89-252 WHITE - CITV CLEriK COUIICII r
PINK - FINANCE GITY OF SAINT PAUL ��J �
BLUERV - MAVORTMENT ��Ie NO. � �`r
� ou il Resolution ��
Presented By `
Referre To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #39391) for a State Class B Gambling
Cice se by the North End Boxing Association at the North End
Depo , 1638 Rice Street, be and the same is hereby a�t�d/
deni d.
,
,
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
I.o�g [n Favor
Goswitz
Renman p B
�he1�� _ Against Y
Sonnen
Wilson
FEB 1 �} lggg Form App oved by Cit Att rney
Adopted by Council: Date -
Certified Passed b uncil Secr ry BY T� 2��
By
t#pprove by 'Navor. Date —
� �EB 1 � 19�9 Approved by Mayor for Submission to Council
By By
�' �a�" "�"�"a . ����
, 1..:tw:�
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- �. g �� a 3�k�'
DIVISION OF LICENSE AND PERMIT ADMINISTRATION DATE � 0�0 8 /
INTERPF.PARTMENTAL VIEW (;HECKLIST Appn roc ssed/Received by
Lic Enf Aud
Applicaut D C�N� �X��� Home Acldress JQU �Q(Z?�
Ausiness Iv'ame � O��'1 �IU1.�D 1.�pe �" Home Phone q ��D �J� �5 ��7
T•� i
Business Address t(p3 b �Lc2 �r�' Type of License(s) C� a5S f�— 114 mb���
Business Phone �JCS`� � �—P�
Public Hearing Date dl �y ��_ License I.D. �f � �3 g�
at 9:00 a.m, in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �t � ��Q.,
llate Nutice Sent; � � �� ���0 Dealer 4� u��"
to Applicant
rederal F�.rearms 46 u,/�
Public Hearing
DATE INSPECTIUN
REVIEW VERFIED (COMPUTER) CUMMENTS
A proved Not A roved
�
Bldg I & D �
�f� �
Health Divn.
u j� '
�
Fire Dept. �
I �/ � �
Police Dept. I �r`t �f' Z3
�
� � gy d/�
,
License Divn. '
�a �% ac�
City �ttorney �
� '�a���� ' o K
ate Received:
Site Plan ZQ � C�
To Council P.esearch 1 �4 �� 1
Lease or Letter �/ Date
from Landlord Z- �i�' a�
�
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
3 ��9/
, . City of Saint Paul n ��
Department of Finance and Management Services ��� �
License and Permit Division
• ' 203 City Hal1
St. Paul, Minnesota 55102-298-5056
APPLICATION FOR LICENSE
CASH CHECK CLASS N0. New Renew
0 � -� �, � � - qC, ��
r I f j(Q / f � ZU
Oate f e 1,��,�,_
� �
Code No. Title of Lic nse
From � 19�To � ^ 19`' �
�J �c�-; � —C�c �7,�lt 3 y 9, �� '
�. ,o0 1�o��-h � �u1� �,,C� ,.� � �} s sv
,
�� e � AppticanUCompany Name
100
�r3�' l�;�r��h �V� l�.�.��
100 eusfness Name
I ,00 �(� 3 � �� C� �-'��`f'
Business Address Phone No.
�
,00 �l , �c, ,.� � ;�� ;J
100 Mail to Address P�one No.
too j�� � L E I Z.
Gc��
ManagerlOwner!Name
, �oo � � 0 �! �0�2Io ��
100 Alanager/Gwner•Home Address Pho�e No.
4098 Application Fee
Received the Sum of 2 10� J � . ���� ( r 1'� Y� �J ���
5 � •o� ManaflerlOwner-City,Siate 3 Zip Code
100 Total 1�
� C� C �1 � � S''. �� c
f2 ,J �'_�-c��-�.c 2.
License InspeCtor I By: Signature ot 7Cpplicanl
Bond•
Com any Name Policy No. Expiration Oate
Insurance:
Com any Name Policy No. Expiration Date
Minnesota State Identification No. � Social Security No.
