90-503 0 R l � I N�L- � �ouncil File ,� G�--�Sd c3
Green Sheet ,� 5848
RESOLUTION
OF SAINT PAUL, MINNESOTA �
`. ��
�
Presented �
Referred To Committee: Date
RESOLVED: That application (ID ��28292) for renewal of a State Class C
Gambling License by St. George Church at 408 Main Street, be
and the same is hereby approved.
Yeas Navs Ab_ s��nt Requested by Department of:
imon
�i � �`
n �
cc ee _�
e nan
une
i son —� BY�
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Adopted by Council: Date MRR � � i��� Form Approved by City Attorney
Adoption Certified by Council Secretary gy; 2�y�9D
L
BY� , �-��� �� <<'� Approved by Mayor for Submission to
Approved by M or: Date ' MA � 0 1990 Council
gy; - �.��� By a
�1�€31.���iE� A�'t; t" 1��;�
�---�a� �-°3 ��—
DEPARTM[NT/OFFif�/COUNCIL DATEINITIATED GREEN SHEET r,o. 5848 �
Finance/License �w�� iNm�ro�TE
OONTACT PERSON R PFIONE �pEpARTMENT DIRECTOR �CITY COUNCIL
Christine Rozek-298-5056 ��� 0 cRV ArroRNev [�]cm c�eRK
MUBT BE ON OOUNpI AOENDA 8Y(DATE) pOUTINp �BUDOET DIRECTOR �FlN.8 MOT.SERIACEB DIR.
3-29-90 � ❑MAYOR(OR ASSISTANn Q o �n i 1 R
TOTAL N OF SKiNATURE PAGiE8 (CLIP ALL LOCATIONS FOR SIGNATUR�
ACT10N REOUESTED:
Approval of an application for renewal of a State C1ass C Gambling License.
Hearing Date: 3-29-90 Notification Date: 3-13-90
ECOMMENDATIONB:�PP►�W o►�1�lRl COUNCIL REPORT OPTIONAL
—�,wNirro co�assiaa —av��se�n�co�issioN ""�� �ONE�.
-CIB COAIMITTEE _
_STAFF _ COMME►�TB'
_018TRICT COURT _
SUPPORTS WNICH OOUNGL OBJECTIVE9
INITUTII�Ki PROBLEM�ISBUE.OPPORTUNiTY(Who�WY�t.When.WMro.NThy):
Sharon A. Awada on behalf of St. George Church requests City Council
approval of their application for renewal of a State Class C Gambling
License at 408 Main Street. Gambling sessions are held Wednesday evenings
between the hours of 7:30 pm to 11:00 p.m. Proceeds from the bingo session
are used for church activities. All fees have been paid ($249.00) .
ADVANTAQE8 IF APPROVED:
If Council approval is given, St. George Church will continue to sponsor
a bingo session at 408 Main Street.
as�ovu��s���ovEO:
DISADVANTAOEB IF NOT APPROVED:
RECEtVED
�ouncil Research Center,
�1��� MAR 1519�
ClT�` CLER�( � �
TOTAL AMOUNT OF TFiANSACTION = C08T/f�VENUE SI�TED(GRCLE ONB) YES NO
FUNOING SOURCE ACTIVITY NUMSER
flNANCIAI INFORMATION:(EXPWN)
d�r
� � . G�'1��5�3
DiVISION OF LICENSE AND PERMIT A.DMINISTRATION DATE =''� � !L� / "� O ��
INTERDF.PARTMF.NTAL REVIEW CHECKLIST Appn Pr cessed/Rec iv d by
Lic Enf Aud
Applicant ��ay[�� ��Ci.� , Home Address t�3 g Cilo»GS �-vr�
Rusiness Name ��� � � �0���. ��'Il�YL Home Phone � ��' J�.3�o�
Business Address ��D � u�n �� Type of License(s) /�l11,QGcJ—
�
Business Phone �'�SS C ��(�'n ���hq LfCpns-�
Public Hearing Date � o`Z� (� License I.D. 4{ c� � �
at 9:00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. 41 �
llate Notice Sent; Dealer 4f ���"
to Applicant 3 1� �Q 1
rederal F3_rearms �� � /4
Public He�.�ring
DATE INSPECTIUN
REVYEW VERFIED (COMPUTER) COMMENTS
A roved Not A roved
�
Bldg I & D �
IV�'q' ,
Health Divn.
i �..���-- �
I
Fire Dept. i �
' �� � �
�
Police Dept. S'e-� ��� I l�'
�l�
License Divn. �
� � �I�V �lC---
City Attorney � ��
� q c���
Date Received:
Site Plan �( m �—(� ` Gv
� To Council Research /
Lease or Letter / G Date
f rom Landlord '� (1� ( �
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
• • ' City of Saint Paul �y�v`��3
, Finance and Management Services/License � Permit Division
� f
' INFORMATION REQUIRID WITH APPLICATION FOR PERMIT TO CONDUCT CHARITABLE GAMBLING GAME IN
SAINT PAUL (To be used with the following: New A & C application, renew A � C
Licenses, and new and renew B in Private Clubs.)
1. Full and complete name of organization which is applying for license
�1"� ��o��� �urzc�,
2. Address where games will be held ��$' rn I�iN 51- c�T• �(�v��.. 55 i0z_
Number Street City Zip
3. Name of manager signing this application who will conduct, operate and manage
Gambling Games ����ti � • `�w�L{� Date of Birth �� -�7-3:�
(a) Length of time manager has been member of applicant organization �`1' �-�►25 �
4. Address of Manager � 1 � c( �,-.1�;�65'j v� �U�. (� •�T p(��,��., �j,-�� � � X
Number Street City Zip
5. Day, dates, and hours this application is for 11��.i�. �:�� - ) � ; {�'r�'► •
6. Is the applicant or organization organized under the laws of the State of MN? T s .
7. Date of incorporation �u2�%� - ��j �3 -
8. Date when registered with the State of Minnesota _ I� � 3 - l���Lr � ���`�
9. How Iong has organization been in existence? 1q I�j
10. How long has organization been in existence in St. Paul? �� � 3
lI. What is the purpose of the organization? f��-�iGip.�,S
12. Officers o applicant organizationc
Name 1°t YY1�,S (�. 1't W p d 1� Name ���;1�t,Y"( J� I"��F i Z �12 •
Address �g�,�j �ummiT �}N� Address �Orj�j �AC�AriC�A�c ��-� -��R►� JrS�.
Title ���. � DOB 3 -;�.-�� Title�i 11f�1'l�.i�{� �C. DOB �- (, -(o� I
Name �0 � ?-C C Name h�, I-�}rN�
���8�}-�Rn �r ��Tt-�- 55e6
Address. `� g Ad�ress ��b� �• �� � — 'rJ J`�I 1 q
Title V 1 C�- �i("-Q,5. DOB g' �q- Title R�}���(..��� DOB ��jo��9
13. Give names of officers, or any other persons who paid for services to the
organization.
Name Name
Address Address
Title Title
(Attach separate sheet for additional aames.)
' � �qo-�d 3
,
14. Attached hereto is a Iist of names and addresses of all members of the organization.
15. In whose custody will organization's records be kept?
Name �OSA �� �m�l Address ��'{a C/�) t�YY�R.T �-�1E J�' Sll�j
16. List all persons with the authority to sign checks for dispersal of gambling proceeds:
Name �'�" OSI� {v� ��1( Name
T
Address ( ��}�, �����T" �i1�. • Address
Member of Member of
DOB +�- II- �1.� Organization? Lq� DOB Organization?
ftame S 1-� A�`on; f� • �i.t)(�I a Name
Address ���� ��, N C S i p ti ��-�� � Address
�,I Member of Member of
DOB 1�-�1�3�5 Organization? �� �o� DOB Organization?
17. a) Does your organization pay or intend to pay accounting fees out of gambling funds?
yes �( no
b) If you do paq accounting fees, to whom will such fees be paid?
"7
Name - Address
DOB Member of Organization?
c) How are the accounting fees charged out? (flat fee, hourly, etc.)
18. Have you read and do you thoroughly understand the provisions of all laws, ordinances,
and 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 funds for the preceding calendar
year which has been signed, prepared, and verif ied by �I�A�►.1 /�• /�t.�,'A� ►�
113`� �� � �t`i C�s'�d i.� �-U�, l�. ��"• �/�v�.� M 1� . 5 5 I I $�
Address
who is the �t�l'�b�ll'�C� V}�1 l�Y114�'yZ�2.� of the applicant organization.
T Name
20. Operator of premises where games will be held: �
Name I v p J(Z'h-Q1 S�A(2_ ��C�G , R 5 5 o C .
