89-613 WHITE - C�TY CLERK
PINK - FINANCE G I TY O 1' S I NT PA U L� Council //�� /
CANARV - DEPARTMENT �7 -( 3
BLUE - MAVOR File NO. ��
Counci esolution �� ,;
� � ��
Presented By
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID 76 33) for a Gambling Manager's
License by Alan L. Ka an DBA The Minnesota Folk Festival
Inc. at 2162 Universi y venue, be and the same is hereby
a pp roved/de�ri�ed.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
Long [n Favo
Goswitz
Rettman
Sc6eibel � A gai n s t BY
Sonnen
Wilson
APR 1 ? Form Appr ed by City Att ey
Adopted by Council: Date
Certified Pa.s Council , retar By `�
By,
A►pprov y 1�lavor: D _ APR � � Approved by Mayor for Submission to Council
By BY
ppgl�{{m A P R 2 `? 19 S
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_ „ �{ Fru�t fr�aa�+r sswi�ces o�craa �crtv�qic
°�'. � — �*� 2 Counci 1 Research
1 �
-... .CRY ATFORNEY � . . .... . .
�ppl i cati an for a C�mbj i ng Mana �r s Li cense.
Noti fi cati on Date: 3-6-89 Ff�a�'ing [��e.: 4�-6-8g ` ''
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.��u+vvro»t�►«+�a�A►� n�nr: -_ ;
a�r�a�r�ar� ,. avw�v�c�resww < o��N a«our �rw:raT q�or�wo:
nDNwc�q0�ow mo era suaa eo�Ao
sr� c�� �s noos.�o.,woEe* ' -w�Dn�a r�iw.",�` ao'+ex"'�',rr
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. DIgIFMCT fS0u1CIL � i�� � . - � , , . � - -� � , .
. .�81FPtMfli�MiMCNQOIN�ICIL�QRJBCTlYE't: �� . � . � � � � ' ! � . . . � �� � .� .
. . . . . . . � � . . � - � . . . . . . , .
. �RI�TMIO MN�C1�OIIiFIIi[r(1Mw.1Nh1R VMhBII.Wt�ers.4VhY1: : , _ ' ._ '
� Alan L. Kagan Q�1 �tte Mintt�sota o1 Festiv�l �nc. �^equests C��y Caunci� :
aPproval of has. �pp'�i�ataon for mbli�ng I�ii�i er's: L�cense�at the
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. /�ce Bax Bar, :21&2 �Jrr�versi ty �4v : . .
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��e+�.r�.��r„r�..A..�a: , , . , . , � , :
Al1 fee� and applicat�fln�> have b en submitted.
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� : tio�..vuB1�rN+�t.+MAan...r�it ro whop�: ' - '
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. If Caunctl approvaT fs given, A1 n. . Kagart �Ii11 manage the pullt�b
booth fo.r the M�nrlesota folk Fes iv 1 at the: Ace B�x �B�r. - � `
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- 8Tntc�lot�(tiet) _. posmoN(+,-,o� -; �-wn+.r�r�nrN�. n�noru�(s�w���)
FINANCIAL IMPACT �sr <smn o.ey . s�,r�u+ r�s:
ovew►rnro euooer:
. . ,
REVENUES 6ENEIiATED ..................................................::........... .
EXPENSEB:
SalerieslFringe Beneflts.......:.. .:...:... '._.....:.............. �
EQ���....................... ............... .........
�PP�........... ................. ......... .......... .......
, , , . ... . :
Contracts for Servioe................................ ....................
Olher _"..:
r+�oar(�oss) ............................................................................:... ,
FUNDING SOURCB FOR 1�NY LOSS(NBme end Mio�nn)
CMiTAL�BUD4ET:
OE81GNCOSTS..............................................................::................ :..
ACCU�filO�1 C06TS : ,:.�_. �
COl�iRUC710N COSTS . ,
TOT/LL .............................................:...................._................................ .
SOURCE OF FUNDN�fi(Name attd AmouM)
MAPACT ON BUDGET:
AM�UNT CtlEiReNTL.Y BUQQEiED ,.........:........:....:............: _ .
-; ., _ ., , _ ,
AMOUNT IN EXGE88 OF CURRENf BUDEiET............................ _ : .
SQtiRCE OF AYOUN�OVER BU�QET........................................
PRQPERTY TAXES GEIItERATED ILQST) .........
N1PE�NTA710N RESPOMSIBILfTY:
� /OFFICE - DIVISION FUND TITLE � . . '
BUDOET ACTIVITY NUM�R&TITLE � � ACTIVI'TY MANAGER . . " . . . - ... :
IIOIN PERFOtU1ANCE YYILL BE MEASURED?:
PRO�RAM OBJEC71YfSp PR06RAM N�ICATORS 1ST YR. �YR.
;
T
EYAWA'iK�N WF.SPOI�NJTY:
. . PERSON�.. � . � . ' � � . DEPT. . . � . � �PFIONE NO.. � :�. - �.