Vehicle Information:
erial Number Ptate Number
Other: � --
THIS IS A RECEIPT FOR APPLICATION
THIS IS NOT A LICENSE TO OPER�TE.Your application tor license will either be granted or rejected subject to the provisions of the zoni�g
o�dinance and completion of the in pections by the Health, Fire,Zoning and/or license Inspectoro.
I
II $15.00 CHARGE FOR ALL RETURNED CHECKS
� �
��� � .
/�-01.3�'�
. . ��-���
,�,�,,,,.,,�, _
. ..,v�o,�so���� Charita le Gambling Control Board FOR BOARD USE ONLY
Room N 475�Griggs-Midway Building
- _.. ;� 1821 U iversity Avenue ���ssN��,�ne.
_ _, .� St. Paul, Minnesota 55104-3383 AMT
(61216 2-0555
���` CHECK#
DATE
GAMBLIN� LICENSE APPLICATIOIY
INSTRUCTIONS:
A. Type or print in ink.
B. Take completed application t local governing body,obtain signature and date on all copies,and leave 1 copy.Applicant keeps 1
copy and sends original to th above address with a check.
C. Incomplete applications will e returned.
Type of Application:
❑Class A — Fee S 100.00(Bing ,Raffles,Paddlewheels,Tipboards,Pull-tabs)
❑Class B — Fee S 50.00(Raffl s,Paddlewheels,Tipboards,Pull-tabs) Makecheckspayableto:
❑Class C — Fee S 50.00(Bing only► Minnesota CharitaWe GambCmg Conuol Board
❑Class D — Fee S 25.00(Raffl s only)
❑Yes�No 1. Is this applicatio for a renewal? If yes,give complete license number � - 0 - 0
❑Yes ONo 2. If this is not an a plication for a renewal,has or anization been licensed by the Board before? If yes,give base
license number( iddle five digits)
❑Yes ONo 3. Have Internal Co trols been submitted previously?If no,please attach copy.
4. Applicant(Official,legal nam of organization) 5. Business Address of Organization _ .
s -
6. City,State,Zip 7. County 8. Business Phone Number
_' ' , - 1 1
9. Type of organization: ❑Frat rnal ❑Veterans ❑Religious �Other nonprofit"
•If organization is an"other nonp fiY'organization,answer questions 10 tMough 13.If not,go to question 14."Other nonprofit"organizations
must document its tax-exempt s atus.
�Yes❑No 10. Is organization i cor orated as a nonprofit organization?If yes,give number assigned to Articles or page and
book number: Attach copy of certificate.
�Yes ONo 11. Are anicles file with the Secretary of State?
❑Yes❑No 12. Are articles file with the County?
�Yes�No 13. Is organization e empt from Minnesota or Federal income tax?If yes,please attach letter from IRS or Department of
Revenue declari g exemption or copy of 990 or 990T.
OYes ONo 14. Has license eve been denied,suspended or revoked?If yes,check al�that a ly:
❑Denied ❑ uspended ❑Revoked Givedate: - -
15. Number of active members 16. Number of years in existence Note: If less than four years,attach
evidence of three years
- existence.
17. Name of Chief Executive Offic�r 18. Name of treasurer or person who accounts for other revenues
of the organization.
• , _
Title Title
Business Phone Number Business Phone Number
1 1 " ' " � � �
19. Name of establishment where ambling will be 20. Street address(not P.O.Box Number)
conducted
21. City,State,Zip 22. County(where gambling premises is located)
CG-0001-02(8/86) White Copy-Board Canary-Applicant Pink-Local Governing Body
. . ���a��
Gambling License Applicatio Page 2
' Type of Application: ❑Clas A C�Class B �Class C ❑Class D
,�Yes❑No 23. Is gambling pr mises located within city limits?
�Yes�No 24. Are all gambli g activities conducted at the premises listed in #19 of this application? If not, complete a separate
application for ach premises(except raffles)as a separate license is required for each premises.
❑Yes�No 25. Does organiza �on own the gambling premises?If no,attach copy of the lease with terms of at least one year.
