90-1993 n � ( � [ � n � Council File � 7 D -/993
�✓ o � �-1
Green Sheet �. 11574
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA �'' �
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Presented By . ���.
Referred To � Committee: Date
RESOLVED: That application (ID ��43288) for renewal of a State Class B
Gambling License by Harding Area Hockey Association at Pub East,
1180 E. 7th Street, be and the same is hereby approved/d��.
i
TYe�s Navs Absent Requested by Department of:
���— � License & Permit Division
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Adopted by Council: �ate NOV 1 5 1994 Form Approved by City Attorney
Adoptio C tified by', Council Secretary gy; � �� 7'9U
By� - Approved by Mayor for Submission to
Approved by�yor: Date . NOV �. 6 �990 Council
By:
�-�,°r/,�/,(�r/f�'/ By:
P���;�N�'} f���`v` 2 41990
. . �����.%
EPARTMEFIT/OFFICE/COUNCIL DATE INITIATED N� _115?4
Finance/ icen e GREEN SHEET
CONTACT PERSON 8 PHONE INITIAUDATE INITIAUDATE
�DEPARTMENT DIRECTOR �CITY COUNCIL
Christin R02 k-298-5056 ASSIGN �CITYATTORNEY �CITYCLERK
NUMBER FOR
MUST BE ON COUNCIL AGENDA BY ATE) ROUTING �BUDGET DIRECTOR �FIN.&MQT.SERV�CES DIR.
ity Clerk ORDER �MAYOR(OR ASSISTANT) �
11-15-9 11-8- 0 �'��
TOTAL#OF SIGNATURE GES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTED:
Approval of a application for renewal of a State Class B Gambling License.
Hearin ; Notification: 11-2-90
RECOMMENDATIONS:Approve(A)or eject(R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWINCi QUESTIONS:
_ PLANNING COMMISSION CIVIL SERVICE COMMISSION �• Has this person/firm ever worked under a contract for this department?
_CIB COMMITTEE YES NO
_STAFF 2. Has this person/firm ever been a city employee?
YES NO
_DISTRiC'r COUR7 3. Does this person/firm possess a skill not normally possessed by any current city employee?
SUPPORTS WHICH COUNCIL OBJE IVE7 YES NO
Explaln all yes answers on separate sheet and attach to green sheet
INITIATINO PROBLEM,ISSUE,OPP RTUNITY( ho,What,When,Where,Why):
Don Sper on ehalf of Harding Area Hockey Association requests City Council
approval of t eir application for renewal of a State Class B Gambling License
at Pub E st, 180 E. 7th Street. Investi�ative fee of $373.25 has been submitted.
Proceeds from the pulltab sales are used to support youth programs.
ADVANTAGES IF APPROVED:
If Counc 1 ap roval is given, Harding Area Hockey Association will continue
to opera e a ulltab booth at Pub East, 1180 E. 7th Street.
DISADVANTAGES IF APPROVED:
DISADVANTAGES IF NOTAPPROVED:
RECEIVED
� .,�_�
N����� � ���:,:...�
�uov , 21990
ClT1f CLERK -
TOTAL AMOUNT OF TRANSAC ON S COST/REVENUE BUDGETED(CIRCLE ONE) YES NO
FUNDING SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION:(EXPIAIN)
dw
� � � ��, � �/�°"/�r 9-3
DIVISION OF LICENSE �IAND PERMIT ADMINISTRATION DATE � a0 � / � �� 'j(>
INTERDEPARTMEN�AL R�VIEW CHECKLIST Appn Proc ssed/Received by
Lic Enf Aud
Applicant S ,r Home Address ��, �J j� n�r �p,-� 2.Q b�
Business Name rc�-►r� � �-�p�kP� Home Phone � � � '�� y�7�
Business Addre�s k�j -� Type of License(s) �
, �,
Business Phone �i � � �D � ���"� ( � m����;v�� l���C� ��w�-�
—�
Public Hearing Date � �l � IJ(r7(� License I.D. 4� ( � C1 D�
at 9:00 a.m. in the Council Chambers,
3rd floor City Hallland Courthouse State Tax I.D. 4� � �A�
Date Notice Se�it; Dealer � ��A"
to Applicant j � � a' Cj�"aj
Federal Firearms � � �-
Public Hearing
DATE INSPECTION
REVIEW VERFIED (COMPUTER) COI�Il�4ENTS
� A roved Not A roved
Bldg I & D , �
' U A-
Health Divn. � �
� �„/ �., �
Fire Dept. I� �
I�-� A- �
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Police Dept. �,.� IoZ� 1�1 b
�! 1 ��a �� D /L
License Divn.� I f
; ���� I
�
l � � ��
City Attorney I �
' Yr �7 ���
�ate Received:
Site Plan '� � / C
-T To Council Research �(1�--`�
Lease or Letter Date
from Landlord � � ���'
� i
- , � City of Saint Paul /��-/]D,����
, Department of Finance and Management Services ��� 7
Division of License and Permit Registration .
