90-1178 0 R I G�I N A L Council File � '7�"/�70 .
Green Sheet # 10477
RESOLUTION
SAINT PAUL, MINNESOTA % �'`
a J
Presented B
Referred To Committee: Date
RESOLVED: That application (ID 4�96254) for _the transfer of a Gambling
Manager's License currently held by Mark Mules DBA West Side
Youth Hockey at Brown Derby Lounge, 657 Stryker Avenue, be and
the same is hereby approved for transfer to Emil Folsom at the
same address.
eas Navs Absent Requeeted by Department of:
o w � License & Permit Division
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—f i son —� By�
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Adopted by Council: Date JUL � 2. tqan Form ppr ved by City Attorney
Adoption Certified by Council Secretary gy: ( .
BY� Approved by Mayor for Submission to
Approved by M or: Date JU L 1 6 1990 Council
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By:
:'l+l��,�c�/ By'
�116�IStiED J U L 2 11990.
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DEPARTMENT/OFFICE/COUNCIL DATE INITIATED �
Finance/License GREEN SHEET N° _10477
CONTACT PERSON&PHONE INITIAL/DATE INITIAUDATE
�DEPARTMENT DIRECTOR a CITY COUNCIL
Christine Rozek-298-505 ASSIQN �CITYATTORNEY �CITYCLERK
NUMBER FOR gUDOET DIRECTOR FIN.&M(iT.3ERVICES DIR.
MUST BE ON COUNCIL AOENDA BY(DATE) City Clerk ROUTING � ❑
ORDER MAYOR(OR ASSISTANT) r,„_ �_��
Hearin 7-12-90 g 7-5-90 ❑ C7-�= R
TOTAL#OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION RE�UESTED:
Approval of an application for transfer of a Gambling Manager's License.
Notification Date: 6-25-90 Hearing Date: 7-12-90
RECOMMENOATIONS:Approve(A)or ReJect(R) pERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_PLANNING COMMIS310N _ CIVIL SERVICE COMMISSION �• Has this personlfirm ever worked under a contract for this department7
_CIB COMMITfEE _ YES NO
2. Has this personlfirm ever been a city employee?
_STAFF — YES NO
_DIS7RICr COUR7 _ 3. Does this person/firm possess a skill not normelly possesaed by any�curreM city employee?
SUPPORT3 WHICH COUNCIL OBJECTIVE4 YES NO
Explain all yas answsrs on separata shest and attach to grasn sheet
INITIATINQ PROBLEM,ISSUE.OPPORTUNITY(Who,What,When,Where,Why):
Emil Folsom DBA West Side Youth Hockey at Brown Derby Lounge, 567 Stryker,
requests Council approval of his application for the transfer of a Gambling
Manager's License currently held by Mark Mules. Transfer fee of $33.50
has been submitted.
ADVANTAQE3IFAPPROVED:
If Council approval is given, Emil Folsom will manage the pulltab/tipboard
sales for West Side Youth Hockey at Brown Derby Lounge, 567 Stryker.
RECEIVFn
DISADVANTAGES IFAPPROVED:
�U�031990
C�TY CLERK
DISADVANTAQES IF NOT APPROVED:
� t�o�n��a ����ar��t �e�t�x
.�U{� �����U
. :4�'L.tii,i
TOTAL AMOUNT OF TRANSACTION S COST/REVENUE BUDGETEp(CIRCLE ONE) YES NO
FUNDING SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION:(EXPLAIN) d�
.� .
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIONAL
MANUAL AVAILABLE IN THE PURCHASING OFFICE(PHONE NO. 298-4225).
ROUTING ORDER:
Below are correct routings for the five most frequent types of documents:
CONTRACTS(assumes authorized budget exists) COUNCIL RESOLUTION (Amend Budgets/Accept.'Grants)
1. Outside Agency 1. Department Director
2. Department Director 2. Ciry Attorney
3. City Attorney 3. Budget Director
4. Mayor(for contracts over$15,000) 4. Mayor/Assistant
5. Human Rights(for contracts over$50,000) 5. City Council
6. Finance and Management Services Director 6. Chief Accountant, Finance and Management Services
7. Finance Accounting
ADMINISTRATIVE ORDERS(Budget Revision) COUNCIL RESOLUTION (all others, and Ordinances)
1. Activity Manager 1. Department Director
2. Department Accountant 2. Ciry Attorney
3. Department Director 3. Mayor Assistant
4. Budget Director 4. City Council
5. City Clerk
6. Chief Accountant,finance and Management Services
ADMINISTRATIVE ORDERS(all others)
1. Department Director
2. City Attorney
3. Finance and Management Services Director
4. City Clerk
TOTAL NUMBER OF SIGNATURE PAGES
Indicate the#of pages on which signatures are required and paperclip or flag
each of these pages.
ACTION REQUESTED
Describe what the projecUrequest seeks to accomplish in either chronologi-
cal order or order of importance,whichever is most appropriate for the
issue. Do not write complete sentences. Begin each item in your list with
a verb.
RECOMMENDATIONS
Compiete if the issue in question has been presented before any body, public
or private.
SUPPORTS WHICH COUNCIL OBJECTIVE?
Indicate which Council objective(s)your projecUrequest supports by listing
the key word(s) (HOUSING, R�CREAT1Q�y„NEIGHBORHOODS, ECONOMIC DEVELOPMENT,
BUDGET, SEWER SEPARATION):(3��COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
PERSONAL SERVICE CONTRACTS:
This information will be used;to deterrtiine the city's liabiliry for workers compensation claims,taxes and proper civil service hiring rules.
