89-421 WHITE - CITV CIERK
PINK - FINANCE COUI�CII �//'�//�
BLUERV - MAVORTMENT GITY OF S INT PAUL File NO. ��� • �"l
� � ounci esolution �g
Presented By '��""-
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #3 875) for a Gambling Manager' s License
by Scott Nelson DBA he Minnesota Waterfowl Association at
Dahir's Bar, 674 Dod R ad, be and the same is hereby approved/
�.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
Long In Favo
Goswitz
Rettman �
�be1�� __ Against By
se�u
Wilson
�R - g 198 Form Appro ed by Cit Attorney
Adopted by Council: Date -
BY a �� ��
Certified Pass y nc.i SC��
By,
Approv d y Mavor o�- MA � 019 9 Approved by Mayor for Submission to Council
gy `-� BY
PUBIiSi�D ►��i�K 1 � 98
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UiVISION OF LICENSE ANI) P�:RMIT A.I)MINIS xZA ION DATE t� �� / � y
INTERPF.PARTMEfiTAL REVIEW CHECKLIST Appn ro essed/Recei ed by
Lic Enf Aud
rL �
Applicant (7'I"f �Q�Sp�_ Home Address '�3U� �Ort�CU)00 d �c�
Business Name �(h� (,�Q� ,v� �j IJ Home Phone `� 3�' OS� 33
Business Address�0.�/'Y'S a�12. Type of License(s) �Gm b��ny /�C� r
Business Phone ��4 ��� ��
Public Hearing Date � License I.D. 4� 3�� ?5�
at 9:00 a.m. in the Council Ch mbers,
3rd floor City Hall and Courthouse State Tax I.D. �� tU�A'
llate Notice Sent; Dealer �1 ��f}-
to Applicant
rederal Firearms 4� N'�
Public He�.iring
DATE INSP CT N
REVIEW VERFIED (C ER) COMMENTS
A proved N t roved
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Bldg I & D �
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Health Divn. '
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Fire Dept. �
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Yolice Dept. SQ�'1� !
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License Divn. ' j
���-3�� I � �.
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City Attorney �i��f� � �t�
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Date Received:
Site Plan �
To Council P.esearch �' a3
Lease or Letter ate
from Landlord � �
� .�' � • � �ity f aint Paul C���`f��
` r Department of Fina ce and Management Services �
. Division of Licen e nd Permit Registration
INFORMATION RE UIRED WITH APPLICATION FOR PE IT TO CONDUCT PULLTAB/TIPBOARD SALES IN
SAINT PAUL (Class B Gambling License in iq or Establishments - New Application)
1. Pull and complete name of organizati n hich is applying for license
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2. Does your organization meet the defi it on of a "large" organization aa o ined in
the November, 1988 revision of Secti n 09.21 of the Legislative Code?
Attach to this application pertinenC fi"ancial and/or organizational inf rmation to
support qour answer to thia queation OTE: Onlq 5 large organizations will be allow-
ed to open pulltab operations under he revised citq ordinance. If more than 5 organi-
zations apply, qualified applicants il be selected randonlq bq the City Council.
3. Address where games will be held �/d0�� � S � � �c5 0
N er Street City Zip
4. Name of manager signing this applic io who will conduct, operate and manage
Gambling Games Date of Birth ',�
(a) Length of time manager has been em er of applicant organization ��QS`�
5. Address of Manager �'! l.�r �
Number Street City Zip
-- 6. Daq, dates, and hours thia applicat n s for ���►'r/�(10A+� /'�i '�avl a�'4��ta'� �''"'�-y
7. Ie the applicaat or organization or ni ed under the laWS of the State of i�l? �,_
8. Date of incorporation '" —
9. Date when registered with the State f nnesota , �—�q-'V�
10. How long has organization been in e is nce? ����v Y''e � r5
11. How long has organization been in e �.s nce in St. Paul? 1�� y�Q �' , _
12. What is the purpose of the organiza iLo ? �� i T� 1f n I�u�T�l� r`��/�/'�A�I��YI �
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13. Officers of applicant organization:.
