89-874 WHITE - CITV CLERK COUI1C11 /'��/� /�
PINK - FINANCE G I TY SA I NT PA LT L yy /�
CANARV - DEPARTMENT (/j�' �/
BLUE - MAVOR File NO• �� • v �
Coun i Resolution '���`�
r ��-.�
Presented By -
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application ID #91429) for a State Class B Gambling
License by GIVE I c. DBA Custom Contracts a� Narducci 's
Lounge, 1045 Huds n d. , be and �he same is hereby approved/
�d.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
��g In F vo
Goswitz
Rettman
Scheibel __ A gai s t BY
Sonnen
Wilson
MAY � 8 Form Appr ed by City A orne
Adopted by Council: Date • - �.`
Certified Pa s by Council Secret ry BY � �'
By � ��
Ap ro d by � avor: Da e �Y � � Approved by Mayor for Submission to Council
By
pjn���� .l!!� _ 198
oa�ownron • � a►,s c��oo.�n.e�o. . ��� ���'�
J. Carchedi
C�FiEE "SF�EET No.0 0 3 4 2 6
� � ���� �����
Chr.istine Rozek N " � _ = �6��� �«n«�
� P»°^�'�. ao �� �Cour�ci l Res�arch
` Finance � t:. 298-5056 . � °R ' � ��„�
_ _ .
E RE . : -
Approvai of .an application f r State C1ass `$ Gambling License.
Notification Date: �'2�89 Hearing Date: 5-18-89
a�cA�wNa+o�TwNS:t�avrae GU«A.lea ca)) ��qr�: :
. . : . PLANrNNO OOMMI9BION CIVIL SERVICE OOWNSBION DA'IE . . � DATE OIIT � AWILY9T . . . PWQNE N0. . .. '
. . IDI�IpO OO�N�1 �. . I�826 Sp1001 80ARD. . . . . ..
� STAFF- . � CHART6i C.�MAI88qN - . A8� � . AL1D1.MIf0.ADDED* . .� iETD TO COHrA�'T . �.00NBTff1JENT ..
. � . � . . . . � � _fpi ADDi IWFO.. _fEE08AGC ADDED• . .
018TItlC�G�OUIiCIL * � . . � .
- - 81JPPON78 YMNCM COUWCIL OEJECTIVE4 � . . . . . . . � �� ... � . .. .
MT1A1N8 PNOlL�.N!1!�O/POR1WRrY(1Mhc.What.Wfw��Wl�ere.N�hy): - �
Michael Sarafolean, on beha] o GIVE Inc. DBA Custom Contracts, requests -�
. City Council approval of his ap 1ication fo.r a -State C1ass B Gambling Lic�n�e
at Narducci 's Lounge, 1045 H ds n Road. ' Proceeds fr.om pulltab sa1es wi11 be
�used tQ prav:ide services .to da ts with mental retardation. :
,�uen�en�(cowa.n.er.°�a�o...p..deQ1:
All fees and applications ha e een "submitted.
COI�QIlS,1�(wlrA.wl�w�.�nd To vYhwn). • .
If Council approval is given G VE Inc. ivil� operate a pul1tab booth at
Narducci's Lounge.
�,�,w,�: � co� . ..
�o�' �cEl Research Center
, f�-��Y � 3 i��9
���:
NOTE: GIVE Inc. has a State C� ss A Gambling License at 1324 E. Rose..
We have had no probl s ith the bingo/pulltab op�ration.
�asuES:
.�---•— -
DIVISION OF LICENSE AND PERMIT ADM NI TRATION llATE � ��/ � �� 1��
INTERDFPAR1fifENTAL REVIEW CHECKLIST A�pn Pr ces ed/Rece ved y
Lic Enf Aud
!�'�i �ael Scira -�o�eG�
Applicant �-� I V Gr 1 h�, Home Address /�{/p �v�e�� P,� D2 �/L
Rusiness Name S (�pn pC Home Phone �o ��- / y8 0�
Ci t- 1J�i rd u u s Lo � � , �y
Business Address j p s Type of License(s) S��C, l.-�Q55 �
Business Phone C Gt.+�t� �lin �( Gc��nS�
Public Hearing Date � g � License I.D. 4{ �'� ya�
at 9:OQ a.m, in the Council Chambe s,
3rd floor City Hall and Courthouse State Tax I.D. �� �1.�
llate Notice Sent; �G /�' Dealer 4� �/�
to Applicant L.� �, �
I'ederal I'irearms >� � �'
Public He�.iring �
DATE I 'SP 'CTIUN
REVtEW VEKFIED (C MPUTER) CUMMENTS
A roved N t A roved
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Bldg I & D �
N1�-
Health Divn.
