90-233 � 0 R I G r�tA L. Council File # �Q-a3,3
Green Sheet # ,'��Oo'�
RESOLUTION
CI OF AINT PAUL, MINNESOTA �7.J
�
Presented By
Referred To Committee: Date
RESOLVEDC That application (ID ��92720) for renewal of a State Class A
Gambling License by Friends of St. Peter Claver at 1494 No.
Dale Street, be and the same is hereby approved/denied.
�II
:
�Y .� Navs Absent Requested by Department of:
imon -�—
osw
on —
ac a ee
� e man �_
une
i son � BY�
Adopted by Council: Date FF R i � t� Form Approved by City Attorney
Adoption Certified by Council Secretary By: I �, ��3e,�—��
By' �'� Approved by Mayor for Submission to
Approved by Mayor: Date ��Q � � »g0 counc��
gy; ,�%I�z.�;/�����/-�`' By:
I
1�1°�"��:��� .,,_ � ; 1990
" � ' • (.�/` !U�'i
DEPARTMENT/OFFICE/COUNqL DATE INITIATED
Finance icense GREEN SHEET NO. 5802 �33
CONTACT PER80N 8 PNONE / �NITIAU DATE INITIAUDATE
�DEPMTMENT DIRECiOR �CITY COUNGL
Christin Rozek 298-5056 ��p ��AITORNEY �CITV CLERK
MUBT BE ON COUNCIL A(�ENDA BY A1'� ROUTINp �BUOpET DIRECTOR �FIN.8 MOT.SERVIf�8 OIR.
2-13-90 ❑�voR�oa�srnwn �]�,�„t R
TOTAL N OF 8iGMATURE GES (CLIP ALL LOCATION8 FOR SIGNATURE)
ACTION REOUE8TED:
Approval of an application for renewal of a State Class A Gambling License.
Notifica ion Date: � � � Hearin Date:
RECOMMENDATIONB:MW�W a lRl COUNCIL MITTEE/RE8EARd1 t�PORT OPTIONAL
_PLANNINO COMMI3810N CMl SERVICP OOMMISSION ��Y� ��.
_pB OOMMrtTEE
_STAFF �ME�:
_DIBTNICT COURT
SUPP�iT3 WNICFI WUNqL OBJE ?
INITIATINf3 PROBLEM.18BU@. 11'Y(YVho�What�Whsn�VIfMro,Why):
June Hus ek on behalf of Friends of St. Peter Claver requests Council
approval of an application for renewal of a State Class A Gambling License
at 1494 0. Dale Street. All fees and applications have been submitted.
ADVIWTAOES IF APPI�VED:
DISADVANTAQE8IF APPROHED:
RECEIVED
�EB0519A0
CITY CLERK
D18ADVANTAOE3 IF NOT APPROVED:
�ouncii Kesearcn (:en�ter.
FE8 0 21990
TOTAL AMOUNT OF TqANSA : C06T/REVENUE WDOETED(qRCLE ON� YE8 NO
FUNDINO SOURCE ACTIVIT1/NUMSER
FlNANGAL INFORMATION:(EXPLAIN)
dcv
. � � �� � , (.F qo -�3
, G 1
UIVISION OF LI I ENSE AND P�RMIT ADMINISTRATION DATE �c� /5 0 / /01- o�U y(�
INTERDF.PARTMFI�T�AL REVIEW CHECKLIST Appn roc ssed/Receiv d b
� Lic Enf Aud
(� Jun-e. �us�.�� ,�
Applicant �I��Qh�S U-� o�'�� 'f'P���u�r- Home Address Jb'3 ft�. J�GKni�ht►21� �'�-/-1--
Rusiness Name I Home Phone `�� � — o� �-{�]t..�
t
Business Addre�s �yG1 � �v� (��� �� Type of License(s) C �G1SS � -
Business Phone �Gm 1��1na L� p �E: l�-2i'�PUJti. �
Public Hearing Date �- 13 �� License I.D. 4� q a� a�
at 9:00 a.m, i the Counc 1 Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �� Il} �/.}-
i
llate Notice Se t; q Dealer �l �'��
to Applicant � a`' l U
I'ederal Fisearms �6 �l} P�
Public Hearing
DATE INSPECTIUN
REVI�W VERFIED (COMPUTER) CUMMENTS
A roved Not A roved
Bldg I & D +
� � �
Health Divn. ,
�
; u�� :
�
Fire Dept. � �
� �{� I
�
� se�I �-Ja� ��
Police Dept. f
� �
License Div . �
� � � �� I ��
City Attorn y � �
1 �j �1� � �l�--
Date Received:
Site Plan C�- � t)
To Council Research „� � � � t��
Lease or Lett r ` _ �± Date
from Landlord I a- �� � ��
��
�
CURRENT INFORMATION NEW INFOIZMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
• • ' . . City of Sainc Paul /,�—,p� a33
Finance and �ianagement ServicesiLicense S� Permit Division ��' � �
INFORMATION REQUT�RED WITH APPLIC?.TION FOR PER�iIT TO CONDUCT CHARITABLE G�,MBLIVG GA.`�iE IY
SAI:iT PAUL (To be used with the following: ,Tew a � C application. renew � S C
Licenses, aad new and renew B in Private Clubs.)
