90-271 O R I � I 1 Y A �., Council File # �a 7�
Green Sheet ,�
RESOLUTION
-- OF SAINT PAUL, MINNESOTA �q
, �
Presented B�
Referred To ` � Committee: Date
RESOLVED: That application (ID �689897) for renewal of a State Class A
Gambling License by Holy Childhood Women's Club at 408 Main Street,
be and the same is hereby approved/denied.
as Navs Absent Requested by Department of:
on ,��
onw '_'"�`_
acca e ��—
e t maz� �T_
-3' u� � By:
i son
Adopted by Council: Date
FEB 2 0 199Q Form App oved by City Attorney ,
Adoption Certified by Council Secretary gy; � /' ���a
�
I
BY� �� Approved by Mayor for Submission to
Approved b Mayor:' Date �B 2 � ir�r��1 Council
J
� _ _
By: �"� By�
� PUBtISNED t,�;:�.;�; __ � �9 90_
I
TO CITY COUNCIL COMMITTEE: �
� FINANCE, MANAGEMENT & PERSONNEL
❑ HOUSING& ECONOMIC DEVELOPMENT
❑ LEGISLATION
❑ PUBLIC WORKS, UTILITIES 8�TRANSPORTATION
❑ COMMUNITY&HUMAN SERVICES
❑ RULES& POLICY
❑ HOUSING& REDEVELOPMENT AUTHORITY
�cYACTION
❑ OTHER
DATE �
FROM
- �-yo-���
DEPARTM[NTIOFFlCE/COUNCIL DATE INITIATED
Finance Li ense GREEN SHEET No. 5818
CONTACT PERSON A PHONE INITIAU DATE INITIAUDATE
�DEPARTMENT DiRECTi�R �CITY CWINCIL
Chri ine ozek-298�SOS6 ��q �C�T�'ATTORNEV �CITY CLERK
MUST BE ON COUNpL AOENDA BY(OAT ROUTINO �BUDOET DIRECTOR �FIN.8 MOT.SERVICES DIR.
2-20-90 �MAVOR(OR A8818TANn 0 Council Research
TOTAL N OF SIQNATURE PA (CLIP ALL LOCATIONS FOR SIGNATUR�
ACTION REpUEBTED:
Approval o an application for renewal of a State Class A Gambling License.
Hearing Da e: 2_20_gp Notification Date: 1-29-90
RECOMMENDATIONB:Approve(Ia a (R) COUNCIL OOMMITTEE/�EARGi f�POiiT OPTIONAL
_PLANNINf3 OOMMISSION L SERVIC�CO�AMIS810N ��YST PHONE N0.
_CIB COMMITTEE _
COMMENTS:
_STAFF _
_DISTRIC'T COURT _
SUPPORTS WNICH COUNpI OBJEC'TIVE
INIIUTINCi PR08LEM,ISSUE�OPPORTU (Who.NR�p.WMn�WMrs.Why):
Jerome B. rzmarzick on behalf of Aoly Childhood Women's Club requests
City Counc 1 approval of their application for a State Class A Gambling
License at 408 Main Street. Proceeds from the gambling session are used
by the chu ch and school for operation, etc. All fees and applications
have been ubmitted.
ADVANTAOES IF APPROVED:
If Council approval is given, Holy Childhood Women's Club will continue
to operate a gambling session at 408 Main Street.
D18ADVANTAOE8 IF APPROVED:
RECE�vFr�
.
�609i9,90
DISADVANTAOES IF NOT APPROVED:
��ur-ic�i tcesearcn c;ent�r
FE B 0�.1990
TOTAL AMOUNT OF TRANSACTI a COfT/REVENUE elJDOETED(CI�E ON� YE8 NO
FUNDING sODURCE ACTIVITY NUMBER
FINANGAL INFORMATION:(EXPWI� ���
�� �I
. . . . . @��o a��
UiVISION OF LIC NSE AND PERMIT ADMINISTRATION DATE / yL� l � /�. CJ(�
INTERDEPARTMF.NT L REVIEW CHECKLIST A.pp Processed/Rec iv d by
Lic Enf Aud
/� f ' �FVO�'►'�L' l�r n�G✓Lrc.L
Applicant �G� � l��i 'Q �,(�r)1�'r1S . Home Address /� �7 �L �i��1Py �t"
-Z/u b +�T
Rusiness Name Home Phone
Fusiness Addres ��� p��%� � � Type of License(s) ��GSS �� ' �1G��16��hG�
I /
}3usiness Phone Li �ns� ���'(.0�� J
Public Hearing ate .2 oZf� � License I.D. 4� � �1�� �
at 9:00 a.m. in the Counc 1 Chambers,
3rd floor City all and Courthouse State Tax I.D. �t ��/.�.
llate Nutice Sen ; Dealer 4� lU�A,
to Applicant �"o`Z�-
I'ederal Firearms �� � �'�
Public Hearing
DATE IrSPECTIUN
REVIEW VERFIED (COMPUTER) COMMENTS
A roved Not A roved
�
Bldg I & D �
�U�4 ,
Health Divn. '
�,1� �
,
Fire Dept. i �'� �
� f
Police Dept. I Se ��� 1�C�u
� � � ►� ��v o�
�
License Divn. �
� a ���v� o
City Attorney �
��3 G� � + ?�L/'
Date Received:
Site Plan � � �? C'
To Council Research � � � � ��
Lease or Letter q Date
f rom Landlord � I� 1 �
CURRENT INFORMATION NEW INFOI2MATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond:
- Workers Compensation:
New Officers:
Stockholders:
• ' ' - � City of Sainc Paul
inance and :ianagement ServicesiLicense S� Permit Division �C���rf�
iNFOxMATiOV REQUI ED wITH �P?LiCaTION FOR PER.�iiT TO CONDUCT CHARITABLE Ga.�L��G Ga.KE iv
SAI:tT PAUL (To b used with the following: :Jew A � C application, renew :� S� C
Licenses, and new and renev B in Private Clubs.)
1. Full and com ete name of orgaaization whic is ap lqing for license
,
/
, � �f�0,2�
Z. Add ess wher�e games wi11 be held 0 '
Number Stree � ci y iP
3. Name of mana,ger signin this application who will conduct, operate and manage
Gambling Gamles Date of Birth ,� �.��
(a) Length qf time manager ha een member of applicant organization � •
4. Address of Manager � � � ' �' 3•
Num er Street � City Zip
S. Day, dates, 'and hours this applica[ion is for �ih� �.30 ��:•3�
6. Is the applicant or organization organized under the la of the State of MN? ,����P �
7. Date of incOrporation c� b
� S. Date when registered with the State of Minnesota � �-
9. How Iong has organizatian been in existence? � �� ����•
� 10. Aow long ha'� organization been in existence in St. Paul? � .3i�4/�� . -
1L. What is thei, purpose of the organization? �
. ' i
' 12. 0 ficers o� applicant organization:
� � � � �
Name Name
Address � � Address ✓rcS� • O ���
� J'J'/O d� �B✓�,_��/
' DOB -' �/ Title
Title — _--��
Name Name •
Addr ss 3 dress ��'L
./-'��G • ✓ `S`'���
�/� ' � " -V bTitle _- g "" °��
Tit1eU I �
13. Give names of officers, or anq other persons who dt"e pold fOr' S2rViCeS t0 the
organizatiOn.
Name Name
Addrass Address
Title Title
(Attach separate sheet for additional names.)
. . �. �-�� ,�,��--�-�-.� , . . o � �yo���
14��ttached hereto is a Iist of names and addresses of aIl mem�ers o[ the organizat?cn.