INITIATING PROBLEM, ISSUE;OPPORTUNITY
Explain the situation or conditions that created a need for your project
or request.
ADVANTAGES IF APPROVED
Indicate whether this is simply an annual budget procedure required by law/
charter or whether there are specific ways in which the Ciry of Saint Paul
and its citizens will benefit from this project/action.
DISADVANTAGES IF APPROVED
What negative effects or major changes to existing or past processes might
this projecUrequest produce if it is passed (e.g.,traffic delays, noise,
tax increases or assessments)?To Whom?When? For how long?
DISADVANTAGES IF NOT APPROVED
What will be the negative consequences if the promised action is not
approved? Inability to deliver service7 Continued high traffic, noise,
accident rate?Loss of revenue?
FINANCIAL IMPACT
Although you must tailor the information you provide here to the issue you
are addressing, in general you must answer two questions: How much is it
going to cost?Who is going to pay?
. �F90 i���
DIVISION OF LICENSE AND P�RMIT ADMINISTRATION DATE � o�l QU l � T ()
INTE,RDF.PARTMF.fiTAL REVIEW CHECKLIST A.ppn ro essed/Received by
Lic Enf Aud
App licant � yn � , �—p�5 p� Home Address �,p � (,� �1 n�p�,,) _ d�
Rus ine s s Name tilJ-�C S� S�� �p� i--�D��[�ine Phone �a y- 3� o�
Business Address �� - y k j Type of License(s) � G? i-yt b ��✓�cl
� � � �
Business Phone �� S`�-Y� ��-2 v^ �q�- � nS .�t
--T� —1 /�
Public Hearing Date ��-- !d License I.D. 46 � (y c�5 1
at 9:00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. 4i �.7 �J�3� �
llate Notice Sent; Dealer 4� �//'t'
to Applicant �'"v�,�"��
rederal F3.rearms �� � l�"
Public He�.�ring
DATE IrSPECTIUN
REVtEW VERFIED (COMPUTER) COMMENTS
A rov�d Not A roved
�
Bldg I & D �
Nl A' ,
Health Divn.
N�� '
Fire Dept. � �
I ��� �
� Se n�I �n�� �1(�
Police Dept. I
� �l� I�Q �
�
License Divn. �
� ����i Q�
City Attorney �
�(� �D �1�--�
Date Received:
Site Plan �1/� � /� � � \
To Council P.esearch v )
Lease or Letter A Date
from Landlord Iv��-
CURRENT INFORMATION , NEW INFOItMATION
Current Corporation Name: 'New Corporation Name:
Current llBA: New DBA:
�
Currer.t Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
. ; ' _ - �;�y�o�i��
CITY OF SAINT PAUL
DEPARTI�NT OF FINANCE AND MAAAGEMENT SERVICES
DIVISION OF LICENSE A�D PERMITS
. APPLICATION POB A CBANGE IN GAI�LING MANAGEB
The applicant must retura this applfcation form, requested supporting
documents and the required fees in person to Room 203 City Hall. Make
aa appointment �rith Christine Rozek, 298-5056, to bring ia youz
application and to review City gambliag rules.
. Date: f � ►'►�t k�/ �7 C�
I) Full and complete name of organization:
�.��s: � \ `... �t... -,,����.
2) Name of licensed location:
��v-=�� �.,.�-2��
CURRENT MANAGER ZNFORMATION
3) Name ���_� S �(�,.�LS _ _
� - First Middle Last
4) Address lSS � 1.s�� �.—��� �� �SS\O^(
Nvmber Street City Zip .
5) City of Saint Paul License � �"1 �� `o _
NEW MANAGER INFORMATION
6) Name �✓!� , � .�a� c S �� �S O ►n/l
First Middle Last
7) Date of Birth �� a 3� .S�
8) Address (v I �l t� ��•s�o�-1 �v� S�'• p�+u � S���d 7
Nvmber Street City Zip
9) Phone # �l� � - 3 C,00 Pt�one ,� ,Z 5 1 �i l� t
Home Work
LO) Member of organization sfnce: /� ��
MontEt Year
11) Fidelity Bond: v��v ����5 - —
Insurance Company Bond Number
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CHANGE IN GAI�LING MANAGER
PAGE 2
� S C� �
State of Minnesota)
) ss C�.v''v4' n��'�v�--
County of Ramsey )
Iv\A.Q�� � • I�►\.�\�s and �',,n�+ i ! � ►�(s�vK -----... -
being duly sworn say that they are the petitioner(s) in the above
application; that they have read the foregoing petition and know the
contents thereof; that the same is true of their own knowledge.
Su scribed and sworn before me this
�=�1-')')day of a, 19�
—L/ " ' �/'�1N�Mn.v.nnn��tnn.V�nnnnM
��'�; :,
MMM/1M■
Notary Public, Ramsey County��5 i nesota ��,�NOT„�;Y �� �_ �,-;-�
RA�ti;�cY�u�;;�Y
My C omm i s s ion Exp ir e s Mr Commission Exp�r�Au�,15,1994
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12) Attach a copy of the bond to this application.
13) Attach to this application proof of inembership in the organization
for at least the most recent two (2) years.
14) Gambling Manager applications must be approved by City Council
before managerial duties can begin. Allow 30-60 days for
processing and investigation. This application is not a Iicense
to operate. You will be notified by letter of your hearing date
before the City Council. We suggest that you attend the public
hearing.
15) Attach a letter from the President or CEO of your organization
requesting the gambling manager transfer and explaiaing the
necessity for such a transfer.
16) 1990 Gambling Manager transfer fees are: ��o � �
7/89