90-1471 � . Council File � � � 1
R I G I i�A L Green Sheet # 1
0498
RESOLUTiON
CI F SAINT PAUL, MINNESOTA ,,
�
t� �_
Presented By , �
Referred To Committee: Date
RESOLVED: Th t application (ID 4�44866) for a State Class A
Ga bling License by Church of St. Peter Claver Social Club at
14 4 N. Dale Street, be and the same is hereby approved/denied.
Navs s nt Requested by Department of:
0
osw z
an License & Permit Division
� cca e
ettman
u e
i son Z $Y�
Adopted by councii: Date AUG 2 1 1990 Form Approved by City Attorney
.
Adoption Certifie by Council Secretary gy; r/?�'r �—�j �gd
By� ���-�'��'��� Approved by Mayor for Submission to
Approved by Mayor Date AUG 2 2 �ggp Council
By: ���'a i� By�
PLSIISNED ��P - 11990
� ,,,�o�'�� �
, .
� .�,
DEPARTMENT/OFFICE/COUNCIL DATE INITIATED G R E E N S H E ET NO _10 4 9 8
Finance/License INITIAUDATE INITIAUDATE
CONTACT PERSON&PHONE �DEPARTMENT DIRECTOR �CITV COUNCIL
Christine Rozek- 98-5056 "�1°" �CITYATTORNEV �CITYCLERK
NUMBER FOR gUDOET DIRECTOR FIN.&MGT.SERVICES DIR.
MUST BE ON COUNCIL A�ENDA BY(DATE) C1 ty lerk ROUTINQ Q ❑
ORDER MAYOR(OR ASSISTAN� �,,�. „�„s�
Hearin 8-21-90 g -14-90 ❑ Q�r R
TOTAL#OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTED:
Approval of an pplication for renewal of a State Class A Gambling License.
Hearing Date: 8-21-90 Notification Date: 7/3//�D
RECOMMENDATIONS:Approve(A)or Re)ect(R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING�UESTIONS:
_PLANNINO COMMISSION _ CIVIL SER ICE COMMISSION �• Has this person/firm ever worked under a contract for thia department7
_CIB COMMITTEE _ YES NO
2. Has this person/firm ever been a city employee?
_STAFF — YES NO
_DI3TRICT COURT - 3. Does this persoNfirm possess a skill not no►mally possessed by any current city employee?
SUPPORTS WHICH COUNCIL 08JECTIVEI YES NO
Explaln all yes answen on separat�sheet and attach to 9rosn shest
INITIATINO PROBLEM,133UE,OPPORTUNITY(W .Whet,When,Where,Why):
Grace Kielbas on behalf of Church of St. Peter Claver Social Club requests
Council appro al of their application for renewal of a State Class A Gambling
License. Ga ling sessions are held Wednesday afternoon from 1:00 - 5:00 PM
at 1494 N. D le St. Proceeds from the bingo/pulltab sales are donated to
the church. Investigative fee of $497.50 has been submitted. This organization
was previous y licensed at 733 Pierce Butler Route. At renewal they are �oving
to new locat on, 1494 N. Dale St. , due to a vacanc at this location.
ADVANTA(3E3 IF APPROVED:
. If Council pproval is given, Chureh of St. Peter Claver Social Club will
__ be�.3,�, to sponsor a gambling session at 1494 N. Dale Street.
DISADVANTACiE3 IF APPHOVED:
DISADVANTAOES IF NOT APPROVED:
RECEIV�D
AUGd31�� Councif ��s��rch C�nter.
�,���}�a 0�1�y(�
CITY CtERK - - - •
TOTAL AMOUNT OF TRANSACTI N 5 COST/REVENUE BUDGETEp(CIRCLE ONE) YES NO
FUNDING SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION:(EXPLAIN) �tA,
YV
, � . ,
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIONAL
MANUAL AVAILABLE IN THE PURCHASING�FFICE (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. City Attorney
3. Ciry Attorney 3. Budget Director
4. Mayor(for contracts over$15,000) 4. Mayor/Assistant
5. Human Rights(for contracts over$50,000) 5. Ciry 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 pagea.
ACTION REQUESTED
Describe what the projecVrequest 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 ,
Complete 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, RECREATION, NEIGHBORHOODS, ECONOMIC DEVELOPMENT,
BUDGET,SEWER SEPARATION). (SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
PERSONAL SERVICE CONTRACTS:
This information will be used to determine the citys liability 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 Iaw/
charter or whether there are specific ways in which the Ciry of Saint Paul
and its citizens will benefit from this projecUaction.
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 service?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?
, . , �- yo-���
liiVISION OF I.ICENSE ANI) P�;RMIT 11DMINISTRATION DATE �a7d O / � �� �(�
INTERDFPARTMFNTAL REVIE CHECKLIST A.ppn Processed/Received y
Lic Enf Aud
Applicant � � ��{,-�2�1 C'4u�Pi-�Home Acldress �1 VQ�ggc�'�Q�wOC-I�r
Rusines5 Name �C��` � C r U� Home Phone yp`�9- aa��
Business Address �� '�-�' � ���-lQ� Type of Lic.ense(s) �_
Business Phone Yf'i U � ! 7�F1�t .. I
Public Hearing Date � � �� License I.D. 46 T � �
at 9:00 a.m. in the C unc 1 Ch mbers,
3rd floor City Hall � id C urthouse State Tax I.D. 4i /UJ,�-�
llate Nutice Sent; Dealer �� /V��
to Applicant ��/`�
rederal Firearms �� � /.�.
Pub.lic He�.iring —�Y
DATE IIvSPECTIUN
REVIEW VERFIED (COMPUTER) COMMENTS
A roved Not A roved
�
Bldg I & D �
u �- �
Health Divn.
���. '
;
Fire Dept. �
i
j � �
I I
Police Dept.
��a�,19
� u OIL.
License Divn.
;
�� � �� Q ��
City �ttorney �
�� � �jp + �/L.
Date Received:
Site Plan � �
To Council P.esearch � � �Q
Lease or Lett r ate
f rom Landlord (� � �
CURRENT INFORMATION NEW INFOKMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
. , , City of Saint Paul �r�D -�1�7�
' Fiaance d �ianagement ServicesiLicense & Permit D�vision vl-
INFORMATION REQUIRID WIT APPLICaTION FOR PERMIT TO CONDUCT CHARITABLE GaMBLI:iG CaME IY
SAINT PAUL (To be used ith the followi.ng: New A & C application. renew A � C
Licenses, and new aad re ew B in Private Clubs.)
1. Full and complete n e of organization which is applying for Iicense
u .Vc .
2. Address where game will be held /�9s/it/. 7�,Q/F Sa�•�:.��./ �S'Sii�
Number Street City Zip
3. Name of manager s'gning this application who will conduct, operate and manage
Gambling Games �c - � Date of Birth G -.,>�/-�L
(a) Length of tim manager has been member of applicant arganization /�Ea,r�o�
4. Address of Manag r ��,�;�9 �',��,ri6,redal� �.c�.� Lt/h.tE�ER.� C��E S.�//a
Number Stre�t City Zip
�Pr. ! i.J�e...
5. Day, dates, and ours this application is for Uf��,yr����i /'�-S•`a?�✓.�r, �..s•�1'/y�/
6. Is the applicant or organization organized under the laws of the State of MN? S%�
7. Date of incorpo ation f.-,�-�j
8. Date when regis ered with the State of Minnesota G -..�'-��
9. How Iong has o ganization beea in existence? l�j�,�r,�<
10. How Iong has o ganization been in existence in St. Paul? ,j�i cj Ep,es
��
lI. What is the pu ose of the organization? T �ss.szj Fiy�.�c,.a./� �vizif t��
r y.�
12. Officers of a plicant organization:
Name Name F�! _S�'.a.0 .S/�a/�
� Addreas ii • Address 37� .t/. 4aCF's�t
Title DOB �-/0 -��' Title�'i��_ssi.�.� DOB �/�-�
Name Name
Address Address
Title DOB Title DOB
13. Give names of officers, or any other persons who paid for sernices to the
orgaaizati n.
Name 6.ur Name
Address Address
Title Title
(Attach separate sheet for additional names.)
(� qa 'i�7i
I4. Attac�aed hereto is a Iist of aames aad addresses of all members of the orgaaization.
I5. In whose custody wi 1 organization's records be kept? �
- Name G' Addre ss ��"�y C,��yb,ecr�/ D�.
16. List all persons wi h the authoritq to sign checks for dispersal of gambling proceeds:
Name Name ^�.rT�;E/����
Address ' Address _�'�'�'�'� �ty�S _ea,�;� 1�,e�.
Member of Member of
DOB _ -.,T�!1 f/ Organization? �/�� DOB j�=/�- ,� Organization? �_
Name Name
Address Address
Member of Member of
DOB - - ,� Organization? y�,s. DOB Organization?
17. a) Does your org nization pay or intend to pay accounting fees out of gambling funds?
yes no
b) Zf you do pay accounting fees, to whom will such fees be paid?
Name �'� - - '— Address /y� �C'�F.�_z Gz` •
DOB - y Member of Organization? }��s.
c) How are the accounting fees charged out? (flat fee, hourly, etc.)
18. Have you read nd do you thoroughly understand the provisions of all laws, ordinances,
and regulation goveraing the operation of Charitable Gambling games? �/�-S _
19. Attached heret on the form furnished by the citp of Saint Paul is a Financial Report
which it .emize all receipts, expenses, and disbursements of the applicant organiza-
tion, as well s all organizations who have received funds for the preceding calendar
year which ha been signed, prepared, and verified by F�,c�..i /11a�,e�ssEZ+t�
�
N
. Address
who is the - of the applicant organiaation.
Name
20. Operator of remises where games will be held:
Name /� c
Business Ad ress /s/yy� Z�A�E .S�•
Home Addres ��7J� ��/� i.�
' � . � � � ��o-i���
21. Amount of rent paid p applicant organization for rent of the Iiall:
. �
/� � D,t, -
22. The proceeds of the games will be disbursed after deducting prize layout costs and
operating expenses or the following purposes and uses:
G d
�
23. Has the premises w ere the games are to be held been certified for occupancy bq the
City of Saint Paul 7� 'cS
24. Has your organizat on filed federal form 990—T? � If answer is yes, please attach
a copy with this plication. If answer is no, explain why:
Any changes desired by the applicant association may be made 'only with the consent of the
City Council.
Sr�•���Er�;,l�ry ASxix/ C'/�fL
Organizatioa Name
F
Date By.
Manager charge of game
5
Organi on President or CEO
^ ( � ^ .
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. . � , City of Saint Paul Page l
Departmaat of Finanee a� Kana;ement Setviees
, Divisioa of License and Pesait Administration ' ��— �� /�7/
. . :1-- �
. IJN'LFURH CSARI'lABLE GAIiSLING FIIiANCZAL REPOR� �•
Date �-�4�9�
1. Nams of Org ization �� �F �r l'�i��a=.� 5'dci.r�/ ���iil�
2. Address �rhar Charitable Gaabling is conducted 7!�.�/"� �<< � -/�'� ��,
3. xaport Por sriod covering /—/—� 19 ehrough ��/ 19�
4. Total numbe of days played G.�
5. Groas recei ts for above p.riod : �/� �.��
6. Gross prizs payouts for abave pariod (i�luda cas6 short) s _?3�3 ��?
7. Net recaipt - line 5 minua line 6 � ;���,�
S. Expenaes 1 curred in conductiag and oparating gae:
A. Gross ages paid. Attach vork�r list vith
namss, addresses, gross vagea, nuabsr of hwts i /L ��
vorked and amouat paid per hour.
� s. Rent f r �� veeks i g/G-�
C. Llcens fee ; �Z,�
D. Insur nce � 7-���
E. Bond S /�
F. Disho ored checka not recovered ; -�'���
G. Accou ting Facpense S .�d�-S
i
H. Empl ers F.I.C.A. ; �`�-�
I. Pull ab Ta�c Paid to Departsent of &aveaus 3 �,� L d�
J. Hinn U.C. Tax �
--r—
R. Fede al Excis� iax 6 Stasp 9�4 / ; ,S 7 d�
L. Stat Casbliag Tax ; �-a�S
H. His llaneoua F�cpensas. Idsntify tha mount
and to vham paid.
1, .X,. s ,,,�1 l
_• �•.��,�d s �i�t�
• s. �•�.��/�a 90 : � e s/�
�. ����'• ,s
9. Total snssa ?OTAL i ��r_-5-31
10. Net In oo� - lins 7 �iaas line 9 ; .,�3 �L�
11. Checkb ok balance begimtiag of p�riod 3 �,� -s-�d
. 12. Total f lins 10 and 11 ; �� g!�
' 13. Total ontributlons (from attached voriuhsst) i 39 .��
—�CS��
14. Check ok balanee end of reportiag period - �z �� �s
� liae 2 lesa liae 13 . :
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CITY OF ST. PAU� PAGE 2
' � . . UNIFaRM CNARITABLE GAMBLING FINANCIAI REPORT
LA11FUl PURPOS� CONTRIBUTIONS - WORKSHEET . C� -(/����/
li ne �13 - Tctal Lawfui Purpose Co�ri buti oAS. �_� .s�. ''�
•. List below 11 cfiecks written from gambling funds which are
charitable awfui purpose contributions. The total dollar
� amounts af hese checks must match the amount claimed in
line �13. e additional sheets as necessary.
CNECK # DATE AYEE CHECK AMOUN PURPOSE
1. �3iS .�-�-�� S •fE�.� C'/Au�.rC�y li � „��. �!! �,�otits f'.tE �..+fa
.�j� .z-��-9f � 5z• i°E'fE.c�c'/ti+a�.c
Z. �7 ��,.�. .-n
G�/fa.��/! i9.�/� �.��
3. ,�3t� s�s/-f�9 �' �,. "' u.s�-'d fd,e a.P�.,�.r.�y .
4. ,2 3 5%S s/�b-�/` .� .�� �� ���'.�t`i.v y� ��✓�oE.vs r.'.�'.
� �
5 . �S�x3 �3 c�-JrY � � ,�
6. .z6fa� �'�''�'� ,��-��
7. .z�1�d� �-.��-�y 3,�.�
8. �siY g- a�-�y j �. �.�
9. �.�!/f� �o -y�y . -7,-��,,.`.� .
io. �s�,� ��- y�y . ��. ��
II. a$yy
,a-.�-�r � � ��� "�
12. .?L �3 i- 9-9� . �� �.�-s
I3. �G s� a-7 �1� ,��,. �.�
��� �t a�f .�-��-9e _ `� �. �
�, a�--�
�'3• °'G y� y ��J� 70TAL CHEC K AhqUNT $,�y s-�. �
«� NOTE: These expendit res wi1T be provided to CouncfT Members at ycur Cauncil hearing.
� Be sure that ur firtaaciai report is complete and accurate.
� '�-
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