89-654 WFIITE - CtTY CLERK �
PINK - FINANGE COVQCII (h J�'�
CANARV - DEPARTMENT G I TY O SA I NT PAU L 9 V
BLUE - MAVOR File NO.
u i Resolution
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Presented By '
Referred a Committee: Date
Out of Committee By Date
RESOLVED: That application ( D 68744) for a Gambling Managers License
by Wes D. Alden DB V K. Arrigoni Inc. at Jeraldine's ,
605 Front, be and he same is hereby approved�i.ed.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
Loa� � In Fa or
Goswitz
�e� 'J _ Again t BY
Sonnen
Wilson
aPR � � Form Appr ved by City Attorn
Adopted by Council: Date • 2/�/��
Certified Yas e Counc.il S tar By �7
gy. �
A►ppr by iNavor: D
� � Approved by Mayor for Submission to Council
By BY
PUBItSt�ED AP R 2 � 1 a9
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C#t�ris.t��e R�o��k ' � �a�,.�� 3�,«� :
°�: ; . ._ �� �. f 2 ,Caur�cil Research
Fi nance � t.... �� 8-50a6 ' °" � I ���„�� .
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Application fojr a Gamblittg Mana rs icense. �
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Notification D�te: 3-29-89 H�aring Dat�: 4-13-89 �
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INTiA7�19}Rl�L�1.�l1�.aPPO1r11M�MTY�(Who.1Mrt.YYFNfI.VW1xe;iNhY):
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Wes D. Alden D�A V..K. Arrigoni In . . quests Cauncil ap roval of his
applic�tion for a Gambling `Manage : icense a� �Jeraldin�`s,��Q5_`�ront A�enue...
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All fees and applications have be bmitted.
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: �cwnw..wh.�:.a To w�,om►:; ,. _ . . : ,
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If Council apprqval is given, Wes . lden wii't manage t�e pu1Ttab boath
at ,Jeraldine's. , .
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�rc�nrir�rrs: �
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14�A,R 31.i�$�J
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sTAKEHOL�RS cuat) Posmoe��+.-.o�:-� s-wa+-�s*�w►.{�Mn � :E� , w►s��u.e csumme�s�ax+,�nwas� ..
FINANCIAL IMPACT ��+��► sECOao ve�a rio�s:
o�mroo sut�cer:
r�veNUES cEr�aa� ............................:.:................................
�nsES:
SetarieslFringe Berreflts........................................................
�.............:................................................................
�............:.............:.......::........:.................................... _
_
Contracts f�Service.............................................................
Other
PROFlT(LOS8) ................................................................................ -
FINrDM10 SOURCE FOR ANY LOSS(Name�d Amourrt)
CAPRAL IMPROVEMEtIT BUD(iET:
DESI�N CQSTS..............................:.................................................
ACAt1FSIl70N C�TS...:.................................:..........:..:.....: .......: _. _ . ,.
tt�NN'STRUCTION COS7'S ................................................................ , , _
TOTAL ....................................................................................................
sou�oF Fuetona+�t�e and anouM>
a�aacr oN suot�er:
_ AIIIOUN'T CURHlNTLY BUDGE7E0......................:.:..................... . _ . _ . _
AMOUNT IN EXCE38 Ole CURRENT BUDOET ............................ . , _ ,_ ,
SOURCE OF AIAOUN7 OVER BUDGEf........................................
PROPERTY TAXES tiENERA'TED lLOS7') ......... �
MIPlE1�NTA710N IiIE:sPONS�.ltY:
.� DEPT/OFFICE DIVISION � � fUND TITLE . - � �
..BUDOET ACTIVITY�NUMBER&TiiLE ' . .... .._. ..' ._ - ACTIVITY MANAGER � � .-. . � . .
FIOW PERFQRMANCE�AIN.L BE MEA${1RED?:
PROdRAN�JECTIVES: PRO�RAM INDICATORS 13T YR. 2ND YR.
_ 1_ _ ,
EVAWATION�T1f:
pEpSpN OEPT. PHONE NO. REPORT TO OF DATE
FIRBT OUARTERLY
_ _ , _ _ BY_
�7 ° �.� �
DtVISION OF LICENSE ANI) PERMIT ADMINI T TION DATE ,�.� j'j / � � � �q
INTERPF.PARTMF.NTAL REVIEW CHECKLIST Appn P oce sed/Received y
Lic Enf Aud
Applicant �,(, es �, Q i�Y�_ Home Address a5� J(.(,�� �'� ,�U�
Rusines5 Name �K• �rri h LZ Home Phone �aa - 3y ��
Business Address ����(�+'1� Type of Lic.ense(s) �yy� b��►-�l.� /"J!q r—
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Business Phone
Public Hearing Date "S �3 O License I.D. �F � �� �L.�
at 9:OQ a.m. in the Council ham ers, ��n
3rd floor City Hall and Courthouse State Tax I.D. 41 Et
llate Notice Sent: �I�� I�� ���0� Dealer 4� � ��'
to Applicant
I'ederal Firearms 4� �J ,C�,
Public Hearing
DATE TNSP 'CT UN
REVIEW VERFIED (C MP TER) CUMMENTS
A proved N t roved
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Bldg I & D �
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Health Divn. '
N I� '
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Fire Dept. � �
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Yolice Dept. I Sen l. �l'f�1 I g
3 ��-� � D�
License Divn. �
�/�"� � ���
City Attorney �
�)�g10 ' ! � �
Date Received:
Site Plan ✓�- � 30 �
To Council P.esearch
Lease or Letter Date
from Landlord �
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CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
�i
Stockholders:
• • ity of Saint Paul �����
. , Depanment of in ncs and Management Services
Lfc ns and Pennit Division
203 City Hail
St. P ul, innesota 55102•298-5056
APPLI A ION FOR LICENSE
CASH CHECK CLASS NO. ew Renew
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�' Date�.�1�,— 19
Cod�Na Tttie of Uce�se � �p
Fro 19�.1To 19�
f C n a' � � 1 , r
WQS �. � ir �n
/►pp�leanvCortqany Nan+s
, 10p '
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. �oo e�.+�.�N.m.
�oo Qf" _�2�r�A I�►►, ��
81qin�p Addhli PhOtN N0.
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�OS �'rCn-�
100 Mafl to Address PAOns No.
,� S i �a :a I ti�n
MansqsNOwn�•Nam�
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�hJ Q� �. f—j 1,_{P✓1 ��Ur�
• 100 Alanaqer/GwnN•Hom�Addrtss PI°ont No.
IOQS AppliCation FN
tA� um of Z 100 �55 Sc.trn��1�
a � � OU M•�•o•���«-�r.StaN 3 Zip COd�
,00 To� i ,00 S (
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Uqnp Inspector v � Br �� � Sbn�tun oi�ppaeant
' �• comp.rry Nam. Pa�cy I+a. Exv+�uon au
Inaurance•
Company Nam� Poliey No. Explrstion Oab
Mlnnesota Stste Identification No Social Secu�ity No
Vehicle information•
SKial Nwnba at� umba
Othe►� �
� THIS IS A EC IPT FOR APPLICATION
THIS IS NOT A LICENSE TO OPERATE.Your applicatfon fo Iic se wi11 eithe�be pranted or rejected subject to the provisions of the zoning
ordlnane�and eompl�tion of the inspsctfons by th�Hsalt , Fir ,Zoniny andlor Uc�nse Inspecton.
$15.00 CHARGE OR ALL RETURNED CHECKS
I S�'h= (�o dQ�t,�S
a a�-�9 ,� � / ,� `�
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- s Cit o Saint Paul
�' � 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 PAi1L (Class B Gambling License i L quor Establishments - New Application)
1. Full and complete name of organiza io which is applying for license
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2. Does your organization meet the de in tion of a "lar e" organization as outlined in
the November, 1988 revision of Sec io 409.21 of t e Legislative Code? �' �j
Attach to this application pertine t inancial and/or organizational information to
support your answer to this queati n. NOTE: Only 5 large organizations will be allow-
ed to open pulltab operations unde t e revised city ordinance. If more than 5 organi-
zations apply, qualified applicant w 11 be selected ra�d/omly by the City Council.
� �ro� �f�' ,.�
3. Address where games will be held ' �-+-�-�- ��d �-
mber Street Ci y Zip
4. Name of manager signing this appli at n who will conduct, operate and manage
Gambling Games � C;� 1� ��S Date of Birth � - � � •_� r7
(a) Length of time manager has bee m ber of applicant organization �1�-��"S '�^'?i %/i�'
r ' �-r-T
.
5. Address of Manager 5��� �' ���`�S�r� �� n .�--� `/
Number StreeC City Zip
6. Daq, dates, and hours this applica io ia for mdNAa�•,��,�+�.r/t �t.�.a��'Y d .�G��a.M� �
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7. Is the applicant or organization o a zed under the laws of the State of MN? �sr`'S
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8. Date of incorporation T �. /
9. Date when registered with the Stat of Minnesota �T� ,�`�1 f ` �/
10. How long has organization been in is ence?
11. How long has organfzation been in e is ence in St. Paul? � �- � ���-�
�
12. What is the purpose of the organiz io ? U� � N w
/L U C � �
13. Officers of applicant organization:
Name LV �Z.0 L Name /�,a, t�i v y1/E� k s
Address a 6 0��/�.S (� Address c0 3 7 �� I 1"0 �IJ � l; ��c-�-
Title �: • � . � . DOB Title �C DOB 9' � � l
Name L( (. . z - Name
Address � S S � ci nn,v� i 7 �/ Address
Title y,�.�;� �� , DOB -.�Y ' � Title DOB
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- � 14. Give names of officers, or any oth r ersons who paid for services to the
organization.
Name � � � Name ��Lt � �.v � �C L �
Address a0 p/ /✓ / Address o�.���) c!/� �h • � '< �C
G � fi �
Title � Title l L'_G – �,Q�.� /,QGo�,J �
(Attach separ te sheet for additional names.)
15 Attached hereto is a list of names an addresses of alI members.of the organization.
16. In whose custody will organization s ecords be kept?
Name �� (. /V� Z c- Te c � (.. Address a 5 � S u ^'�M i f�Y�. s'1'� P.v�,L
17. List all persons with the authorit t sign checks for dispersal of gambling proceeds:
Name w �- �. C– Name
Address U � �.�.rv ^' (�< <j! / —S� Address
Member of � Member of
DOB �' ` Organization? r DOB Organization?
Name � L /�/. � F N Name �
Address o�lj� �4MM��� A Sl t°At.�(. Address
Member of � Member of
DOB `t� –a`! '�3� Organization? , DOB Organization?
18. Have you read and do qou thoroughl u derstand the provisions of all laws, ordinances,
and regulations governing the oper ti n of Charitable Gambling games? _T�
19. Will your organization's pulltab o er tion be operated/managed solely by members of
your organization? yes no � y
20. Has your organization signed, or d es it intend to sign, a consulting agreement or a
managerial agreement with any pers n r company to assist your organization with the
pulltab sales and/or recording kee in ? yes no �
If answer is y s, give the name a dress of the person and/or company contracted.
Name Address
Name Address
If answer is yea, how will such a on ultant be paid? (percentage, flat fee, gambling
funds, gener 1 funds, etc.) Atta a copy of said contract to this application.
21. Operator of premises where games 11 be held:
Name �
Business Address
� Home Address
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, 22. a) Does your organization pay or t d to pay accounting fees out of gambling funds?
yes — no �
b) If you do pay accounting fees, o hom will such fees be paid?
Name ' Address
DOB Member of Or anization?
c) How are the accounting fees ch rg d out? (flat fee, hourly, etc.)
d) What do ou anticipate will be yo r average monthly deduction for accounting fees?
23. Amount of rent paid by applicant o ga ization for rent of the l�al.3r� ��2
�`������
24. The proceeds of the games will be is ursed after deducting prize layout costs and
operating expenses for the followi g urposes and uses:
.. ."' ' � ^" 9 .�� /�J` �� vr ��
-v T- � � �
25. Has the premises where the games a t be held been certified for occupancy by the
City of Saint Paul? �
,
26. Has your organization filed �federal fo 990—T? �0 If answer is yes, please attach
a copy with this application. If sw r is no, explain why:
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�N `-'1-4-C S N -c I
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Any changes desired by the applicant ass ci tion may be made only with the consent of the
City Council. .
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on Name
P '�,.k.,A_�
l✓ �f, /) � �i
Date l % " � I BY� �1`��
Manager in charge game
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Org ation Presid n or CEO
TO E OMPLETED BY
ORGANIZATION PRE ID NT ANO GAMBLING MANAGER
I understand and will uphold S in Paul Ordinance 409, Sections 409.21
and 409.22 relating to pulltab a d tipboards in bars.
Further, I understand that my ar ar must meet city standards; that 10%
of the net profit from pulltab sales must be returned to the City-Wide
Youth Fund on a monthly basis; th t monthly financial statements must be
filed with the City; and that lq of net proceeds must remain in St. Paul
or be used to support St. Paul re idents.
�-�
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Signature - Manager -
Si na ure Organization r ' t
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i2(� � ,� r � L
rgam ation a �
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Ga g o tion
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Date
Please retain the at ached ordinance for your records.