INFORMATION REQUIRED W�TH APPLICATION FOR PERMIT TO SELL PULLTABS & TIPBOARDS IN SAINT PAUL
(Class B Gambling Lice�se in Liquor Establishments - Renew)
1. Full and complete�'Iname of organization which is applying for license
� � �:. �� /�
2. Address where gam�s will be held / d ' �� � 5� n �
Number Street City Zip
3. Name of manager signing this application who will conduct, operate and manage
Gambling Games �� �� �����`Z Date of Birth /�-. i7-.�(j
(a) Length of time manager has been member of applicant orgaaization �y��y'Z�
4. Address of Manage; � fy�,�j� U.�j �R��1 N � I.� �'/ � f A�t� M i�t �,,,'��!�}�
Number Street City Zip
5. Is the applicant �r organization organized under the laws of the State of MN? _/�t�
6. Date of incorporal�ion l Z -la- �Q
I
7. How long has orga�ization been ia existence? _ 1 Q�, y
8. How long has orga�ization been in existence in St. Paul? � g(� c/
9. What is the u o e of the or anization? Z � ^
P rP � 8 ��v � l� j� e cr�r_�
i
10. Officers of appli�ant organization:
Name � 1 !nn� /��vt�/YS°t1 N Name _�) � 1� �L�V�l iiv� �I�
�ddress a�9 ,�y5�/yT�� ,dv � Address /��� ���i�
Title /�' �� /��,�j DOB - - Title _ DOB �- n
Name t� � Name �'u � /� /1/�� �
Address o�a 99 j�AG rva �,� A Address y)�,ej/� ����,�, �,3/ /r
Tit1e � DOB - Title�1��,�5 DOB
11. Give names �# off�cers, or any other persons who paid for services to the
organization. ,
Name Name
I �
Address ' Address
Title Title
(Attach separate sheet for additional names.)
��f�D��I/�3
� j2. Attached hereto is a list of names and addresses of all member� of the organization.
• 13. In whose custody w�ill organization's pulltab records be kept?
Name j p �J�Y��� Address �� 7�� U�l��F� ��/�n� 1�
14. List all per�ons �iith the authority to sign checks for dispersal of gambling proceeds:
Name �! V► �/�'yV J1�1 1411/ Name � P, �i �/"� }Z}�
Address �bCf� /�1/a.�s/V�L/� Address 1� ��''�, ,�r�rr2 ��,�/bh( �1]
Member of Member of
DOB . Organization? � DOB /�.(����1 Organization? �_
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 or� the form fumished by the city of Saint Paul is a Financial Report
which itiemizes all recefpts, expenses, and disbursements of the applicant organiza-
tion, as well as all organizations who have received funds for the preceding calendar
year which has be�n signed, prepared, and verified bq �� �5 /�� ��
.
� �_�'�t,s 7���2 /� h'Jen� t�\
Address
who is the �,�.�,�����, ( 1�f�/,�hi/�(,�''�! of the applicant organization.
Name
17. Will your organiz�tion's pulltab operation be operated/managed solely bq members of
your organization'� yes no
18. Has your organizaKion signed, or does it intend to sign, a consulting agreement or a
managerial agreem�nt with any person or company to assist your organization with the
pulltab sales and,Yor recording keeping? yes no
If answer is yes, , give the name and address of the person and/or company contracted.