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Fire Dept. � �/� �
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Police Dept. I J�n� I Q� ��3/�/
3i��
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License Divn. '
�/��� ; c�-
City Attorney �
`l z� �� � � ��--
Date Received
Site Plan � �" � r
To Council P.esearch b
Lease or Letter Date
from Landlord �
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ot Saint Psul
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Z03 Gtr Mall
St I. nesota S610Z•2965066 �
APPL ON FOR LICENSE
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t00 Malt to Addrtss M+e��N0.
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� TMIS is R CEIPT FOR APPLlCATION „
TMIS t8 NOT A LICEN8E TO OPEiiATE Yow appliwt fa icanae�Mthe�b�panted a roje�ted wbikt to tM provisbes of tM toNnO
OrdIMnW and eompNtbn ef t1N i�spktlons b�r lM H Ith Fih.Zonin�andia Lk�ns��esiN�to►s.
�15.00 C � OR ALL RETURNED CHECKS
3-�D�y � � / ��
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Charitable Gambling Control ar FOR BOARD USE ONLY
. . Room N-475 Griggs-Midway uil ing u�,NN�..
1821 University Avenue
St. Paui, Minnesota 55104-3 83 PAID
(612)642-0555 AMT
`'` CHECK#
DATE
GAMBLING LICENSE APPLI A ION
INSTRUCTIONS:
A. Type or print i�ink.
B. Take completed application to local governing body obt in signature and date on all copies,and leave 1 copy.Applicant keeps 1
copy and sends original to the above address with che k.
C. incomplete applications may be returned.
D. Enclose license fee with application.
Type of Application:
❑Class A— Fee 5100.00(Bingo,Raffles,Paddlewhe Is, pboards,Pull-tabs)
�Class B— Fee$ 50.00(Raffles,Paddlewheels,Tip oar s,Pull-tabs) �"��'p°�0 m°
❑Class C — Fee S 50.00(Bingo only) M�""°a cn«tc'a'camai"°�°""°i 8°°`d
❑Class D— Fee S 25.00(Raffles only)
Check ons: ❑1 A. Organization has never been licens .
CS1 B. New site—Give base license numb r. v2`}Z�
�1 C. Renewal of existing license—Give om lete license number. � - L�� - �
❑1 D. Change in class of an existing license—G e complete lice�se number. � - l�J - �
❑YesGWo 2. Has organization ever received a Law I G mbling Exemption Permit from the Board? If yes,give complete
permit number
C�Yes�No 3. Have Internal Controls been submitte pre iously on a form p�ovided by the Board?If no,please attach copy.
4. Applicant(Official,legal name of organization) 5. Business Address of Organization
v � ,- � • „ 1410 �.ner Park ��cive �ui*_e 12
6. City,State,Zip 7. County 8. Business Phone Number
St. Paul� cII�1 551C3 ���Y � b12 1641-14�2
9. Type of organization: ❑Fraternal ❑Veterans Rel gious OOther nonprofit•
•If organization is an"other nonproftt"organization,ans er q estions 10 through 12.If not,go to question 13."Other nonprofit"organizations
must document its tax-exempt status.
OYes O No 10. Is organization incor orated as a no rof o�ganizationT If yes,give number assigned to Articles or page and
book number: —17 n • �1C Att ch copy of csnificate.
[�Yes❑No 11. Are articles filed with the Secretary f St te?
[SYes�No 12. Is organization exempt from Minnes ta o Fede�al income tax?If yes,please attach lettsr from IRS or Department of
Revenue declaring exemption.
❑Yes G3No 13. Has license ever been denied,suspe de or revoked?If yes,check all that a ly:
❑Denied ❑Suspended �R ok d Give date: -
14. Number of active members 15. Number of ear in existence Note: Attach evidenca of
22 j�e 3 th�es yean existence.
16. Name of Chief Executive Officer(Cannot be 17. Name of treasurer or person who accounts for other revenues
Gambling Manager) of the organization(Cannot be Gambling Manager)
(�eorge i�uth Bave .1unz
Title Title
Prasident Treaburer
Business Phone Number Business Phone Number
.� � 612 1 854-2211. ( 6I2 1 375-7064
18. Name of establishment where gambling will be 19. Street address(not P.O.Box Numberl
f conducted
ducci'e Lounge 1045 Hudsoa Road
20. City,State,Zip 21. County twhere gambling premises is located)
St. Paul� ?-�T 551I9 Ramsey
CG-0001-0318/88) � White Copy-Board Canary•Applicant Pink-Local Goveming Body
Page 1 of 2
.
C� �i
i:...(,'• • .
Gambling License Application
Type of Applicadon: ❑Ciass A p Ctass B � lass C �Cisss D
DYes ONo 22. Is gambling premises located within ty li its7
C]Yes�No 23. Are all gambling activities conduct at t e premises listed in #18 of this applicationT If not,complete a separate
application for each premises(excep raff s)as a separate license is required for each premises.
❑Yss�No 24. Does organization own the gambling re ises�If no,attsch copy of the Isass with terms of at least one year,and
attach a sketch of the premises indi ati whet portion is being leased. A lease and sketch are not required for
Class D applications.
25. Amount of Rent Per 26. Do you plan o�cond ctin bingo with this Iicensel If yes,give days end tanes of bingo xcasions.
Month or Bin o Occasion Day Ti e Day Time Day Time
$4CO.G0
�Yes ONo 27. Has the S 10,000 fidelity bond required y M nesota Statutes 349.20 been obtained7
28. Insurance Company Name(not agency name) 29. Bond Number
�t. ^aul ?ir� �3n�? '`ari.ne !;c��nan u 'Fi;::i�" '.''-
30. Lessor Name 3 . dress 32. C'rty,State,Zip
�- f . - � ,., ;. 45 ;iuc35on :o::�.r`: ?t. :'uitl ',; "�i_'�
�rC�:.CC� � _�Ul.Ii' 1
33. Gambling Manager Name dress 35. City,State,rp
:iicl.a�l J. Saru�olean 9 3 Lim+�ood Avenu� �t. �3au1, :��� �510�
36. Gambling Manager Business Phone 37. Date amb ing manager became
� ��1'� � u41-1'�:�2 mem roforganization: Month g Year,;t
�Yes�No 38. Has the license termination form been mpl ted7 Attach copy.
❑Yes❑No 39. Has the compensation schedule been a pro d by the organization?Attach copy.
40. List the day and time of the regular meeting of the org niza ion.Day �+tti i ue� 3v r� �s:v� _�.�:t.
41. Bank Name 42. k dress 43. Bank Account Number
- 1 ,t. �I 1 Z • : :� , n� ���,
'�;r:a� :�3�:::.:� 1 � :i�n�;l .�i .��. . . �t. a �. u..-;_�-�
GAMB IN SfTE AUTHORIZATION
By my signature below,local law enforcement office s or gents of the Board are hereby authorized to enter upon the site at any
time gambling is being conducted to observe the ga bli and to enforce the law for any unauthorized game or p�actice.
BANK EC RDS AUTHORIZATION
By my signature below, the Board is hereby authori ed o inspect the bank records of the gambling bank account whenever
necessary to fulfill requirements of current gambling ule and law.
I hereby declare that: OATH
1. I have read this application and all information bmi ed to the Board;
2. All information submitted is true,accurate and m ete;
3. All other required information has been fully di los ;
4. I am the chief executive officer of the organizati n;
5. I assume full responsibility for the fair and lawfu op ation of all activities to be conducted;
6. I will familiarize myself with the laws of the S e o Minnesota respecting gambling and rules of the Board and agree, if
licensed,to abide by those laws and rules,inclu ing mendments thereto;
7. Membershi list of the or anization will be avail ble ithin seven da s after it is re uested b the board.
44. Official,Legal Name of Organization 45. Signature(must be signed by Chief Executive Officer)
X
Title of Signer Date
ACKNOWLEDGEMEN OF NOTICE BY LOCAL GOVERNING BODY
I hereby acknowledge receipt of a copy of this appl' ion By acknowledging receipt,I admit having been served with notice that
this application will be reviewed by the Charitable G mb ng Control Board and if approved by the board,will become effective
60 days from.the date of receipt (noted below) unl ss resolutio� of the local goveming body is passed which specifically
disallows such activity and a copy of that resolution re eived by the Charitable Gambling Control Board within 60 days of the
below noted date.
46. Name of City or County�Local Governing Body) If site is located within a township,item 47 must be completed,in
�, � �_> ���� addition to the county signature. If township is not organized,
+�;_�,� county must sign.
Signatu e of er�o receiving applic tion 47. Name of Township
` � r���:J
_ X � .� c���� ��.�-
Title Date received(60 day riod Signature of person receiving application
; w J begins from this�,1d�e) G X
, C ;:.-r�� � . fn �
48. Name of person delivering application to Local Go Title
CG-0001-03 (Sl88) White Copy-Boerd Canary-Applicant Pink-Lxal Goveming Body
Page 2 of 2
C i q f Saiat Paul
� " � Department of F na ce and Management Services
Division of Li en e and Permit Registration �
INFORMATION RE UIRED WITH APPLICATION OR PERMIT TO CONDUCT PULLTAB/TIPBOARD SALES IN
SAINT PAUL (Class B Gambling License a iquor Establishments - New Application)
1. � Full and condplete name of organiz ti n which is applying for license
G.I.V.E. , Inc. dba Custom Cont ac s & Services, Inc.
2. Does your organization meet the fi ition of a "large" organization as outlined in
the November, 1988 revision of Se ti n 409.21 of the Legislative Code? /���
Attach to this application perti nt financial and/or organizational information to
support your answer to this ques o . NOTE: Only 5 large organizations will be allow-
ed to open pulltab operations un r he revised city ordinance. If more than 5 organi-
zations apply, qualified applica s ill be selected randomly by the City Council.
3. Address where games will be held 1045 Hudson Road St. Paul 55119
Number Street City Zip
4. Name of manager signing this app ic ion who will conduct, operate and manage
Gambling Games Michael J. Sara ol an Date of Birth 9/13/56
(a) Length of time manager has b en ember of applicant organization 7 years
5. Address of Manager 973 Linwo d venue St. Paul 55105
Number Street City Zip
6. Day, dates, and hours this appli at on is for Mon-Sat, 12 noon to 12:30 a.m. ; Sunday,
� 12 noon-11:30 p.c
7. Is the applicant or organization or anized under the laws of the State of MN? yPG
8. Date of incorporation Ma 22 1 66
9. Date when registered with the St te of Minnesota May, 1966
10. How long has organization been i e istence? 22 years
11. How long has organization been i e istence in St. Paul? 22 years
12. What is the purpose of the organ za ion? to provide services to adults with
mental retardation
13. Officers of applicant organizati n:
Name Geor e Ruth Name Dave Aune
Address 23221 Woodland Rd. , Lak i e Address 4869 Churchill, Shoreview
Title President DOB 9/1 /4 Title Treasurer DOB 4/25/56
Name Jane Wells Name rtichael Michlitsch
Address 4209 Oakmead Ln. , White Be Lake Address 3870 Effress, White Bear Lake
Title Vice President DOB 7/2 /5 Title Secretary DOB 12/18/56
14. Give names of officers, or any o he persons who paid for services to the
organization. ' � -
Name none Name
Address Address
Title Title
(Attach sep ra e sheet for additional names.)
15. Attached hereto is a list of nam s nd addresses of all members of the organization.
16. In whose custody will organizati n' records be kept?
N� Michael J. Sarafolean Address 1410 Energy Park Drive
I7. List all persons with the author ty to sign checks for dispersal of gambling proceeds:
Name Michael J. Sardfolean N�e George Ruth
Address 973 Linwood Avenue, St. P 1 Address 23221 Woodland Road, Lakeville
Member of Member of
DOB 9/13/56 Organization?' s DOB 9/14/48 Organization? yes
Name Dave Aune Name Michael Michlitsch
Address 4869 Chruchill, Shorev'ew Address 3870 Effress, White Bear Lake
Member of Member of
Dpg 4/25/56 Organization? es DpB 12/18/56 Organization? yes
18. Have you read and do qou thoroug ly understand the provisions of all laws, ordinances,
and regulations governing the op ra ion of Charitable Gambling games? yE�
19. Will your organization's pulltab op ration be operated/managed solely by members of
qour organization? yes no •
20. Has your organization signed, or do s it intend to sign, a consulting agreement or a
managerial agreement with- anq pe so or companq to assist your organization with the
pulltab sales and/or recording ep ng? qes no '�
If answer is yes, give the name d address of the person and/or company contracted.
Name Address
Name Address
If answer is yes, how will such c nsultant be paid? (percentage, flat fee, gambling
funds, general funds, etc.) Att ch a copy of said contract to this application.
21. Operator of premises where games wi 1 be held: •
N� Perr �arducci
Business Address 1045 Hudson Ro d; 55119
Hame Address 834 N. Hazel; 51 9
.
22. a) Does qour organization pay or nt nd to pay accounting fees out of gambling funds?
. yes �X no
b) If you do pay accounting fees, to whom will such fees be paid?
Name Stan Babel Address 4618 Parkridge Drive, Eagan
DOB Member o 0 ganization? no
c) How are the accounting fees c ar ed out? (flat fee, hourlq, etc.)
Flat fee
d) What do you anticipate will b y ur average monthly deduction for accounting fees?
$100.00
23. Amount of rent paid by applicant rg ization for rent of the hall:
$100.00/week
24. The proceeds of the games will b di bursed after deducting prize layout costs and
operating expenses for the follo ng purposes and uses:
all lawful purposes
25. Has the premises where the games ar to be held been certified for occupancy by the
Citq of Saint Paul? Yes
26. Has your organization filed fede al form 990—T? x If answer is yes, please attach
a copy with this application. I a swer is no, explain why:
not required
Any changes desired by the applicant ss ciation may be made only with the consent of the
City Council.
��`�� G'T(.-
� Organization Name
,Date ,,�� �,�l.tLt,(,l�J� / BY s /�Cl-u ft.ctLt',„-�2�u..�i ��Q•�c�
Ma � ger charge of game
�
Or izat on President or CEO