1. Full and co�plete name of orgaaiaation w6ich is applying for license
2. Address where games will be held o��}.cl �t�. ��L,�.,�. �,t. �Lu-� �S /i '7�
Number Street ty p
3. Name of man$ger signiag this application who will conduct, operate and manage
Gambling Gatnes Date of Birth ��- � - o"��
(a) Length af time manager has been member of applicant organization �a�.
4.. Address of �ianager /� I�. �� � •� • �-� 4�� �� 11
' Number S eet City Zip
I and hours this a lication is for '7"dv - :/.'oU S� �'�
5, 1ay, iztes, r!
6. Is the appl�icant or organization organized under the laws of the State of MN? �Q�
7. Date of inc�orporation i 9�t�
8. Date when registered with the State of Minnesota � � ��
9. How Iong h$s organization been in existence? � � .�-a�
10. How long hAs orgaaization been in existence in St. Paul? �� �-vYt�tJ. _
lI. What is the purpose of the organization? � � �"�
�� � �
� � -M�-���
I2. Officers of applicant organization:
� , '
Name ��..-�- /�--��G � • Name �.,ir,_s� �
Address �D�i ���J �� Address i S 3 �
Title °(� �'�� D DOB -�- i� - 3 3 Title .�-�s-o . DOB a�- � - �v
Name ( � �'� - Name �2c.c-.�a� �
� y�
Address �,�_ li�.�� � a�� Address Z •z a� J�-�-�-�-��*'y✓
Title �ch-�-✓�J. DOB o"'� - � -�� Title ��adf• �a� �B �-!9�- '�'7
13. Give names� of officers, or any other persons who are paid for SerV1C85 t0 the
organizatibn.
Name Name
Addrass Address
Tit1e Title
(Attach separate sheet for additional names.)
. . . � �yo a,�.�
14. attached hezeco is a Iist of names and addresses of all members oi the organizat�cn.
15. In whose custody will organizatioa's records be kept?
Name � Address /'�� l(J . l o J _ � �a��
16. List all pe�rsons with the authoritq to siga checks for dispersal of gambling proceeds:
�Name ('.� G��"�-t�l�-a-�C-cJ Name
?,ddress � S� � � a
Address /'8� �lJ. �� � )�� � .
Member of �/ Member of
DOB �- g • yf� Organization? � �B �-� ��`�- Organizatioa? ���
Name
Name
Address Address
Member of Member of
DOB Ozganization? DOB Organization?
17. a) Does your organization pay or intend to pay accounting fees out of gambling funds?
yes s� Il0
b) If you do pay accounting fees, [o whom will such fees be paid?
Name .w.�c�
�,(�� Address �� / � � ' � �
DOB � D - i �o - -t-L,� �Iember of Organization? _`,�
�-
c) How axte the ,accounting fees charged out? (�flat fee, hourly, etc.)
�-
Lg. Have you �ead aad do you thoroughZy understand the provisions of all laws, ordinances,
and regul�tions governing the operation of Charitable Gambling games? -�-��
19. Attached �ereto oa the form furnished by the city of Saint Paul is a Pinancial Report
which it .emizes all receipts, expenses, and disbursements of the applicant organiza-
tion, as well as all organizatioas who have received funds for the preceding calendar
year which has been signed, prepared, and verified bq �-�-�
J
/ ?5 � !l� ��"1C'_ T"�' •^.� O�-dL � J �.
