90-1683 Y� � � � ! �A L Council File � :�� ��✓�
areen Sheet ,� 10546
RESOLUTION
CI � SAINT PAUL, MINNESOTA
Presented By
Referred To Comaiittee: Date
RESOLVED: Tha application (ID ��17339) for renewal of a State Class A Gambling
Lic nse by Rosette's, Inc. at 1494 N. Dale Street, be and the same
is ereby approved/d'�e�.
s Navs Absent Requeeted by Department of:
— sw z —
on ., License & Permit Division
acca e �,
et an
�
i son BY�
Adopted by Council: Date
S EP 1 3 1990 Fo� Approved by City Attorney
Adoption Ce if ied b Council Secretary g • G3j/gQ
ys • � d
BY� � Approved by Mayor for Submission to
Approved by Mayor: Date , l s�� � �: ���uncil
By: C �G..r By�
FU9liSHED S E P 2 � 1990
�d-��3 ��� �
�
DEPARTMENT/OFFICE/COUNCIL DATE INITIATED N� _10 5 4 6
Finance/Licen e GREEN SHE T
CONTACT PERSON 6 PHONE INITIAUDAT INITIAUDATE
�DEPARTMENT DIRECTOR �CITY COUNCIL
Christine Roz k-298-5056 A3S1°" �CITYATTORNEY �CITYCLERK
NUMBER FOR
MUST BE ON COUNCIL AOENDA Y(D E) ity Cle ROUTING �BUDGET DIRECTOR �FIN.&MQT.SERVICES DIR.
� �� / G ` �� ORDER �MAYOR(OR ASSISTAN� � Council
Hearin [ a
TOTAL#OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTED:
Approval of a application for renewal of a State Class A Gambling License.
Hearin : � �U Notification:
RECOMMENDATIONS:Approve(A)or Reject(R) PERSONAL SERVICE CONTRACTS MUST ANS ER THE FOLLOWING QUESTiON3:
_PLANNINO COMMISSION _CIVI SERVICE COMMISSION 1. Has this person/firm ever worked under a contr t Tor this depe�tment7
_CIB COMMITfEE _ YES NO
_STAFF _ 2• Has this personlfirm ever been a city employee
YES NO
_DISTRICT COURT _ 3. Does this person/firm possess a skill not norm I
y possessed by any current city employee?
SUPPORTS WHICH COUNCIL OBJECTIVE? YES NO
Explafn all yes answere on separate aheet an attach to gnan sheet
INITIATING PROBLEM.ISSUE,OPPORTUN (Who,What,When,Where, 1.�1!�'�"_-.. -- ��
ct-d,_--�gv
Lisa M. Kats on behalf of - ar /3 a Cit Council approval
of their app ication for : A G bling License. Gambling
sessions are held Monday � 9 . rs o 7:00 - 11:00 PM at
1494 N. Dal Street. Pro� _ �'r�� sess on are used to support
the operati of the Rose tion Investigative fee of
_ _.-.__
$497.50 has been submitte Q-- - ��
ADVANTA(iES IF APPROVED:
If Council pproval is given, Rosette's, Inc. will co tinue to sponsor
a gambling ession at 1494 N. Dale Street.
DISADVANTAOES IF APPROVED:
DISADVANTAGES IF NOT APPROVED:
���EIVED ounci! Re�carch Center
��,2��� S E P Q 41990
CITY CLERK
TOTAL AMOUNT OF TRANSACTIO S COST/REVENUE BUDG Ep(CIRCLE ONE) YES NO
FUNDING SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION:(EXPLAIN) .
� � �,/�y�=1��3
f �
,
DIVISION OF LICENSE PERMIT ADMINISTRATION DATE � rl� ! O / �� �j�
INTERDEPARTMENTAL REV EW CHECKLIST App ,' ro essed/Receiv d by
` Lic Enf Aud
--7- �.. I S c� k,�..�
Applicant (� e � ._1_ C.� Home Address � a p� �, Ov��ctnc� ,Q.� ,�
Business Name 1 /�J • ,�L� Home Phone ��� - ���-J r
Business Address Type of License(s) l� ��S S �}'
Business Phone `-y�.�,,,h I�rt�, , �c C.QinS Q�
Public Hearing Date � �3 � License I.D. � n3�j c(�
�
at 9:00 a.m. in the ounci Ch bers,
3rd floor City Hall nd Courthouse State Tax I.D. �� - �(� ��g��
Date Notice Sent; Dealer � ���-
to Applicant
Federal Firearms 4� 1V �
Public Hearing
DATE INSPECTION
REVIEW VERFIED (COMPUTER) ! CON��ENTS
A roved Not A roved
Bldg I & D +
N�/�.