�Yes�]No 26. Does the orga 'zation lease the entire premisesllf no,attach a sketch of 27. Amount of Monthl Rent
the premises i icating what portion is being leased.A lease and sketch g
is not required or Class D applications. �
❑Yes ONo 28. Do you plan on conducting bingo with this license?If yes,give days and times of bingo occasions:
Days Times
�]Yes�No 29. Has the S 10,0 fidelity bond required by Minnesota Statutes 349.20 been obtained?Attach copy of bond.
30. I�surance Company Name i 31, Bond Number
, :"1
32. Lessor Name 33. Address 34. City,State,Zip
'.. . I . _ . j .
. , , . � � ' , r,
35. Gambling Manager Name 36. Address 37. City,State,Zip
, � . ' � � - .
, . . . _ . . . . _, �;
38. Gambling Manager Business hone 39. Date gambling manager became
( , � � � �,...� , member of organization:
GAMBLING SITE AUTHORIZATION
8y my signature below,local la enforcement officers or agents of the Board are hereby authorized to enter upon the site,
� at any time, gambling is being onducted,to observe the gambling and to enforce the law for any unauthorized game or
. practice.
BANK RECORDS AUTHORI2ATION
By my signature below,the Bo rd is hereby authorized to inspect the bank records of the General Gambling Bank Account
whenever necessary to fulfill r quirements of current gambling rules and law.
OATH
I hereby declare that: �I
1. I have read this application and all information submitted to the Board;
2. All information submitted i true,accurate and complete;
3. All other required informati n has been fully disclosed
4. I am the chief executive of icer of the organization;
5. I assume full responsibility or the fair and lawful operation of all activities to be conducted;
6. I will familiarize myself wit the laws of the State of Minnesota respecting gambling and rules of the Board and agree,
if licensed,to abide b tho e laws and rules, includin amendments thereto.
40. Official,Legal Name of Orga ization 41. Signature(must be signed by Chief Executive Officer)
;� �•. � :-+ . .� =-. . X ,f _ ' ! { „f,� ..,.L
Title of Signer I Date
ACK OWLEDGEMENT OF NOTICE BY LOCAL GOVERNING BODY
I hereby acknowledge receipt o a copy of this application. By acknowledging receipt, 1 admit having been served with
notice that this application will e reviewed by the Charitable Gambling Control Board and if approved by the board, will
become effective 30 days from he date of receipt(noted belowl,unless a resolution of the local governing body is passed
which specifically disallows su h activity and a copy of that resolution is received by the Charitable Gambling Control
Board within 30 da s of the bel w noted date.
42. Name of City or County(Local Governing Body1 tf site is located within a township,item 43 must be completed,in
. _ addition to the county signature.
Signature of person receiving appli ation 43. Name of Township
X _ __
Title Date eceived(30 day period Signature of person receiving application
begi from this date)
• X
44. Name of Person delivering appl' 'on to Local Governing Body Title
CG-0001-02 (8/861 White Copy-Board Canary-Applicant Pink-Local Governing Body
��1�� J�' �C�iu.�a
. , . Cic;� oc Saint ?aui ���— ��
�
. IDeparcmenc oc �inance and Managemenc Services
. • I Division of License and Pe�it Regisc�ation
INFORMATION REOUIRED 1.v�ITi�i :�P.°LIC�TION e0R ?E:ii'tIT TO CONDUCT C:3ARI?'�.BL: GdMBLI�IG G�E T_'.V
SaINT PAUL
I. Full and complete name of organization •.rhich is applying for license � /L�c %�
� o � iv s � �� � <"o�v c�,�� -- � 1 e e �S'T-� � 7- y n��
2. Address where gam�s will be held l�v 3 •� ,� I C� ,S T- sT/'�c�L- �'�.3'��7
I ;lumber Stzeec Cicy Zip
3. Name of manager s�.gning this application vno will conduct, ooerace and manage
' G :�c -3/
Gambling Games -- ��c�t2- �•� �� Date af Birti
(a) Length of tim� manager has been ae�ber oi appLicant organi�acion � �t'-S
4. Address of Manage� ��4 �f ���P T it.� ��/ � ��' J'/i1 vL �`5%/7
;lumber Screec Ci[? Zy?
