _ : r n s � '��
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