89-416 WHIT'E - C�T,V CLERK
PINK - FINANCE G I TY O A I NT PA U L Council
GANARV - DEPARTMEN7
BI.UE - MAVOR File NO• � �j�
.0 unci esolution �
Presented By
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #1 668) for a Gambling Manager's License
by Mark Mules DBA We ts de/Westend Youth Hockey at John & Paul 's Bar,
731 Rando1ph :Avenue, ,be and the same is hereby approved/d�ed.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
t.onns [n Favo
Goswitz
Rettman
��;�� � _ Against BY
"Soencs-
Wilson
�R 91gB Form Appr ved by City Atto ey
Adopted by Council: Date
2 �3 �
Certified Passe il Secr ary By
By
A►pproved b � vor. ate —
MAR � Q �g Approved by Mayor for Submission to Council
r
By �
PUBI.tS�D Mi�� 1 � 1 89 By
. • �� ��
+ UiVISION OF LICENSE AND PERMIT ADMINI T TION DATE �°� � 0 �l � % U �
. INTERPFPARTr1ENTAL REVIEW CHECKLIST A.ppn P oc ssed/Rec 've by
Lic Enf Aud
Applicant Qf� / '�I P S Home Address ��� � --1�5�-��
Rusiness lvame (�V�S�SIde� (,(J�S� Home Phone °���+ b o�� 2-
0 u cKP�
Business Address `] '7y� � n Type of License(s) ��Cc �'y�.b�`r
a � �
Business Phone �� U� D � l� n� 'e�
J o h n f �Is t3a�e. /-
Public Heariiig Date 3 � � License I.D. �F � �lp�j�
at 9:00 a.m, in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �� �I�
-�
llate Notice Sent; �� �� ���� Dealer 4� �)��-
to Applicant
Federal Firearms �� 1�7I�
Public He�.iring
DATE TNSP CT UN
REVtEW VERFIED (C MP TER) CUMMENTS
A proved N t roved
�
Bldg I & D �
� �� ,
Health Divn. �
N ��+ �
�
Fire Dept. � � �
i N � I
': S e�t I
Yolice Dept. �
II� I� � j� G� ��
0
License Divn. � �
i
3� g� � o�
City Attorney �
� ���� � b ��
Date Received:
Site Plan N �� k
To Council P.esearch � �-� U
Lease or Letter Date
from Landlord V
� City of Saint Paul /� ���
Department of Fi an e and Management Services
Licen a d Permit Division ���
2 3 C(ty Hali
St. Paul, Min esota 55102-298�5056
APPLIC TI N FOR LICENSE
� CASH CHECK CLASS NO. Ne Renew
i � � . '� 0 �Z v , � �
Date 9
Code No. Tftle of L(cense I � �( C
From �Z �+ ��To �� 19" �
��►m �I, n� ,�'1a ,��4 P�e., l 1. � n�y
J �� 1' I G r� �(. ��,5
• ApplieanilComps�y Name
100 � � ,,I,, �^
� •-
W :1—(. �l V.l. � �!_���� C.;'1�
100 eusln�ssNarps, r r J �y y ,,,j ��UG
yo c, � � �to c ; � �
`� �
�� � �, L �CGnC���L�h �-*�.e
Business Addrssa Phon�Na
100
S�• �G Lt� /�h S����---
100 Mail to Addrsss � Phon�No.
I � o���r
�� �Gr � /"lL< �PS D.� � z
ManapeHOwner•Name
100 '� •
� 1:J� I S�� � �
. 100 AlanageNGwnsr•Nom�Addroas Phon�Na
, 4098 Applfcatlon Fee Z � �/ J- /
Aeceived the Sum of 100 • � ���� (' c Y� ��< 6 7
� Q(� ManapeNOw��r•Citp,Stale 3 ZIp Cod�
100 T tal 100
�c� �� � .� . � �`�_.`��,
License Inspector By: Signaturo of Applieant
Bond•
Company Name Policy Na ExpiraUon Oatt
Insurance:
Company Name Polfey No. Expiatfon Datt
. Minnesota State Identification No. ES 3�35� Social Security No
� Vehicle Information:
Serisl Number ats Numbar
Other
THIS IS A R EI T FOR APPLICATiON
THIS IS NQT A IICENSE TO OPERATE.Your application for I �en will either be granted or rejected subject to the provisions of the zoning
ordinancs and completior►of the inspections by the Hea1tA, ice, oning andlor License Inspectora.