F#NST OUARTERI.Y '
_. _ . . Y
. ���r�0�3
DIVISION OF LICENSE AND PERMIT ADMINI T TION DATE � � a / / � �� ��
' INTERDF.PARTMF.NTAL REVIEW CHECKLIST Appn roc ssed/Rec iv d by
Lic Enf Aud
Applicant �Ai an L, �(.L Cc� Home Address ( y! p/1
7 � r.5 5
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Business Name d. �, 0((� Home Phone ��7 U
�e�va-f �nC. /' `
Business Address Type of License(s) l.`1 C�t�►� b�rr1 G
Business Phone a � �a �l VQ-y Si 4� `(,�(,[(�,er
Public Hearing Date �� `�133 License I.D. 4� '1 !o y33
at 9:00 a.m. in the Council Chambers, � ��
3rd floor City Hall and Courthouse State Tax I.D. 4�
llate I�otice Sent; � � �� r��� Dealer �{ �`�
to Applicant L
Federal Fixearms 4� IJ I�
Public Hearing
DATE INSP CT N
REVI�W VERFIED (C ER) CUMMENTS
A proved N t roved
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Bldg I & D �
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,
Health Divn. ��
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Fire Dept. j i ,I� �
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Yolice Dept. �.Pn'f �I1 g9
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License Divn. �
3�3 �� ' 6�
City Attorney �
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Date Received:
Site Plan
To Council Research �`Z 31 5s'`i
Lease or Letter � Date
from Landlord
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
-,..TT--
� 7�0�33
• ' ' City of Saint Psul
. . . Oepa�tm��t of Fi s snd Mans��M S�rio�s ���j-�C/3
Ucen a P�mnH Dhrisioe
City Nsll
� • � St. Paul.M sota SS102•298�SOSS
APPLIC N FOR �ICENSE
CASM CNECK CU1SS NO. Renew
0 0 � 0 a� _ ��
COd�No. TitN OI Llcans� p� `Jr� 1 1��TO `�� � 19 /l
�� C,a ►�, bl,r `Y, G ,� � s• o /'� /�
, �oo r'-t' Q r� �• I`G �
NMM
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^� f'1G -��ii n����� t-:?I� '�a��i�.�c� 1 .l_ : �
100 Bialn�ss Namt
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e�,...�►a�. •�.�+e.
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S i. -f-c-,�.�L � l ,, _;S
100 MMt to Addnss � ��t�
,00 ��a r� �, 1`a�G � _4�,��;,%�
wlsnpapwn�r•Nanw 1
100 ...i (_
��J !� �� t ��-}�r��Q% ► �`���.e.�
too 1►++n.ou/Gwn«•Mem.nadap rAee.�+e.
IOOS AppliCdbn FN . Sp
tM n+ot , G. 1Q0 � S � ' � ��L� �� � �S II: .
o �� �n�p�wn�•uM.sea�.s eoa.
100 N 100 �
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�UtspeCtor � gy: l _ giqn�urr e1 A�Me�I �
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eOfld'
ComWnp Nanw Poltep�b. E�ial+o�
Insursnee•
Canvany Nam. Pouep No. bo+rslb^ sN
Minn�sota Stste Ide�tification No Soclal Security No�
V�hiclt Iniormation•
SNlal NwnpN
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THIS is A RE p FOR APPLICATION
TMt818 NOT A LICENSE TO OPERATE.Your spplkation lor li will eiiher be qanted a rejecl�d wb�et to tM p�orisioes of fh�toniiq
otdln�e�e�aiM rAmOlNIOn ol tM insp�etlons�►tM N�alih, F inq anQ/p Lie�nN Inap�Cton.
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�15.00 CHARGE F L RETl1RNED CNECKS
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. . Cit o Saint Paul � f���(0/3
_ �, . Department of Fi an e and Management Services �
� Division of Lic ns and Permit Registration
INFORMATION RE UIRED WITH APPLICATION F R ERMIT TO CONDUCT PULLTAB/TIPBOARD SALES IN
SAINT PAUL (Class B Gambling License i L quor Establishments - New Application)
1. Full and complete name of organiza io which is applying for license
I o �. �PS�f/ r 41r' �
2. Does your organization meet the de in tion of a "large" organization as outlined in
the November, 1988 revision of Sec io 409.21 of the Legislative Code? �
Attach to this application pertine t inancial and/or organizational information to ���
support your answer to this questi n. NOTE: Only 5 large organizations will be allow-
ed to open pulltab operations unde t revised city ordinance. If more than 5 organi-
zations apply, qualified applicant w' 1 be selected randomly by the City Council.