Name Name t`f
Addresa f G�D Q � � ' Address B '�t� - .
Title /� n noB 3'l�- Title V �2 PQA DOB ���( ✓� _
Name ( Name ��
Address� b�o /"` �� �� ' Address !�- � rr���
�' 9 (�
Title ��ds�1� DOB ` ��3 Title D�B � " 1
•, J � � ` �y L/• ' � ��/
r
. 14. Give names of officers, or any othe p rsons who paid for services to the
• organization.
Name r► Name /1C�� �'Q e�
Addresa � � q,� �? Address ��� ��/1�� 'e ' ,
Title C � �`/' Title �� �✓� �
(Attach separa e. heet for additional names.)
15. Attached hereto is a liat of names d addresses of all members of the organization.
16. In whoae custody will organization' r cords be kept?
Name � � Address 1��4 ' '
17. List aIl persons with the authoritq to siga checks for dispersal of gambling proceeds:
Name Name ��/^C��Q �� y�//� �
Address 0 � Address ��I / 7� /7+��/U� ���,�N7 1�',
Member of Member of
DOB l�'30-��0 Organization? DOB rp Organization? 1��"`�}'
..
Name ' Name
Address
Addresa ,
Member of Member of
DOB OrganizationZ DOB Organization?
18. Have qou read and do you thoroughly un erstand the provisions of all lav , ordinances,
and regulations governing the opera io of Charitable Gambling games? �_
19. Will your organization's pulltab op ra ion be operated/ anaged solely by members of .
your organization? yes no +
20. Has qoar organization signed, or d s t intend to sign, a consulting agreement or a
managerial agreement with anq pers o company to assist your organiza o �aith the
pulltab sales and/or recording kee in yes , no
If answer ia yes, give the name an a resa of the person and/or companq contracted.
Name Address - `-°- - -
_.� .�.-s----._,.------- -
Name � . Address .
If answer is yes, how will such a on ltant be paid? (percentage, flat fee, gambling
funds, general funds, etc.) Attac - a copy of said contract to this application.
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_.�.�..�_..._=.�sti...
21. Operator of premises where games w ll be held:
Name Cl �1�� .
Businesa Address 7 a � . ��O
' Home Address
I� , . . ��/
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22. a) Does your organization pay or int nd to pay accounting fees out of gambling funds?
- . � yes no �
b) If you do pay accounting fees, to wh m will such fees be paid?
Name . Address T-�� t✓00 . � q
DOB ����_ Member of 0 ga ization? �_
c) How are the accounting fees char ed out? (flat fee, hourly, etc.)
. � - _ � � ' _ � �
d) What do you ant cipate�1 be y ur average monthly deduction for accounting fees?
� D
23. Amount of rent paid by applicant org ni ation for rent of the hall:
. T � /ND �
24. The proceeds of the games will be di bu sed after deducting prize layout costs and
operating expenses for the following pu poses and uses:
.
+ i �� (� a i'd'V► — � c�.
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25. Has the premises where the games are to be held been certified for occupancy bq the
City of Saint Paul? �/
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�•.•26. Hae your organization filed federal 0 990-T? � If answer is yes, please attach
a copy with this application. If an e is no, explain why:
/�� � �.
�of O "2 �'!I'� Gi � !{rlCd�►�C� .
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Any changes desired by the applicant asso ia ion may be made only with the consent of the
City Council. .
° e �,� SsOc�a ,'o
� rgan zation Name
Date � �"�7`O� By:
T' Ma ager in charge of gaae
�, "" ' Bet� � �rz9 �/�/�/�v�(�[� , _ A /
NOTAQI PUlUC-MtNNE$OTA J ��%!6 ' - _ � '�!!�
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j ��i,:";i�; RMASET GOUNTY Organization Pre nt or CEO
�!£:::.`% dy comm�ssion exp�res 1-5-94
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_. _ . . _- � .38�8ZS
City of Saint Paul
Department of Fi an e and Management Services ���a�
` ' Licen e a d Permit Division
2 3 City Hali
: St. Paul,Min esota 55102-298-5058
� APPLIC TI N FOR LICENSE
� CASH CHEC}C CLASS NO. Ne Renew
! � � a Date ' � _ 19 �i
; Code No. Title of Ucense �'J
, From j( 19�Tb �� 19��-
� �1 UP C�m �i rx, A nli 5 `J�
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GT �C � t ��S �G� s �r � !�
; ioo a�w��N.�,.