$15.00 CHARGfi F R LL RETURNED CHECKS
.
.
a.�r�1�,2_�J�-9�"9 ��`� ��
C�.:; : :>a+_r.[ Paul L�,,_° ' _��
' Deparcment oE Fina ce and Management Services �
Division of Licen e nd I'ermit Registration
INFORMATION RE UiRED wITH APPLICATION FOR PE IT TO CONDUCT CHARiTaBLE Ga.KBL:vG G� i:�
SAINT PAUL
1. Full and complete name of organizati n hich is applying for license
�<.� �-Sl ��2, L�
2. Address where games will be held ( f��C�o� �•. c��A� I�n SS�OZ
Nu ber Streec City Zip
3. Name of manager signing this applica io who will conduct, operate and manage
Gambling Games ��QS Date of Birth 1 ' Z-�' ��
(a) Length of time manager has been em er of applicanc organization r
4. Address of Manager ��s � • �SA�e-� �.3':��•�` � SSI o'"]
Number Streec Citq Zip
5. Day, dates, and hours this applicati n s ror ,(�� f� �� "� ��'^ � �� �
6. Is the applicant or organization org ni ed under the Iaws o= t4e State oi !�II�T? �
7. Date of incorporati�n 1�OV `� �1 �
8. Date when registered with the Scate f : innesoca � 1� �
9. How long has organization been ia ex sc nce? �� Ll�ar 5
10. How long has organization been in ex st nce in St. Paul? �� �IQ A T S
11. What is the purpose of the organizat on �v�"� ��^����-S \ l�-oc-�-y�
I2. Officers of applicant organizatian
Name - l��o *iame ���e,r� \�-xN��..,
Address 3`� �- �����-�- Address Z�-� ���'c�C
T i t le •,.Z '�a,:;_„_— DOB b • 3� •`�1 Ti t Ie ��-��-j-e � DOB � `- Z-Z-'`� 1
Name � b Name ��+�a-� L��.�• �`^•l`
Address Z.,SZ � L9-� ��^ ?►ddress �S �- �`�`^�'�
Title�} ' `�sti�e,.."i DOB � ' � '` � Title ���� ti DOB � �� � ' `� l
13. Give names of officers� or any ot:�er ve sons �ano �aid tor serv�.ces to tne organ��at'_on.
Name vame
Address address
Title T=='-e
(Attach separat s' ee� `^� aca.:=or.s: ::a=as. �
. • ' . ��`���
14, Actached hereco is a list of names nd addresses of all members oi the o:ganiza�ior. .
15. In whose custody will organization' records be kept?
Name � �. ���,c S Address `S 5 �. =sa�sa�
16. Persons who will be conducting, ass sti g in conductfng, or operating che games:
Name `� �'����. S �-, Date of Birth � - Z3� �{'�
Address � S S' � �s
Name of Spouse � ,e Da[e of Birth �J ��- �d
,
Dates when such person will conduct, as ist, or operate
Name Date of Birth
4ddress
Name of Spouse Date of Birth
Dates when such person will conCUCC, as �st , or operate
17. Have you read and do ;�ou thoroughly nd rstand the provisions of alI laws, ordinances,
and regulatfons goveraing the operat on of Char�table Gambiing €ames?
18. Attached hereto on t:�e forT �ur^.ishe b che City o: St. Paul is a Financial Reporc
which itemizes al'_ rece?pcs, expease , r.d disbursemencs ei the applicant organization
as well as a�: o:gan=zat'_ons who nav : ceived �unds ior c:�e orecediag calendar year
whicl has been s_gned, prepa*ed, and ve _=�ed Sy �w�.� J �L�
e
vame
�S S \ ��� � �t�.�� ��•� S S�o`�j
:� dress
who is the c �Acti.� . � C' . of the anplicant O:ganizat:on.