L5. Ia who custody will organizatioa's records be kept? /3 �� � �
. /
Nam Address � � L. �l�'�l"1�0�,
16. t all persons with the authority to sign checks for dispersal of gambling prcceeds:
�Name ' Name
. � ` �
���� ri��ddress
v
ber of v��0� Member of
DOB � � � �Organization?!%�� DOB Organization.
N � Name
res�• . / �+�'ddress
mber f �cT�� �` Member of
DOB � � , rganization? 1��� DOB Organiza[ion?
17. a) Does your orga 'zation pay or intend to pay accounting fees out of gambling funds?
yes no
b) f you do pay accounting fees, to whom will such fees be paid?
' � !/�
Add'�e��/
�"�c��0 �
DOB �/� Member of Organization?
c) How are the ;accounting fees charged out? � at fe hourly, etc.)
�O � '
18. Have you read and do you thoroughly understand the provisions of all laws, ordinances,
and regulations governing the operation of Charitable Gambling games? �t
. O
I9. Attached hereto on the form furnished by the city of Saint Paul is a Financia2 Report
which it .emizes all receipts, expenses, and disbursements of the applicant organiaa—
tion, as well as all organiZatioas who have received funds for the preceding calendar
ar which has been signed, prepare and verified by _
' �3 ' %�ls�
A dress �`O�
who is the of the applicant organization.
Name
20. Operator of pr mises here s ' I be held:
. i�'c�.
Name , •
Business Address
O� ` ,�r.�,� 08'
Some Address c�c�
� . , '�� �C'9����
21. Amount of rent paid by applicant organization for rent of the hall :
. .. . : . . _ . . . . _ . . . . . . . . . . �urCr
D' o-a
22. The procleeds of the games will be dis6ursed after deducting p ze layou costs �
and oper�ting expenses for he followi g purposes artd� uses: � � �
. . . � - - : . .
Any changes d�esired by the applicant association may be made only with the consent of
the City Counicil .
/� J
' Organization Name '
�`, � �
Date: �}�—c� �� �' By: �O ��
; Manager in Cha ge of ame
l/ m� �.�
' Orga�a�i zati on Pres i. ent or�'
_�
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• • City of Saint Paul Yage 1
Departmeat of Flnanca and Managemeat Servicea ��Q a��
Division of Licenae and Persit Adminiatratioa
. (IIiIFORM CSARITABLE CAMBLING FINANCLIL REPORT �
. Date �' � �L
. � T
� 1. Name of Orgaaization /
�
� 2. Address where Chsritable Iing is conduceed ' /����ic
3. Report for period eovsriag 19�through 19�
. 4. Total nuaber of days pLyad
S. Cross receipts tor sbove p�riod ; � �
6. Grosa priza payouts for abw� psriod (iacluda eash ahost) ; �
. 7. Net racsipts - liae 5 minus 13ae 6 � � � �V�
8. Expsns�s incurred in condueting and operating gae:
A. Gross vagsa paid. Attach worter liat rieh
n�ia, a�dreasas, grosa vagea. n�b�r of houts � �
' vorked� and amount paid per hour.
• B. Rent for ��—`�+veeks � �Ta d O. (/ �f
C. License fee�� ;
�O. 0 �
D. Iasurance . r s a
• E. Sond . �r���; /� � � ��
° /�cS�e�-fl
i. Dishonorsd ehecks not reeovered ;
G. Accounting Expeasa � ;
, H. Employers F.I.C.A. ; �
I. Pulltab Saz Paid to Department ot Revenue � V � /• �
' J. Hinn. O.C. ?az ; O
1C. Pedesal Excise Tu b Stamp = /� O��/
L. Stat� Ca�bling 'fax ; ����+� "
H. Hiscsllaasous Expaaaaa. Ideatify tha amount
and t/�id. �
1, • ; �
. : z. �� s 3
� c�f���IJ�.,�a�
3. �
4. �
9. 'Potal Expenses �T� i �D ��"�
L0. N�t Iaeos� - line 7 ai�• Iias 9 : v � � D
lI. Checkbook balanee ba;ianing of Qeriod = `
12. Total of lins 10 and 11 ; � `'�
; 13. Total contributions (fros attached vorkaheet) ; ��
14. Checkbook balanes end of reportiag period - p� ��_L-�
' : lina 12 lesa line 13 . _ �� �� /�����
' �"�-��
IV��1� V��• �...._.�...��� �.'.���..� . �.__ _____ - -_ _
� ' • L�111FUL PURPOSE CONTRIBUTIONS - '�IORKSHE�T /�r�0��,/
U`�
I
Li ne �I3 �- Tatal Larvfui Purpose Contri butions. S ��
• Lis� below all checks written fran gamblinq funds which are
� cha�itable lawful purpose contributians. T6e tatal dollar
• ama�nts of these chetks must match the amount claimed in
lin� �13. Use additfonal sheets as necessary.
CHE_ OA E ' PAYEE ECK A1�Ot1 PU OSE q��.'
� w �
• � • �
3 �3 f-� I ,, %o-a-o. . �-,��
I. � ' k �� . , � 7, ..
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.
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3.�v�'� � c��9� • 4 �� �� �`'r��� � ,� „r �i '� .
4.3 c�c�� ��.+� �� �� '� �d''fl"°' ' � ,, i, ,
4
L/ N � � � ���
5 .3 S� � • ��'�" ~ ,, o� Q�'d�� '' t/ �, 4
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I �.�v�- /� 7-� , �' " � �� ' �
.
-� '
TOTAL CHECK AhDUN�/_ . �
' b at our Council hearing.
NOTE: These! expenditures will be provided to Council Mem e y
� Be sut�e that your financial report is complete and accurate.
,. ♦ .► rt s w ��e.
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DEPARTMENTlOFFICE/COUNGL DATE INITIATED 5 S 1 H
Finance License GREEN SHEET No. �NITIAUDATE
CONTACT PERSON 8 PHONE �DEPARTMENT DIRECTOR �CITY CAUNCIL �
Christine Rozek-298-5056 N'u�e�FoR �ciTM"TTO�"�r �CITY CLERK
MU3T BE ON COUNCIL AQENDA BY(DATE) ROUTING �BUDOET OIRECTOR �FIN.3 MOT.SERVICES DIR.
2—ZO-9O �R�R �MAYOR(OR ASSISTAWn 0 Council Research i
TOTAL N OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REOUESTED: �
9
Approval of an application for renewal of a State Class A Gambling License.
Hearing Date: 2_20_90 Notification Date: 1-29-90
RECOMMENDATIONS:Approve(A)a Rsject(H) COUNCIL COMMITTEE/RESEARCH REPORT OPTIONAL
ANALYST PHONE NO.
_PLANNiNG COMMISSION —CIVIL SERVIC�COMMISSION
_CIB COMMITTEE _
COMMENTS:
_STAFF —
_DISTRICT COURT _
SUPPORTS WHICH COUNCIL OBJECTIVE4
INITIATINO PROBIEM,ISSUE,OPPORTUNITY(1Nho,What,Whsn,Whsre,Wh»:
Jerome B. Krzmarzick on behalf of Holy Childhood Women's Club requests
City Council approval of their application for a State Class A Gambling
License at 408 Main Street. Proceeds from the gambling session are used
by the church and school for operation, etc. All fees and applications
have been submitted.
ADVANTAl3E3 IF APPROVED:
If Council approval is given, Holy Childhood Women's Club will continue
to operate a gambling session at 408 Main Street.
WSADVANTAGES IF APPROVED: "
RECE�vFn
.