Address
who is th�e ��'� • of the applicaac organization.
Name
20. Operator of premises where games will be held:
Name . �-�-E�- '
Business IAddress � � �l � � �� � `'�
. j� %'y�
Home Add�tess a 9''y 5�v �� �"�
_ . . � �90 _a,��:
21. Amount �f rent paid by applicant orga�ization for rent of the hall :
� �? . . . : . . : : . . . . . . : . . : . . :. . . . . . : : . . .
�_G�''"�.
22. The pro�eeds of the games will be dis6ursed after deducting prize la�yout costs
and opefiating expenses for the following purposes aRd� uses: � � �
• � ,,::�,� _-s�.��,L o7 r,�; . . . . . . . . . . . . . . . _ • J
^��1� -- �
.�
...�� ✓n-�-�°�-t�✓• --
Any changes desired by the applicant association may be made only with the consent of
the City Couhcil .
�J �v�Lt.c.
Organizati n Name
Date: � ' / �`ll � 1� BY:
Manager in Char of Game
� � � .
Organization President or CEO
v e+ � . � .�. n ^ p- c�
a� a �-co �o c s � or w � c
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� , , • Cltq of Saint Paul Page i
Deparement oI Finanel And Hanatement S�cvlee� �9U��,3 3
Divi!!on oE Lielnle !od Plroit Admini�ttation �i�
()t7iFORH C7tARITADLE CAMDLINC FLNANCLAL REPOR?
� Dit! ��
l. illsm� ol Or�enisition �f l 1n.O�S d� J� ��` � ���'� _
2. IAddtis• vhe N Cfiaritabl� C��blin` !A eondnctld ^_ n1',Q CI � �
�. Report for p�riod co��tin`� 1�� ' t�� lhtouah �OU � —�; � 1
b. '�Totil number oE days plapad ��
� . , ��j '�7, ��3.��
S. 'Croii cieiipe's toc �bovi p�ciod
d. CroN arili p�routl tor abo+� P�ried (ieelud� e�ih ihocf) � �� 11�-�G�. �V
� 7. ,Ni! ticiiptl - lin� S iinu� lie� 6 f `� � '
d. �xpiese• incurred in eonductine and ep�ratin` tii�!
A. Groe� va�e! paid. Attaeh vork�r li�t vith
nam�s. iddriase�, �ross vases. nwb�t ot honr! � ��C C'L
vorked. and soount paid p�c hont.
• �. Rent for veek� �GZ-1Q �� ��� �
C. LicBn�� E!e � �����
D. In�urance }
E. 9ond # ��j�'���
T. Distionoted cheekA not reeot�[ed s � ��� C�
C. Aeeountin� Expeasl � ���•�
. tt. �P�o�.ti r.t.c.A. ;
I. PullEab ia�c paid to Depart�ent ot Ri+�nu� � � �� ��v�
� J. Ninn. V.C. ti: : ' ��•��
. t�. r�a���� ��ir+ Tu a s�..o ! .�/3 .S°I
L. 3llt� Casblin# iVt 3 � S-1�•�v
. N. Nlsc•ilaeioue E�cpans�s. IdMntil� tl�� iiouat
!nd eo �ho� Peid.
i. �1�.Tc�OS Znvt'�r.� : v�a�`�•��
z. '�1�iS�-- S�pi�,es s 5ao.�l�.
3 13a.�..k c��.c��� � cJ.v o
a. �'�u.:;,(� �c°,v�- � 5��.s�t►'
��.,;�,Y �5�..� � l, 0.5�.9�
9., iot�l l�cp�e�i• tOTAL �
10. 11�! Ieco�� - lin� � ainn� lie� 4 � �� ���"`3�
ll.i Ch�ckbook b�l�aei b�tianins et p�:led � �'(�v' "`--�
(2.j ?otll oE lie� 10 ind 11 = ��' �5���
••� 13.i Tot�l coatribution� (iro� atuehed vorki6�lt)
, 3 �,� c�.� ►
. . 14a C1+lekbook bilanca ead ot reportint p�riod — � � 4p��-�O�
• lin! 12 lesA 1lnA 1] •
. , . UNIFaRM i.�-i�Ri iA3�� �aMBLING �ii�ANl:ir�L i�E�UR+ #�
' LAWfUI PURPOSE CONTRIBUTIONS - WORKSHEET �
Line #13 - Total Lawful Pur,pose Contributions. g 3 5��5,�
• Li�t below all checics written fran gambling funds whichla�e �yp-o233
charitable lawful purpose contributions. The total dol
� amounts of these checks nast match the amount claimed in
line �13. Use additional sheets as necessary.