Vame JL 0 *i e
19. Operator of premises where qames :r��' b held:
Name
B�rsiness Address
Home Address
20. Amount of rent paid by aop:;canc Or3a i� cion ror re�c or the hall; specify amounc
paid per 4-hour se�s;on �1� 0p � d„--��
, , ' . C�° ' 'f�1�
2t. The proceeds oi the games will be di bu sed after deduccing prize layouc costs and
operating expenses for the t"ollowing pu poses and uses:
�-LC: ��c�� <n�oo` ' 2 �+.� ��-i2_.S � �- �,.� �'h.�-�i.
22. Has the premises where che games are to be held been certified for occupancy by the
City oE Sainc Paul?
23. Has your organization riled cederal 0 990—T? If answer is yes, please atcach
a copy wlth this applicacion. IF an wa is no� explain why:
Any changes desired hv tae apol:cant �sso ia :on may be �ade only wich the consent of the
City Council.
n�,s.- �-.�1 � ���1,. ����,
Organizaci n
Date Zg �c.. �� By: lf� � �\ � l��
Manager in charge of game
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TO LErF.D BY
ORGaNIZATION P ID AZID GA1�LIIqG MANAGER
Z understaad and will uphold S t Paul Ordinaace 409, Sections 409.21
and 409.22 relating to pulltabs tipboards in bars.
Further, I understand that my j rb r must meet city standards; that 10�
of the net profit from pulltab aI s must be returned to the Citq-Wide
Youth Athletic Fund on a monthl b sis; that monthlq fiaancial state-
ments must be filed with the c y; and that all proceeds from pulltab
sales must be used for youth at le ics.
0��-U� � �
Signature - Manager
Signature - Org z ion Pres de t
2..ST � � �ty
Organizatioa Name �
-�3� ����,�\ �. Q�\>
Gambling Location
� � g
Date �
Please retain the atta he ordinance for your records.
___
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olManAroa... � , , nn�te.an� oi�s�r,orne.�o ;���
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i �. �arct►ed� - Gi��� ��i�i���T �Nb. �035.04
�� . ��� �����
_ "ss�a". — �a��� 3�«�
�n
. • . , — �� 2 Counc�l Res�arch
�a: 1 cm��,oa�r .
Appli!cation for a Gambling Nhan r s License.
Notification Date: 2-10-89 #learing Date: 3-9-89
�c� . . i!�wvw t�«�cR)) �p n�qilr:• ,
- �PCAM�IMO COM�BIDN..... . pVIL SEAVK�E COA�M3910N DATE M�� DA7E dlT �� . .� ANILLYST ., MK)NE NO:� . . . . . .
- DOMN9 CO�tA�81Q.M. . 18D 6�b 8G100L BOAHD. . �. . . . . . . � � � .. .
, � gTAfF: -.. �- � . .. . .. GY1qi�ppM�pN �� .IS�. . .. . .Af7D1.INF0.A�* . � iET'Q�TO OOMM�T -. ... CQl16T�1t1B11'. . .
.. . . - - � . _ �POp AOOL MIFO. ._FEDBACK ADDEb* � . ..
�� � � 016TitlCT OOIMCIL � . . t� - � . - � . . . � .
.. BUPPORIB YNMCM OOIMdL OlAECT1VE7 .. � � .. . . � - . .� �- � � �. . . . . . .- � � . � �. .
R�f1A1Mq lIIOM.�I.NMIf O�OM11�Y pMw�Nmaf.When.'WAe►!.WhYk _
Mark t�les DBA Westside/Westen� Yo th Hocke�r a� Jahn. & Pau1 's Bar, .
.. 731 Ra�dalph Av.enue, requests , n i1 apprn�afi of his aipp1ication fo.r
` , a Gan�ling Manager's License. - ,
- .�uti.qc+��,�.�wv.�r.u.e.ns�ir�: _ , , . ,- . ., . . , _
All- fees and applications have e submitted.
',oa+e�nuaicea�,w�+..�a�a wno�r. .. ,
If Co�ncil approval is given, rk Mu1es will manage the pulltab op�ratio�
for-WeStside/Westend Youth Hoc � �
�u.�u►�s: _ ooMS . .
_ , �ronri�s:
t"`;�s,d,;�,�
. . . . . . , . . ., . , . . . . . .� - _ . � � .`.!v4i�;�vi3� �E.r"i�US�1� � . . . . ..
C:cnter _
�. ��.�.�: .. . . . . I./W .� .� .j' .
t..v.J