Health Divn. I
��� �
Fire Dept. �
�v f./-�- �
Police Dept. �n� r���J l�� ,
� �I �� q� c� � ;
License Divn. (
g�3/ 5v � �, '
City Attorney J � ;
8'I 3i �ul ��-- ,
Date Received:
Site Plan �..1 A- C�
To Council Research � �� � '� ! �
Lease or Letter Date
from Landlord �g q Q
I
- City of Saint Paul �"�/�3
Finan e and Management Services/License & Permi� Division
� INFORMATION RE UIRID TH APPLICATION FOR PERMIT TO CONDUCT CHAR�TABLE GAMBLING GAME IN
SAINT PAUL (To be use with the following: New A & C applicatioa, renew A & C
Liceases, aad new and enew B in Private Clubs.)
1. Full and complete name of organization which is applyiag for license
O . Z
2. Address where g s will be held ���{� �.��Q_ ��-, . �'� �(�l. ���/7
Number Street City Zip
3. Name of manager igaing this application who will conduct, operate and manage
Gambliag Games �� Date of Birth /(�-�3--�Q
(a) Length of t e manager has been membeZ of applicant organizatf.on '�� �
7n'!J C '
4. Address of Manag r �(';7 �Gt'P�C�'(1C` l l l}�' C�. (.�i•����_��1-� 5 -����
Number Street City Zip
5. Day, dates, and ours this application is for �C;(1�t C��;LD -�(. 00� : ��z r (�C.i.1.�.
6. Is the applicant or organization organized under the laws of the State of MN? ,;;
7. Date of iacorpor tion ��(�-(��
8. Date whea regist red with the State of Minnesota L���(��
9. How Iong has org ization beea ia existence? �.(�C�.1�C
10. How long has or nization beea in existence in St. Panl? ����t,rS
� .
11. What is1 �he pu ose o� the orga izatio �T ' � , "` ` L'+�. � l..r � "
-f-0��.�.,r`N1k� '�-►1 CE'l� �:C.�� 4�-�G�k CS,UeIr�, vi--N�S� +�'lk.Y�'i �... �
m � r� � . 'r �
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12. Officer y of p icaat or aaizat on:
Name Name
/
�,d3r�ss � Add��ss
J�C�
Title DOB /�-�(.��'Z Title C '� DOB �-d`�-�q
Name� � N�
Address / � � I ` - Address
Tit1e ('(� ,Q DOB /—�-S% Title DOB
13. Give names of o ficers, or any other persons who paid for services to the
organization.
�
Name �,G1`Nn ', c� �,� ���1 � �L.C(�ame
,. !
Address �?r�� � � � �vk"_�� Address
�`
Title Title _
�
(Attach separate sheet for additional names.)
. . . �� ,��
14. Attached hereto is a Iist of names and addresses of all memb�ers of the orgaaizatfon.
15. Ia whos� custody_ , 11 organization's records be kept? ���� �i �, S� � `�+�G�.l,� .7,�/C�3
��1C1r1 U 'n • I Tl
Name Address c��J7 Mr��r�YI��vQ� ;(,l)< <��•�G3.1,�
��18
16. List all persons th the authoriry to sign checks for dispersal of gambling pr�ceeds:
Name Name �� ��0,�1��(���I(L�Q(1
Address '` (�,St•� Address �Q c , , S � T C?
Member of �� Memb r of �
DOB O� -. Organization? (� DOB !�-(_,�-�'o Organization? i�
Name ('L,
M �r r Name
Address , � T� ���I� Address
Member of Member of
DOB / f-.�� -�"/ Organization? � j.p� DOB Organization?
�_—
17. a) Does your orga ization pay or intend to pay accounting fees out of gambling funds?
yes � no
b) If you do pay ccountiag fees, to whom wiZl such fees be paid?
Name L� �11 � Address � . �
\1 ��/ �
\,.I�
DOB 1 �. - Member of Organization?
c) Hcw are the counting fees charged out? (flat fee, haurly, etc.)
��
18. Have you read an do you thoroughly understand the provisions of a11 laws, ordinances,
and regulations overniag the operation of Charitable Gambling games? ����
19. Attached hereto n the form furaished by the city of Saint Paul is a Fiaancial Report
which it .emizes 17. receipts, expenses, and disbursements af the applicant organiza-
tion, as well as all organizations who have received funds for the preceding calendar
year which has b en sigaed, prepared, and verif ied by � ��('� ;�� , �0'�' I`1 .�PY'�(1(1_
�- � �.�• S •� ' I
Address
who is the � vJ�,1� ' '� of the applicant organization.
Name
20. Operator of pre ses where games wi11 be held:
Name 't� �
Busfness Address���{�-I �. ��� \t-• \,T• � f`11V �.����
Home Address
. . . �y� ,��
. 21. Amount of rent pa d by applicant organization for rent of the hall: .