5. Day, daces, aad h�lurs chis applicac�cn is cor
,6. Is che applicant Or organizacion erganized under che lavs oc c:�e State o= �i? _���
7. Date of incorporaclion y����'S
8. Date when registerlled with the Stace. oi �`�anesota ���S��SS�
T
9. How long has organ�ization beea ia e:cis caacs? l� ��S
_�
10. How long has otgan�.zatioa been ia �Yiscenca ia �t. Paui". � ,S
11. What is the purpos of the o:gan=zation? 6 /IV G X ���S �� �
c�a� � �r-T��6 — �� ;� �<�T,�� ,� �,� ��-���� ;z rti F,� rti F ��-�-��
�,�- �rh �. s�����T�
I2. Officers of applic nt or3an�zat=on
Name �AU i .!' � . �-�1►ZS v � Ya�e �L.V I N/� �/�'Ul-:.�nl�=Y�
Address l `f'+-`f f,") � xlh/L.� � Address ( �'1 1 Mr3 Ie10� �SI ,
Title ,��1;'�1 pl-,"�1"� DOB �- 3"3�/ T==?e �t�s�1 ��Z, ]09 �S'- 3 � -`�V
Name �AV lr. ' 1ej�c. t.._ Yame
Address ��j2� l � ,�{V� � _ �dd:ess
Title �rL� ;�'h't�� -W DOB �� �D-`-F�-} '"_�_e 70B
13. Give names OI OL:i er5, Or dAV OG�e� 72rS:.rS '7[SO 73'_: �0� Sc?^%=C_8 =0 =:e or3a^::3L:Ott.
Vame y�e
Address ada=°=;
Title � -=-=
I (�;t�ac� sepa�ace �;.z� . - a�:.---_••=- ..�=_.
I
. �����-�
.
14. . A�Lached hereco ils a lisc of names and addresses oi all members oi the organizat_on.
15. In whose custody �rill organizacion's records be kepc?
: Name T���o��r � .s' � ,��"`�-��r aaaress � � o � N „rTe ti� sJ .Pr��� ,Nw�
T---
I6. Persons who vill �e conducting. assisting in conduccing, or operating che games:
Name ��l��al2l�� S'_ ��(_Z�/"` Dace oc Birzh ��zv �3 �
Address ! 1 � 9 I l`�fC�1'Df�{ �ST. 3 T �r��+ l, � rJ 5�'11 7_—
Name o= Spousa �C°� � � I T�= � . �/' ��-ZC �L. Dace of Birzh 7 3� 3G
Daces vhen suc:� o rson vi11 conducc, assist, or operace Q����i+�'V I �� n,��SS
�
✓ C i o � �ti �= f C •
Name L.. �JIti1 �l'G1:I'� �.;rJ'L Dace of Birth �'- 31 � Lf'�
:�ddress �� i Mr� iZC 4�ti` S'i , _Sl, r�1J t„ j jll
Nane ai Spouse 1:j:1�L l� v t.�'�1�tYL Dace of Birth (� ' 3 � 3 �•
, Daces �nea sucz pe soa *.rf?I conctcc, ass_s�, or ope_ate �V,�1�./(� l �-�-N�S
�/�C�1110�% I� �1� a �� •
_ 17. Have ��ou rea�+ a�c �o �ou c:�oraugnl.i understand �he orovisions of a�l 1aus, ordiaances,
_.
and regulatzor,s �e��e�_::g, tze operac_on ci C�ar_tab_e Gaab.i�g ga�es? Y�5
18. Attac::ed here=� oa Ic:�e :o:r cur..ished '�•s c�te C�t7 0� St. ?aLl is a Fiaancial Report
whica :�e�izas a?= :ece==cs, e�enses, a.-.d d;s�ursemencs o= che dDDlicanc organization
' as we1� as a?? e:aa�r.:zac_ozs .aa aa��: _e_�:red :sZds �or tze grec2c_::g cal�ndar �ear
whfca ;�as beez s:;::led, ^r_�a-ed, aad ve_==_ed �y rfl^I E0�4IZ� �j, +��L�E tZ
. `ame
(t o� ti`��2 T�,� s T . .s / . ,lf�v t... � �� - ss i�7
I d�c_ess
whe is che C,lio`I C /-/ oi c�e aDpLicanc Organizacion.