3. Address where games will be held �� Z- V„I1/'�p'Si� r c� ss��
mber St eet City Zip
4. Name of manager signing this appli at n who will conduct, operate and manage
Gambling Games �� � � � Date of Birth // /.S� 3Z
(a) Length of time manager has bee m ber of applicant organization 0 �4l"
5. Address of Manager 7 ��/' S � �" ' �• S ���
Number Street City Zip
6. Day, dates, and hours this applica io is for �� �, � �� �y� oZ- "" �� /-•�
7. Is the applicant or organization o a zed under the laws of the State of MN? _���
8. Date of incorporation � 1� &
9. Date when registered with the Stat of Minnesota � /7�
10. How long has organization been in is ence? �! Y'S
11. How long has organization been in is ence in St. Paul? /0 r QQf�'S
12. What is the purpose of the organiz tio ? �k. 'f'" S�r'✓l� M�/`-- �
�v��r+ryti 0.r S • n�tuK� ' wca oc�, e rrn¢r5
I -dt vers�- h�c.. �t- cMQ. i e�.s,
13. Officers of applicant organization:
Name f� D' f(SC4'� Name �h�. A
I �
Address �, S � Address (�7�p �1''�S��S�..�. 5�'r�eG•
Title f'e5� DOB w 3 a Title�►�'L'Ot�tC.t"e`� DOB _ 34
Name ��'C��4'K�- Name �
Address ,�-7y � �'Q`���� � `� '3T� �`C Address
Title �LG} '1'� i� DOB g p�6� � Title �B
� � � � - ��c�- (�i3
. 14. uive names of office s, r a � oth pe sons whoPpaid for services to the
organization. �y� ��
ro
Name Name
Address Address
Title Title
(Attach separa e s eet for additional names.)
15. Attached hereto is a list of names d ddresses of all members of the organization.
16. In whose custody will organization' r ords be kept?
Name (� � at. Address �37�p L%�^rl5 2K.SP•�,��V�'•, w•s���
�'164. SS/I 8
17. List all persons with the authority to ign checks for dispersal of gambling proceeds:
Name I, • I�a �� Name
� r Q• 5� �7C S�lifj Address
Address �3��0 � 1 P.�.sev.- ��
Member of Member of
DOg 11 Is 3 Z— Organization? DOB Organization?
� , Cb�
Name � fl Name �
Address l8 3 _�_ 1 ce� p Address
Member of Member of
DpB /0 3 .S'�a Organization? S DOB Organization?
18. Have you read and do you thoroughly un erstand the provisions of all laws, ordinances,
and regulations goveming the opera io of Charitable Gambling games? T�
19. Will your organization's pulltab op ra ion be o$erat�managed solely by members of
your organization? yes no
20. Has your organization signed, or do s t intend to sign, a consulting agreement or a
managerial agreement with any perso o company to assist your organization with the
pulltab sales and/or recording keep ng yes no ,C
If answer is yes, give the name and ad ress of the person and/or company contracted.
Name Address
Name Address
If answer is yes, how will such a c ns ltant be paid? (percentage, flat fee, gambling
funds, general funds, etc.) Attach a opy of said contract to this application.
21. Operator of premises where games wi 1 e held:
Name �J
Business Address � 2 WN�111� , ' � tv � 1
Home Address � �`� �3
, . . (",,���`�0�3
22, a) Does your organization pay or in nd to pay accounting fees out of gambling funds?
` yeg no
b) If you do pay accounting fees, to wh m will such fees be paid?
Name Address
DOB Member of 0 ga ization?
c) How are the accounting fees char ed out? (flat fee, hourly, etc.)
d) What do you anticipate will be y ur average monthly deduction for accounting fees?
23. Amount of rent paid by applicant org ni ation for rent of the hall:
�/OU c
24. The proceeds of the games wil1. be di bu sed after deducting prize layout costs and
operating expenses for the following pu poses and uses:
�e ' er M � a.r� � � r 5
�
�, • o r
.
o r c �.
25. Sas the premises where the games are to be held been certified for occupancy by the
City of Safnt Paul? .Ff7
26. Has your organization filed federal 0 990—T? � If answer is yes, please attach
a copy with this application. If a we is no, esplain why:
� (,(/H. � � �h Cl��-- �
S re�c.� � c� /0 0 ,
Any changes desired by the applicant ass ci tion may be made only with the consent of the
City Council.
�
iNh,e cc r5 �fa� �ia �
Organization Name
Date a' 7 �� By: A. !� � a-�'1
a a e f game
a.r ���rr
0 nization Presiden or CEO
� �^
� //'
� : , . . . ��_��3
State of Minnesota )
) ss
County of Ramsey )
� u�
being duly sworn, say _that e_is
(are) the petitioner _in th a ove appli-
cation; that _he_has re d he forego-
ing petition and know the con en s thereof;
that the same is true of h o knowledge.
Subscribed and sworn to befor m this
^� day of ��u-- 19 ��
■�nnnnnn�w,n�nn�v���•„��� .
�"'� �HRlS�;��,_ �
�NOTARY PUBUG—���:.;.�.�.:� 'a . -
RAMSEY�OUNTY '>
MrGpmm�sion E�cpires Aug.15, 19 �
•
. — �
Notary Public, Ramsey County� nesota
My commission expires