�'E`609i99D
DISADVANTAOE3 IF NOT APPROVED: 1
��u�-�c« Kesearcn �e��t�r
FEB 0�.1990
TOTAL AMOUNT OF TRANSACTION : COST/REVENUE BUDGIETED(CIRCLE ONE) YES NO
FUNDING SOURCE ACTIVITY NUMBER
FlNANCIAL INFORMATION:(EXPUIN)
a f w ►3G j�
��
• ' • . I . City vf Saint Paul
Finance and Kanagement Service'siLicense & Permit Division �C y��rf�
INFORMATION REQU�RED WITH P,PPLICaTION FOR PER�SIT TO CONDUCT CHARITABLE Ga►KBLI\G Gd.`iE Iv
SAI:iT PAUL (To be used with the following: ;iew A � C application, reneW :� S C
Licenses, and new and renew B in Private Clubs.)
1. Full and co�p ete name of orgaaization whic is ap lqing for license
� /
r �f�0�
2. Add ess whe�e games will be held � �
Number Stree � i y iP
3. Name of man�ger signin this application wEio will conduct, operate aad manage
Gambling Ga�es Date of Birth ��7�.��
(a) Length of time manager ha een member of applicant organization � ' .
4. Address of Manager v � l/ • �I 3,
Num er Street � City Zip
S. Day, dates, and hours this application is for , �3� ���`?�
6. Is the applicant or organization organized under the la of the State of MN? ,����
7. Date of inc,orporation t� b
8. Date when r�egistered with the State of Minnesota .� �-
9. How Iong hals organization been in existence? � ��_ •
� 10. How Iong ha�s organization beea in eaistence in St. Paul? � 3i�-1/1,� .
1L. What is the! purpose of the organization? �
,
' 12. 0 ficers o$ applicant organization:
� � , �
Name Name
Address � � Address � • ��,
� / .�-.r'/o d'
Title � DOB � � Title �B✓���`"'
Name Name .
Aaar Ss ' 3
dress �
./—.t'/o • .� �S//�
�/� � B
Title!/ � � y "' —��Title _ �""' _ 9
13. Give nameslof officers, or anq other persons who are paid for SEt"v1Ce5 to the
organizatipn.
Name Name
Addrass Address
Title Title
(Attach separate sheet for additional names.)
. . . , � ��,�.� ,� -� ,�"'��°w`- �:�:�- �yo���
i
14�attached he�eto is a Iist of names and addresses of all mem�ers or the organizat'cn.
L5. Ia who cu3tody will organization's records be kept? /3 �� � �
Nam . , Address ,�t,wC �il'1�0�,
16. t all pe�sons with the authority to sign checks for dispersal of gambling proceeds:
�Name ' Name
. /y
���� �rr�G�ddress
v ?
mber of c���� Member of
DOB '� � .:/ �Organization? DOB Organizatioa?
!%7�
N Name
re �• . / ddress
mber f �" c�T���� � Member of
DOB � � , rganization? !%G��. DOB Organization?
17. a) Does your orga 'zation pay or intend to pay accounting fees out of gambling funds?
yes no
b) f you dlo pay accounting fees, to whom will such fees be paid?
' ����� � ��
�c��0 �
DOB —� '� ,tember of Organization?
c) How are► the ,accounting fees charged out? � at fe hourly, etc.)
b � '
18. Have you r@ad and do you thoroughly understand the provisions of all laws, ordinances,
and regula�ions governing the operation of Charitable Gambling games? _
19. Attached h�reto on the form furnished by the city of Saint Paul is a Financial Report
which it .e�izes alI receipts, expenses, and disbursements of the applicant organiza—
tion, as w�ll as all organizations who have received fuads for the preceding caleadar
ar which has been signed, prepare and verified bq
' �3 ' i�
A dress �`��
who is the of the applicant organization.
Name
20. Operator o pr mises here s �all be held:
Name ' �
. •
Busiaess Ajddress �4.
� „er,� 08'
Home Addre�ss c�cs
I
i
�
� � , I - . �9���/
21. Amount o�f rent paid by applicant orga�izatioo for rent of the hall :
D��'D-a . . . . _ :. . ��.'o-�
22. The proaeeds of the games will be dis6ursed after deductirtg p e 11you costs �
and operiati ng expenses for he fol l owi g purposes attd� uses: � � �
. . . . �
�
Any changes desired by the applicant association may be made only with the consent of
the City Council .