' Vaae �= 0�:_�s '
19. Operaco: o: pre�ise� .aere zames �:�: �e ae�d:
Naate N Q � �?�i, ,�C-�'� %
B�ssiness nddress ( � ;�-� � ►C E S �' , S%• �i1 V l- /���;� �� //
Home �ddress �
20. ?�mounc oz rer.c �aid �y a?o=:�anc Or3aa:�ac:on :or -er.c o: ct:e zall; spec�:;� amounc
�
pafd ?er :+-hour se==�:on S�-�" � � .,-:�X
�
�
� . , � � � � ����
2I. The proceeds oi ae 3anes will be disbursed afcer deducting prize Iayouc coscs and
- ` operating expens s ior �he iolloving purpcses and uses:
O /'ulNd ml1T'�� ✓L � v '� iNL_.. FC � i ti �
y o �;h r T �e /4�2 fz',�Z
_
2T. Has the premises �rnere che gzmes are co be held been certified for occupanc� by the
City of Sainc ?aul? y eS
23. Fias your or3ar.�za ion �:1ed cedera= �or� 9°0-T° I� ansver is ves, please actaca
a copy v±c;� �;;:s policac:on. I: ans�:ar is r.o, explain vhy:
�'�j pR o � �s�
Any changes desi:ec b•r :�e a�?I_ca::c �ssociac'_on �a� be aade onlr vich t::e conser.c o: the
Ci�y C�uncil.
/��c�1ZT�1 ,E%h'C� ��k/ic- �s.s�c�`/.�T,'a�
' Orgaa_za _on
�
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.
Date � �� � I By: � �?�- � ' -.���3�/L
�iaaage: in charge or game
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�r,►c�r�ao�+ o��ar�r o�n�ei�a: ►���a+�s�rnrrn
CMris�fr�e Ro�e �� _ ����� ��«.� ,
� _ �°. nou;,�o �� 2 Council Research
Finance & M �. -50�b ono�a: � ���_. —
Application ffl a State Class B Gambl�ng Licer�sg (Pu11tabs/�'ipbeards).
Notification te: 1-24-89 1�aring Date: 2-�4-89
71WIM:(AppioMe(Ap or Fte�t(A)) COUpCL RE86/a1CFI RE►ORT:
ryuwMO oo�ow cm� �issroH a►�w aare arr �ra�ver rr+4r�No.
�owno oow�oN �so ax� eawo. :
� -STAFF. . . qMR7EA OMM13&ON.�. � . � � OOMPIEfE.AB IS - . .- .AODL N�FO.AODEDi� � �� T�O OONTA�T� � . OON61tTUENT � ..
. � . � . . . . _ . . . 1{ODL RIPD... _�DB�pC ADD�• � .
DIB1frLTOOUAICIL .... •EXPLANA710N: . . � . . .. �.
'811�POKf8 WHICM�COUIVCIL.t7l�IECTNE7 . . . . .. . . . . - � � . . . . � . .
.i � . . . . . . . . ... � .
MIM7M9�IIO�kEM,�YIlE.:4PlORTINMTY(VYfw Whati When.W�rs.Why): : -
Jay Pelzer, on behalf a� the Morth End Boxing Association, quests City _
Council approv 1 of his application for a State Class � Ga ?1ng License
(Pulltabs & Ti boards) at the North End Depot., 1638 Rice St .eet. Proceeds will
� be used to tra n boxers at the Rice Street Gym. �
.
�,incmao��a.aen..�a.�....�xs�: .
All fees and a plications have been submitted.
�e.o��v�.wn.A..na w�aam: . . , , ,.. � �
' .
If Council app val is given, the �P�orth End°�oxing Associat on wi11 be able
to sponsor a 11tab booth at the Narth End Depot. �
�4
�.�� . �os
ounci! Research Center
J�N 2 G "��:��-J
'"°''°""�e North End xin Association has a Class A License Bi� o u a s a
1079 'Rice St t". �Th� Class A 1icense was approved for re ewa1 by �Council
. I0-27-88.) .Qt er organizations have 6eer� approved f'ar both Class A and .Class B
Li ns s in St Paul Sho Pond Gan St. Paul Turners .
''uo��nea: