90-853 O � I G� �A � Council File #` �'O�J3
Green Sheet � 7680
RESOLUTION -`-
CITY OF SAINT PAUL, MINNESOTA {'I,j� `�
� ��. _
Presented By >
Referred To Committee: Date �,,� �v
RESOLVED: That application (ID ��74849) for renewal of a State Class B
Gambling License by East Twins Babe Ruth League at Louies Bar,
883 Payne Avenue, be and the same is hereby approved/�c�l..
eas Navs Absent Requested by Department of:
m n
OSW1 2 \:
on �_ License & Permit Division
acca e
e �an �
un �
i son � By:
�
MAY 1 7 1990 � Form Approved by City Attorney
Adopted by Council: Date .
Adoption er ified by Council Secretary gy; �j .Zf�U
By� ���'r>"�� Approved by Mayor for Submission to
Approved by ayor: Date MAY 1 8 1990 Council
By: � By�
PI��.iSI�E� �„�;:� � � 1°Su
' '. . � � � ' �D'��,�3
DEPARTM[NT/OFFIi�/COUNpL pATE INITIATED Q
Finance/License GREEN SHEET NO. 76p
CONTACT PER30N 3 PHONE INITIAU DATE WITIRUDA7E
�DEPARTMENT DiRECTOR �CITY OOUNCIL
Christine Rozek-298-5056 N��F� ��An�NEY �CITY CLERK
MUBT BE ON COUNqL IU�ENDA BY(DATE) y� (��}p RWTIN(i �BUDOET DIRECTOR �FIN.6 MOT:SERVICE8 DIR.
For Hearin 5-17-90 c`'� CIe.K. ��u►von��ssisr��r Q (:rnmc�i 1 R
TOTAL N OF SIONATURE PAGES (CLIP ALL LOCATION8 FOR SK�NATURE)
AC170N F1EpUE8TED:
Approval of an application for renewal of a State Class B Gambling License.
5-17-90 Notification Date:
REOOMMprDA710NS:MD��(�)a►R� C011DK:IL REPOR'T OPTIONIIL
_PLANNII�COMMISSION _CIViI 8ERVIC�OOMMI8SION ANALY8T PNONE NO.
_p8 C�AMIT�EE _
_STAFF _ COMMENTS:
_D18TRICT COURT _
SUPPORTS NlNiqi WUNpL 08JECTIVE9
IIWTIAT11�0 PR09LEM.ISBUE�OPPOfiTUNITY(YVIro.�Nhet,WMn,WMn,Wly�:
James Faser on behalf of East Twins Babe Ruth League requests City Council
approval of their application for renewal of a State Class B Gambling Licens2
at Louies Bar, 883 Payne Avenue. Proceeds from the pulltab sales are used
for youth sports, scholarships and donations to other organizations. All ,
applications have been submitted. Fee of $373.25 has been submitted. Al1
divisions have given their approval.
ADVANTAOE8 IF APPROVED:
If Council approval is given, East Twins Babe Ruth League will continue to
sponsor pulltabs at Louies Bar, 883 Payne Avenue.
ois�ovu�r�s��u:
D13ADVMITAOEB IF NOT APPROVED:
RECEII�D V��;i�t� K�seGrcr� �;e,»er.
�a�� �1AY 0 I ri��0
CiTY CLERK .,:
TOTAL AMOUNT OF TRANSACTION : C08TJREVENUE BUDOETED(qRCLE ONE) YES NO
FUNDING SOURCE ACTIVITY NUMeER
FlNANCIAL INFORMATION:(EXPLAIPq
�'1/
. . . �yo��3
DIVISION OF LICENSE ANI) PERMIT ADMINISTRATION DATE � o���yo � 3 a(� ��
INTERDF.PARTMENTAL REVIEW CHECKLIST Appn rocessed/Received by
Lic Enf Aud
Applicant �)U,IrY125 t-QS.p,r- _ Home Acldress �c� rJ Cj f���t�r�
Rus ine s s Name �j�� � i.v�r�,S �,�., ��� Home Phone � y�j - �!<�� ��..
Business Address �. wUIQs �� Type of License(s) l�l(1SS�`-
Business Phone 0�3 `�� �Y1Pi ��.�eJ (�tti,v,�j��,-tc, �.! (-E,yt S-e, �21'I.Q t-�Jc�
Public Hearing Date � � � License I.D. �F r l ��� ��
at 9:00 a.m. in the Counc"1 Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �� � $" ��3�
llate Notice Sent; Dealer 4f �I.�
to Applicant �
I'ederal Fi_rearms �6 ��
Public Hearing
DATE INSPECTIUN
REVIEW VERFIED (COMPUTER) CUMMENTS
A roved Not A roved
�
Bldg I & D �
�)� ,
Health Divn.
�
N�A� '
�
Fire Dept. i �
I ��� �
� S`Pn� � ��ol�I�1D
Police Dept. ' I
31a•� I�� ��
,
License Divn. '
�F�t�I�j�; D��
City Attorney �
�la��yv , o�
Date Received:
Site Plan �'d(���(s
To Council Research J � ��
Lease or Letter Date
f rom Lar�dlord � O
CURRENT INFORMATION NEW INFOKMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond:
wbrkers Cornpensation:
New Officers:
Stockholders:
. .. . � �,�,�3
u • �w�"�� � City of Saint Paul �
�1.
. Department of Finance and Management Services
Division of License and Permit Registration '
INFORMATION REQUIRED WITH APPLICATION FOR PERMIT TO SELL PULLTABS 6 TIPBOARDS IN SAINT PAUL
(Class B Gambling License in Liquor Establishments – Renew)
1. Full and complete name of organization which is applying for license
—_L��s� �i n S
2. Address where games will be held ��3 �GL,yr1�, �- �� SS'/OG
Number St eet City Zip
3. Name of manager signing this application who will conduct, operate and manage
Gambling Games ���� ��y,s�,� Date of Birth /�/3'Y'�
(a) Length of time manager has been member of applicant organization
4. Address of Manager /,�$5 �doeY�nr �- S�-�aa,( SS�D/
Number Street City Zip
5. Is the applicant or organization organized under the laws of the State of MN? {�P�S
7��=--
6. Date of incorporation ��Q� l �J� �
7. Aow long has organization been in existence? �Q �/�
8. How long has organization been in existence in St. Paul? � � �.
9. What is the purpose of the organization? �3 -�-c� /S Uel4r� D�d �/3Sc.. b�cl�
10. Officers of applicant organization:
Name �o�a ��C 5'�'. 54�V tr Name �dU"o a�te�" c5'�'.Sa.v el .v
Address ���j g L�� Address L�6� �/v� /0�
Title �/4�S DOB Title T'�$ DOB [
Name �//y �D�S T�Tr�/Q N� ` l
Address Address ��{ �^ /(/
Title �, p/Q�s DOB Title s°�, � DOB Q
11. 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 names.)
. �t'� . r� . , , / •����F��
�� �... v
. �' 12. Attached hereto is a list of names and addresses of all members of the organization.
13. In whose custody will organization's pulltab records be kept?
Name �pyK,e,S �X��,� Address /asf �c��e,i�,�vh
14. List all pezsons with the authority to sign checks for dispersal of gambling proceeds:
Name Ti�m�a �Abt►- Name ��(�prsi,l� W(ehn
Address /oZ$'�'j �s�dqer-�+p� Address /OG 5' �r��enbr�e✓
M ber of Member of
DOB Organization? �eS noB 3 a �S� Organization? �/�e$
�-
Name Name
Address Address
Member of Member of
DOB Organization? DOB Organization?
15. Have you read and do you thoroughly understand the provisions of all laws, ordinances,
and regulations governing the operation of Charitable Gambling games?
16. Attached hereto on the form furnished by the city of Saint Paul is a Financial Report
which itiemizes all receipts, expenses, and 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 verified by
Address
who is the of the applicant organization.
Name
17. Will your organization's pulltab operation be operated/managed solely by members of
your organization? yes y no
18. Has your organization signed, or does it intead to sign, a consulting agreement or a
managerial agreement with any person or company to assist your organization with the
pulltab sales and/or recording keeping? yes no X
If answer is yes, gine the name aad address of the person aad/or company contracted.
Name Address
Name Address
If answer is qes, haw will such a consultant be paid? (percentage, flat fee, gambling
funds, general funds, etc.) Attach a copy of said contract to this application.
19. Operator of premises where games will be held:
Name � L-�.. .E: 7 `�L��
8`�3 �`"
Business Address Pci,�a�
Home Address
.�� [.:_ ; � � ��o�S3
�
• 20. a) Does you organization pay or intend to pay accounting fees out of gambling funds?
yes no
b) If qou do pay accounting fees, to whom will such fees be paid?
Name �����j�����G f Address �/� ,�� �� S� �T/��
DOB Member of Organization? _ (�Q
c) How are the accountiag fees charged out? (flat fee, hourly, etc.)
d) What do you anticipate will be your average monthly deduction for accounting fees?
�.�'D�°
21. Amount of rent paid by applicaat organization for reat of the pulltab sales area:
/O 0 n e.r Ltle.�e.�C.
22. The proceeds of the games will be disbursed after deducting prize layout costs and
operating expenses for the following purposes and uses:
� `
�cl? OUf�/P_S"',�/,a S
�
� r
e
23. Has your organization filed federal fo=m 990-T? � If answer is yes, please attach
a copy with this application. If answer is no, explain why:
���
Anq changes desired by the applicant association may be made only with the consent of the
City Council.
C,�sf Ti�;hs
• Organization Name
Date By; ect��•
Manager in charge of game
.
Or iz on President or CEO
�� � � City of Saint Paul Page 1
. � Depatcaent oi Yinanee and Maaa;ament Servieea �GD,����
� Division of Licenss aad Per�it Admiaistracion �
UNIFOR?I CHARITABLL CAlIDLINC FINANCIAL REPORS
Dac•
1. Name oi Ot�anizatioa �a-� ����K�
2. Addr�s• vh�re CAatitabl• Gutrlinf i• eoaduec�d �p3 �i��hG.
3. R�poit tor period eov�rin� �J 14^n � 19�! thsou�h DCC. 3 � 19�
4. ?ocal ewber of daya play�d ,�Y
S. Cro�• r�eeipta for abov� pstiod : �� �a�
6. Cross pris• payw�cs for abwe O�riod (inelud� ea�6 �horc) _ � 7'�3��
7. Nec r�eaipcs - lia� S sinus lin� 6 S -``7�(��J
8. Expense� ineurred in eonduetia� and operacinf =aa:
A. Cros� va�es paid. Attaeh vorker liac rith '/^ G
aas�a, addre�sas, tro�s va=es. au�b�s oi dours i �(/ �S/
� vorksd. and mount paid p�r honr.
H. Rent fot veeks = ��60
C. Lleens• Lee = ����
D. Insuranee f �O s
E. Bond = I�`�
!. Dlsdoaocad eheeks not reeo��rad = ��
C. Aetoeatia� Expeast ;
H. [splor�rs i.I.C.A. ; � a
I. Pulltab iu Paid to Departa�nt oI It��auu� � �d��J
J. Mlnn. U.C. Ta: :
R. l�decal iseis� ias i Sca�p s �aS3
L. Staa Wablint Su = �� �i
!t. Mi�eallanaow Espsnses. Id�ntit� tM oouee �t�� — 7��a
and to vAo� paid.
1. 'PwllT�bs : ,�a.?as. Sf� �
� Z. �o(✓ (llo I,..orryc.r) : i�cSO.pO v '
po �
�. �hon�. (no lor�e.r) s 6 � �'
i .. M �sa s �s3� �
� �c?c� sccr G ,/
� 9. iocal t:pea,.. ,, iG'fAL s /_�a�O`,'—
I 10. N�t Iaeo�� - lin� 7 aita• lins 9 s 3 8'�73
I11. Cheekbook balane� bs=ianin� of p�riod = ID.ss�, �`'r
i
12. ?otal of lioe 30 and Ii : �94 G�
" � 13. 2otal eontsibutions (Lro� attuhed eoriuA��t) i 6A0�
14. Cheekbook balaaes ead of r�Portin� Paricd ' :t� / �
line 12 l�ss liaa 13 � �J �D
13�nk 3/a3• �S
` /'N�n� d �s�.o 7
-� � 6y
. . , , UNIFORM CHARI7ABl� GaM6LING �iN�NCiAI RE?�RT
' �� � ` L�IWFUL PURPOSE CONTRIBUTIONS - WORKSHEcT ��0���3
� Line #I3 - Total Lawful Purpose Contributions. =1 0D4
List below all checks r+ritten from gambting funds which are
charitable lawful purpose contributions. 7he total dollar
amounts of these chetks must match tt� amount claimed in :
line �i13. Use additional sheets as necessary.
CHECK � DATE PAYEf CHECK AMOUN PURPOSE
-
1. /�T6 4C '3/// ���" �i�in s a?�.
,�/� „ ,, 7000
z. �baa�. �
3. /633 ��/3 � . +�
s+a°° -
4. /(,67 `S�`� �' ., 'y�DOd
5. /G �� �'� „ �i a,aoo
6. �6�/ �'�o " " aopO
7. /7�� ��. �i �� °Z'o d'D
8. / 7�� ��G '` '' ��oo
9. /7�� �i�
« '� 3a��
Io. �79� �� h •� a000
lI. /�0�.3 �� �� �• �oao
12. � �35� �, �Qoo
�/�, �,
�O �� ' �o°°`r.
q��- •� � �vpo�/
13. �'�� , ,� . �o �
ap/!. '°"'' .. - �q000 � .
�o�� j�� .I T07AL CHECK ANOUN7 S��� �G�DD
• T �"" � r rill be rovided to Council Members at yo�r Council hearing.
NOTE. hese expenditu es p
Be sure that your financial report is coa�plete and accurate.
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