CNECK� D�TE � PAYEE CHECK AMOUN PUR_
1. ''1''7 a.. ��+�18� ��' .�� CI�.�wCh�►�, 1 ���:�-F`"1 S�pbr�-o�t�,I��eo.,s�S�ish ti�-d
i. � � � i � . +i
, � �-�-��er- C�a.�.�rCG,�.,- aia�.8'1 � •
2. 7Ss 1a��8�
3. . �aq ��.si�; ��."���� Ci�.�-ci�c. a�a.�.sa
a. ��J`� ��-3189 ��.���- �i�.�c�. a3��.3 y-
5. g �� �J�� �-�.�e�er- C�.���� �i�.3�L.
6• �d.3 `���c�$°t �-�-�1 e�tP,�''C�A,�''Cl�urr (o�lu�•S S
�. g3v �I��I fl�i ��_�c�,�er C-�-�"C1''.u.Y��, 3 iq'l• ��C
s. ��w '�1��I� �4-. �� Ci�c�� �-��3, i o
9. g� gl�I�� 5-�-:���- C&�.�ch�Q. ►�si- a3 .
� �.�C��,h '75�,oa.
�o. 8s� �o� lg�c �.��-e,�
��. ��a� ql�sl� ��-. ��-�c-i�,�-c.��-. 33 �.c� r
�2. gi�I �°�rR� ��.��� '`lc�C�.�ct.
31�Q.33
13. �'l0 �'�obl8q ��'�e�.�' C�CL��rCh�.D. (�3�►•'lS
��. $�8 ��r�l�s`1 �-��Gr- C:l�t'-C�.�, 1�D3.�?9
� TOTAL CHECK ANbUN7 3 3� ���
NOTE: These expenditures will be provided to Council Members at your Council hearing.
Be sure that your financial report is complete and accurate. .
� 3 , . �.
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. . UN[FORN �.-�aRti�B�� G�MBIING �ii�A�II;iAL RE�URi�-- � � ..�
' ! LA1rFUl PURPOSE CONTRIBUTIONS - WORKSHEET � °
. . . �g�,�5-
Li ne �13 - Total Lawful Pur,pose Contri butions. �°� �� �� (G �•c��
� Lis� below �11 chpcks r+ritten ft�rnn gambl ing funds rrhich ar� J�' �j4 -a33
charitabl� lawf�l Purpos� contributions. The tot�l dollar
Amounts of these checks must n�tch th� amount cl�imed in
linp #13. Use additional sheets a5 n�c�SS�ry.
CHECK � OA!TE � PAYEE CNECK AMOUN PURPaSE
� 1. ��� �'���Ig� C;� �-� S�-.�i� �9'`? C►� `�(�,�•. -�.�.,,�
� 2. �q o �1J-1 i� C�� o� S��a.r;.�[ 1��,r7"�-� �+� t�o��.�u.���
�3. -�Ict�`I ��-SI�( C.�� o� S.(..�� I b�l.`7 G� C,� �o�:�.. ��-�%'
�4. �5 �1�3j�', C�� cr� S�-.t�-� I�'-�. �� C:; � �c�- ���
5 . �31�;0 ��[al� �'•-�r�u.c�� �Hu�L�e1Cf�.c.� IR��-o y o,.�r-t•. ���
6. �"�� 1 i I�I S'�i IYto.x�u.i�.c� T,�nerC��
�?,y�.(�1 �cw� �"�=cX-�.j
7 .
8.
9. .
10.
11.
12. .
13. �
� �� � ,� � ` TL O�L CNECK AMbUNT $ 8�.� .
� �J` �-✓► cn-,
NOTE: These expenditures will be provided to Council Members at your Council hearing.
Be sure that your financiai report is complete �nd accurate.
� . �
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