� c:� r � �;, � � -,
� /
22. The proceeds of t e games will be disbursed after deducting prize layout costs and
operating expense for the following purposes anil uses:
� I� � r �c�.ur a� '� � n
,
� -� i
. ,
23. Has the premises here the games are to be held been certified for occupancy by the
City of Saint Pau ? cIP�
24. Has your organfza ion filed federal form 990-T? �_ If answer is yes, please attach
a copy with this pplication. I� answer is no, �xplain why:
�(�r; i� .l, � l' �V�' ��(". CSJ C�c. U� -.�` �- f PCc-t"C
i � � �
C'�� � !� "�-rr,'` �;,^�
Any changes desired by the applicant association may be made onl,y with the consent of the
City Council. �
� _�
O�gaai ation Name
Date - ( ` � � By: i
� Ma. ager in charge of game
wMMMi'�^�°�nM^�rnnn�n .nnn^�1�nn;�M�`
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� `� _ ;. Organi�tatfon Presideat or CEO
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Dirision oF Lieensa aad P�rsit Ad4lnistrstion
'"' . IJNLF'ORM (:8/sRI'TABLB GAl�LI!(G FII�IAttCIAL REPORS
nZ '
Dats ��--�. J�4�
1. Name of 0 gaaization ��`.��%1�PC . �C,
—�
2. Mdress sre Charitable Caabliag is eondneted ���� N• �-W�?_�i-• . .\��Q.UI�, ��j����
3. R�pozt to period ewariag I9�, ehrough �'�T�1 �1 �,�(�.� 19�Q
— / rr ,1/
�. ?otal sr of days pLyad ��25� �����t�C�-�7
S. Crosa s�e ipts for above pesiod r i �_r,��S�`}CJ
6. Gsoss p e pa�ouu fos abw� pasiod (includa eaab short) ; �S,4 7�f� � �U
�}, ,-
� 7. Nac recs ts - Iias 5 minus lia� 6 � ��:�°'J�� • `r�
8. Exp�nse• incurred ia eonductiag sad operatiag gae:
A. Gros vages paid. Attach vorker list vith
aam� , addr�sses, ;zo�a vages, n�bes of harra f ����"�.� �� L�?
vor(c . and amoune paid per houz.
• B. Rent for ���veeks 3 ���:��)��-'( ;
C. Llce se fee � /��� ' 't-'� -�
D. Inau anee ; ���� �=-
E. Sond ; ��
' T. Diah nored ch�cb not recoverad ; ,�, � � i-7 '�-�-'
6. Aee ting Eapense i �=�1,' r( '1..�
t / �
. Ii. Eapl �eza l.I.C.A. i I ��ci� =J
. I. Pull ab ?as Paid eo Depastaent of Ar��m�s i � � 7 �3•�O��
' J. tiian U.C. Saz i �—
. 1C. Pede al Ezcise Taz 6 Stasp ; �C�� 'Q�
L. Seat Gatb2iag Tas = � �=����r�%`,
. H. tii�a llaneoua Espaasss. Idsneit7 eh� a�oant
. and o vhos patd.
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3. C��� : ,.a `
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I0. II�e Ine - lin� 7 aims Iim� 9 � �.7i(� L(i�l;;��
11. Ch�e k balanee besinnia; of pes3od i � oZ:��� ; ` �
12. rotal o lins 10 and 11 ; U_ ����� ��
" . 13. Sotal c tr3butions (froa attached vorlcsh�et) i ��UT�,iv�
16. Cheekb Ic balanee end oP rsporting psriod - ; �'/�,�•'�, '��
line 11 less liaa 13 . __:.� '
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�IIT OF 5T. PAUI ' "'—' '
� UNIFaRM CHARITABLE GAMBLING FINANCIAI REPaRT , ,- �
� LAWFUI PURPaSE CDNTRIBUTIONS - WORKSHEET }�'�� � ��"`'
. . .. . . . . ������
Li ne ,'#13 - Tota Lar+fui Purpose Contri but�ans. . 3 ��,�o�'-I.(��(�
-. List below a11 cfiecks written frart gambling funds whi�h are
charitable lawfut purpcse contributions. The total dollar
. amounts af these checfcs must match the amount claimed in
line �13. Use additional sheets as necessary.
CHECK # OATE ' PAYEE CHECK AMOU PURPaSE
- ^ �
i. �.5�I -�-�'�9 k' �tcS.�-.v�,�.�u�"�rc;� ,�u�.r�� ����c�o.�. �u�,�r�-
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4. ,==(,v L� �)-J"lr�� � 'CL\C�.�G..i c���t�..111 lJ(�,� 1c�C7�L>U 'n ��rv�:�..���x'r �
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13.���.� l�-� -v�f ��•�'UG�.!�.�.R�.1+'t�- 1 v`��(.,�(..� ��'
� � 70TAL CHECK AI�qUNT S-��i'��L
NOTE: Ti�ese expendi ures Nill be provided to Ccuncfl Members a�t your Cauncii hearinq.
� Be sure that ur financial report is complete and accurate.
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line �I3 - Total Laxful Purpose Contributions. S
, Lf st be?cw 11 chetics written fraa gambi f nq funds rri�ic�h are
charitable arrful purpose contributions. The total dallar
. amounts at ese cf�ecfcs must match the amount clatmed in
lire �I3. e additionai sheets as necessary.
CHECK � DATE AYEf CHECK AMOU PURPOS� I
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70TAL CHE�K AbDUN7 S ra�3C�
NOTE: These exper�dit res wi11 be provided to Ccuncil Members at your Cauncil hearirtq.
� Be sure that ur financial report is complete and accurate.
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