; ,� �o � �` 1.�a�I��. ��
i Business Addnss Pho��Na
� - �� �1 '�G u � ; /"1 r'� S 5�p�
100 Msil to Addross Phon�No.
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� ,o0 5 �ofZ'" �e I Sa� �n�3'�
ManapeHOwner•Name
100 �—
� 3aa �0�}��vo�o�1 ��
100 AtanapedGwnx•Home Addreaa Plw��Na
; 4pgg Application Fee �
2. 50 ,/ /
; Received.the Sum ot � �1:Q0 ��i�l7 e'��'7/�S, �,� � ��L! .
; �J INanaqerlOwner•City,State 8 ap Cod�
+ 100 tel 100 A -r •� il
i �(d/ �'`e"'""'' l
J� �
lfcense Inspector By: Signature of Applicanl
; Bond•
Company Neme Polfey No. Expiratlon Oate
� Insurance•
Company Name _ Policy Na Expiration Dat�
Minnesota State Identification No. Social Security No
�
, Vehicie Information:
Ssrial Number Plats Number
Other
THIS IS A R CE PT FOR APPUCATION
THIS IS NOT A LICENSE TO OPERATE.Your appllcatfon fo� Icen e will either be granted or rejected subject to the provisions of the zoning
! ordinancs and completion of the inspections by the Health, Fire,Zoning andlor License I�spectors.
� $15.00 CHARGE F R LL RETURNED CHECKS
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Purpose and Mission Statemen
The funds raised by and asse s f this corporation shall be used
for the improvement and prot ct on of waterfowl habitat and the
education of the public to t e enefit of waterfowl and its habitat.
OR191NATON � . DATE MIU DATE C0�ll�l0 . . . ��?�
�. Carchedi �= ���'���`.w��� po. ��5�Q
oorrr�icT - o�aw�arr aaee.a+ wiroa�ow nse�num
, ristine` Raaek � _ �s��� ��«�
. . �*� �.Gat�nci l Research .
ORDER' � GTY ATiCfINEY
Fl ,.. . ��— Q .: _ , •'
Application for a Gambli�+g Mana' er License.
Notifjcation' Date: a/a31k�7 Hearing .Date:. "3'-9-89
t�ows:�naro»w«�cR►► nE�: �
�oa.weaN cnm.seAV�oc�ure�oN o�s�a� o�rE our w�var. a+o�Ho,
aaado oo�eaN. �so eza ac�aa aaaw
sr� c.�ua�e co�esiow � ��+ron�4' •nEs�o�oa��r c�maa�t .
— — .
_"FOn' r��. ,��aeu�ac�eoEO*
o�s►wcr oaMC�
*�xr�
st�wvara rw�oo��aa�ec�r�� : :
M1/N7r18 PIIO�LEM,I�IIE,O�PORiul�Tlf�Mho.wh�t when.wMre,Nmyfi
Scott ..Nelson, DBA The Minnesota . at rfowl Associati�n requests City Council
approval of his applicd�tian f6r a ambling Mariager's .License at
DaMir.'s Bar� 674 Dodd Road. . _ � - _
. , _
_. :.
, ��co.ve.o.�.�rwa..A+.�,r.t: . . .. . ,
Aj1 fees and applications have ee submitted.
= �iw�t wn:+c.�a�o�irwm►: -
If Cauncil approval is given, a ot Nelson wi11 �nage pulltab s�e� for
the Mi-nt�esota Waterfawl Associ � at Dahir's Ba►r: � -
- � >. : . . . . _ . . . .. . .� .
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. . ���:�.r:l ��,_�;,t::,�c� �enter
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