Name Address ' •
Name Address
If answer is yes, how will such a consultant be paid? (pe- ,entage, flat fee, gambling
funds, general fu�ds, etc.) Attach a copy of said contract to this application.
! .
19. Operator of premi�es where games will be held:
Name � f� ��,,,,! �� � �1�'!�,� !�c
Business Address ` �/ �P> � � ( �+ s / `
Ln � � .� � � � �
Home Address �l�) � �� �� �\1�'�' � r� �� `� �•.5 /ev�
. . � � �c-�a-1�9�
20. a) Does your orga�nizatfon pay or intend to pay accounting fees out of gambling funds?
� yes no `�
b) If you do pay �ccounting fees, to whom will such fees be paid?
Name Address
DOB Member of Organization?
c) How are the aCcounting fees charged out? (flat fee, hourly, etc.)
d) What do you anticipate will be your average monthly deduction for accounting fees?
21. Amount of re�t paid by applicant organization for rent of the pulltab sales area:
_�D��O �
22. The proceeds of ttne games will be disbursed after deducting prize layout costs and
operating expenses for the following purposes and uses:
�,r r-� � � G , �.�-,s
23. Has your organiza�ion filed federal form 990-T? If answer is yes, please attach
a copy with this application. If answer is no, explain why:
Any changes desired by 'the applicant association maq be made only with the consent of the
City Council.
n
Organization N e
Date g- J�— �_; BY�
Manager ' c ge o game
�y°
Organization Presi ent or CEO
� City of Saint Paul Page t
� - Depactmene of Finanee and Hanagemanc Ssrvieea /�,� (^�j
Division of Licensa aad Permit Administration • �n /!/�.-�(��Z7�
„ , �� oi �/i
� . UNIFORH CttARITABLE GAMDLINC FtNANCIAL REPOR?
Date +
_ n !1. Nam� of Ojr`anizacioa � G �
2. Addr�st vhere Charieabl� Casblin; is eonducted � /
�. Re�ort lo�e pariod eoverin� � (�� � _l9� ehrou`h 19�
�
4. Total number oE days playad ����j �
S. Cro�• recKipes foc abov� psciod � ��,�
6. Ctoss prLse parouts for above p�riod (iaelud� ea�h short) i � � � 7���,
n
7. Net rec�ilpca - lin� S ainu� lin� 6 = �j� � ��
8. Expsnses 'laeurred in eondueeins and op�ratin; =au:
A. Ccos� vas�s paid. Aecaeh vorkec list vieh ��i .�r+
namta�. addresses. jro�s va`ss. nua�er of honrs i _��a5i ��� � ��
vork�d, a�d amouat Qaid p�r hour.
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B. Renc for � ve:ks = �� �� � � �
.�
C. Lieensa f ee f �Q•����
D. Inaut7anee : "�`�*'� -
E. sond ;
T. Diahonorad eheeks not reeo�sr�d ;
C. AceoUntin; Expenss . s
�.,,.� �,-,1�
N. EmplOrers F.I.C.A. s �'S+s-�---�---
I. Pullksb Tax Paid to Depar utnt of R��eeua = �.5�/ � ��
J. itinn. U.C. rax ;
R. ted�ral Excia� Ta: 3 Sta�p s �J.s=-��^��
�. 5�.�� �..���n� zu : �/aa, � /
� M. Misel{ellaneous Expentes. Identif� tA� a�oant
�nd ko rho� paid. c
t, �...h/�/� �/a'�`�'�'-. s .��S- �_5�•' 1S'6
2, ,�.Lz`�A�R��r2�r : , 9��� a c�. �
�. s � � � �
4. ; '
9. 7ota1 F.xlpm�es T.OiAL i .� �'3�° 7 •.-1�
10. N�t LaeoY�� - lin� 7 ainn• lin� 9 � � �
i n
11. Checkboolk balance be;im�ins o[ p�riod s � � �
l2. Tocal oEl liae 10 aod 11 ; 7�^L1'' � -��
' ' l�. Toeal eajetributioes (froa aeeach�d vork�h��t) _ ��
l4. Cheekboqk balanee ead oE raporting p�riod - _ � ��� ` � �
line 12 'leas llae l3