Business Address y-0 $ �1/�i N �T' > �T� �f�v,L- �N � ��J I G L
Hame Address
. ' • , ��p��03
21. Amount of rent paid by applicant organization for rent of the hall:
,;
� � U�j,oo �r W,-�t--�
� 22. The proceeds of the games will be disbursed after deducting prize layout costs and
i operating expenses for the following purposes and uses:
�- I �N D (-� - 2., L � �ers --6 r�� ��r �t,-� 5-�-�-`�e-�
f�v h.�ch C..IIo►.0; �4 vrti bl�ru, -�u.v�dc �i�o (o.e� l.lse d �'o r I��I,ti ,o�.c s
- O Y' e.�UCct.�}��,1 a� vance.vr�en+� C� Z- iS-`i��
23. Has the premises where the games are to be held been certified for occupancq by the
City of Saint Paul? t� �j ,
24. Has your organization filed federal form 990-T? _ (�0 If snswer is yes, please attach
a copy with this application. If answer is no, explain whq:
T/��c �XC m�i' '�j -�G 3l 9 '��i � TAx s.� �f �
Any changes desired by the applicant association may be made only with the consent of the -
City Council. �
�T. �Eo�� �-��r�,
Organization Name
. �
Date y, -� •
� Manager in charge of g e
�/ t�
rganizatio esident or CEO
� v � s = z :n � _ � .. - -; �
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• • C1tq of Saint Paul Pags 1
+ Department of Finance and Mmagfsent Sesroices
Division of Licsnsa and Yesait Adsinistsation
l
' . IJNIFORH CHABITASLE GA!lELINC FINANCIAL REYORT
� Dat� �- � � -��
1. Ra� oi Orgaaisation �� ' �L 6R-� � �--Y�ul'��-1r�
• 2. Addr�s• wh�ra Cluritable Gubliag is condnct�d �{�g m 1�� � �T� �T'����-' 5 S'D�-
3. Report for psriod covsring I l- 3v � 19$ ehsough l�- �vZ 19�1
4. iotal nuvbar of days pLysd 5�
S. Cross r�c�ipu for abov� p�riod ; !5� . �:33- � 'Jr
6. Gross pris• papwts fos abov� p�riod (includ� eash short) : �) � � � l�. d �
. 7. Net racaipts - Iine 5 miaus line 6 ; 3 hr -1 �J�:. �.,_7
8. Lxpsnses incvrred in conductiag and opazating gm:
A. Gross va;es paid. Attach wrker 11at vith N i�
names. addresses, gross wases. m�sb�r of hoazs ;
vorked. and amount paid p�r hour.
B. Rent for � veeks � iJ �J ��5� ��
C. License fee : 5� . o a
D. Inaurance s
� E. Bond ; � L �� C �
!. Dishonored checks not reeovsred � f � C. C �
G. Accountin6 Expensa i �
. H. mPior.r, r.Z.C.A. ;
. I. Pulltab ?a: Paid to D�part��nt of ltrsnu� ;
' J. lSinn. U.C. Tax i
1C. Fedsral faciss Tax 6 Sta�p 3
L. Stat� Ca�bliag Tax ; 3 `� ��. O b
M. l�iscsllaneous Facp�asas. Identif� tha a�aunt
and to w6oa paid. i�3•�.�
R dJe.r►�s;r►�
i. 1:5,�n�ch�s.�h�� c..i.ks� s �I.5c
� 2. INv�s���Pri�o�+ r=��. ; � 38•�L'-.�
s. M,�. �"��`�c r�+��. � 5 .3�59
4. �'��'�'���s��;las`.rr���KC.� i ��3.3ti
9. zot�. ��.� �. : � �, yb� . o3
10. 11�e IneoN - lin� 7 atau� Iias 9 i ^� y 7�� �"Z'
,11. Cheekbook balanee be;inaiag oi p�siod 3 � �C� • �3
• 12. Total of lina 10 and 11 i �-���`f� � 5
: 13. Total contribntions (fros attached vorbh��t) ; v�-r� c C C ' C L�
. 14. Checkbook balancs end of rsportiag p�siod - �--��� ��
' � lina 12 less lina 13 . _
<.=�..:.
CITY OF ST. PAUL rhuc c
• � UNIFORM CHARITASLE GAMBlIN6 FINANCIAI REPORT �_�-Q 3
� LAWFUL PURPOSE CONTRIBUTIQNS - 4�RKSHEET �1�
� . . .. . . .
` Line #13 - Total Lawful Purpose Contributions. �n n . n p
-. List below all �checks written from gambling funds which are
charitable lawful purpose contributions. The total dollar
� amounts of these checks must match the amount claimed in
line #I3. Use additional sheets as necessary.
CNECK # DATE ' PAYEE CIiECK AMOU PURPOSE
I. ! ' I '� �1-1G,. �3� �T•C��cv'��- C-�re�, ��o�.00 'lE�'L�G�oe.c,s
11�5 I-�_�=1 �� '' '' �cj�0.�v rr
Z. � i�
3 -18-�,�i ,, �� �� �a���, o�
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5. ll3�I �`"� -�-'
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6. I l�3 �-io �'I ,�
�� 3��GV. ac�
7. /��� fi-�- �`I �� �, ,� �
8. 1153 �' -l$- �j „ ��
„ ����; ��,
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9. //GO �-�3 -�% r� �,
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i�-���9 �dv a- aa
1I. //7l� " � ��
I2. .
13. �
T07AL CHECK AMDUNT � c�o.c o
NOTE: These expenditures wi11 be provided to Cauncil Members at your Council hearing.
� Be sure that your financial report is complete and accurate.
-
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