, �� !
,
Organization Name '
/ p� . �
Date: /G�i�.—� '�! �D �i BY: ✓ �y"�
Manager in Cha ge of ame
✓ C�� m� ��Q�
Orga ization Presi ent or��
��
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� � • � City of Saint Paul Psge 1 /
Departmeat of Financ��aad tlanagament Services ��Q��
Diviaion of Llcanaa and Pes�it Adainiseration
. I IJNIFORH CBARITABLE GAMSLING FINANCLIL REYORT �
Date �I � �L
. � T
i. Pl�me of Organization �
2. Address vhsre Charitable liag ia eonduceed � ��iO.t
� � .
3. �sport for p�riod eovarin� 19�through 19�
4. '1�otal nusbar of days pLyad
5. qro�a sacaipts for abov� period ; G:/ 3
6. Qrost prisa payouta for abova period (iaelud� ea�h shost) � �
7. Net racaipts — lina 5 mimas line 6 ; � v ���
8. �icp�nsss incurred in conductiag and opazating gaa:
A. Gross vages paid. Attach vorker liat vi0h
nidRs, a'ddresses, gro�s vages. numb�r of honrs ; � ,�
worksd. and amount paid pes hour.
• �. Reat for ���weeks � 'TQ d 0. ��
�. License fee�� ;
v0. ��
�. Iasuranee . r ; d
�. Bond �r���� �d � r ��
° /�cs:'e—�
�. Disho�ored checka not racovered ;
¢. Accounting Expanaa � �
. N. Employers F.I.C.A. ; �
. X. Pulltab ?a�c Paid to Departmsnt of Bevenue � V � /• �
� J. Iiiaa. U.C. Sax i O
*. F�deral Exciae 2ax b Stasp S /�r/ 0 J�/
�.. Suu Cambling Tax i K—�/�-��
�I. liiscellaneow Expaas�s. Identit7 Cha mount
and t/�id. �
1, � /J ; �
2. �T C'��rr�; 3
� ��'�
3. ;
4. _
9. �ot� �.� �u � �`"'D 3
10. �1�t Ineos� — Iiaa 7 ainn• lias 9 = v v � D
11. �hsckbook balance be;imiag of period :
. 12. Rotal of lin� 10 and 11 ; � `"�
. 13. !Total contzibutions (froi attached vortshset) ; v �
14. iCh�ekbook balanca ead of rsporting period — � p� ��_L"�'
' lina 1Z leaa lina 13 . �J v
/�����
' '_'-y...
I UI�1fV�'1 V��^n��noLG ur++�obl��u rtiw.van� n�rv�.�
� � LA1�1FU1 PURPOSE CQNTRIBUTIONS - '+lOR1CSiiE�T /�r�a��,/
W`
Line #13 '- Tatal Lav+fui Purpose Contributions. S ��
• Lis� below all checks written frap qamblinq funds which are
� chatTtable lawfut purpose contributtons. The total dollar
� amounts of these chetics must match the aaaunt claimed i n
linp �13. Use additional sheets as necessary.
CHE_ oAfiE � PaYEE ECK PU OSE �O,c�F=
h � �
3 ��3 IL�� • � • . �-,���.
I. ' �, �� , /,D'.�. ,�� 7, .. ��_
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3�'"o �
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G /3 . „ � , • ,� ., �
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$3� SS. / � . /o,�o (��
• �,�,,� `''r'``v �
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C� �
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1 3 �3�- o io � �t . '� � '� � • �'�"'� �
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� �
I � .�"c�— /I� 7_� � s� �� �' t�aZ • .
.
TOTAL CHECK Al� /_ _ • �
at our Council hearing.
NOTE: Thes� expenditures will be provided to Counc�l Membe y
� 6e s�re that your financtal report is cort�lete and accurate. .
.
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