89-1066 WHITE - C�TY CLERK COI1QC11 / !!
PINK - FINANCE G I TY O �A I NT PA LT L
CANARY - DEPARTMENT /O//�
BLUE - MAVOR File NO• �V���
ounc 'l Resolution ����'F
Presented By � �y w �
Refe d To Committee: Date
Out of Committee By Date
RESOLVED: That application ( D 39651) for a Class Gambling License
by the White Bear ox ng Club at the Dutc Bar, 899 Rice Street,
be and the same is he eby approved
COUNCIL MEMBERS Requested by De rtenent of:
Yeas Nays
Dimond
Lo� In F or
Goswitz
Rettman '�7 B
�he1�� Agai t Y
���
Wilson
�N � � Form Appr ved b City Attorney
Adopted by CounciL Date •
Certified Pa s Council Se et By rs
By f
t�pprove�by �Vlavor. Date i � �` 4 9 Approved by May r for Submission to Council
B � \ �i --i'��� ' � �C.�v>-2-- ' By
� PUBl1Sl�D� J U N 2 4 8
. . y ���-io��
DEPARTMENT/OFFICEIOOUNqL DATE IN TE � �O�
Fi nance/�i cense GREEN SH ET No. �N��
CONTACT�RSON d PHONE �DEPARTMENT DIRECTOR �CITY OOUNCIL
Christine Rozek/298-5056 �`�10N OCITYATTORNEY �CRYC�ERK
MUST BE ON OOUNCIL AOENDA BY(DATE) �BUDQET DIRECT�1 �FlN.8 MOT.SERVI(�8 DIR.
6-13-89 ��YOR(OR AS81ST �] R
TOTAL#�OF 8IONATURE PAGES (CLIP A L L TIONS FOR SIGNATUR�
ACTION REQUESTED:
Approval of an application fo a Class B Gambling Li ense.
Notification Date: 5-24-89 Hearin Date: -13-
RECOIiAMENDATIONB:Approw(Iq w Rejsct(i� COUNC C MITTEE/RESL/►RCH REPORT IONAL
_PUWNINO COMMISSbN _qVIL 8ERVICE COMMISSION ANALY8 PFIONE NO.
_qB O�AMITTEE _
COMME .
_$TAF'F —
_DISTRICT COURT _
SUPPORTS WHICH WUNqL OBJECTIVE9
INITIATINCi PFIOBLEM,IS3UE,OPPORTUNITY(Who,Whst,When,Whsre,Why):
The White Bear Boxing Club re ue ts Council approval of its application
for a Class B Gambling Licens a the Dutch Bar, 899 Rice Street. Proceeds
from the pulltab sales will b u ed for the training of amateur boxers.
All fees and applications hav b en submitted.
ADVANTAOES IF APPROVED:
If Council approval is given, th White Bear Boxing lub will be licensed
for pulltab/tipboard sales at th Dutch Bar, 899 Ric Street.
.��f'��f � ���k�� et����o,- �e
/�.�/`�-`�X � �
DISADVANTAOES IF APPROVED:
DiSADVANTA(iE8 IF NOT APPROVED:
Co ncil Research Center
rv1AY 3 0 ��89
TOTAL AMOUNT OF TRAN8ACTION a COST/REVENUE BUDOETE (CIRCLE ON� YES NO
FUNDINO SOURCE ACTIVITY NUMBER
FlNANdAL INFORMATIOW:(EXPWN)
. " � _
� , ,
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE CiREEN SHEET INSTRUCTIONAL
MANUAL AVAiLABLE IN THE PURCHASING OFFICE(PHONE NO.298-4225).
ROUTING ORDER: '
Below are preferred routings for the five most frequent types of documeMS:
CONTRACTS (assumes suthorized COUNCIL RESOLUTION (Amend, BdgtsJ
budget exists) Accept. C3rants)
1. Outside Agency 1. Department Director
2. Initiating Department 2. Budget Director
3. Ciry Attorney 3. City Attorney
4. Mayor 4. Mayor/Assistant
5. Finance&Mgmt Svcs. Director 5. Ciry Council
6. Finance Acxounting 6. Chief Accountent, Fin &Mgmt Svcs.
ADMINISTRATIVE ORDER (Budget COUNCIL RESOLUTION (all others)
Revision) and ORDINANCE
1. Activiry Manager 1. Initiating Department Director
2. Department Axountant 2. Ciry Attomey
3. Department Director 3. Mayor/Assistant
4. Budget Director 4. City Council
5. City Clerk
6. Chief Accountant, Fin&,Mgmt Svcs.
ADMINISTRATIVE ORDERS (all others)
. 1. Initiating Department
2. City Attorney
3. MayodAssistant
4. qty Clerk
TOTAL NUMBER OF SIGNATURE PAGES
Indicate the#of pages on which signatures are required and a ercli
each of these pages•
ACTION REQUESTED
Describe what the project/request seeks to accomplish in either chronologi-
cal order or order of importance,whichever is most appropriate for the
issue. Do not wNte complete seMences. Begin each item in your list with
a verb.
RECOMMENDATIONS
Complete if the issue in question has been presented before any body, public
or private.
SUPPORTS WHICH COUNCIL OBJECTIVE?
Indicate which Council objective(s)your pro)ecUrequest supports by listing
the key word(s)(HOUSING, RECREATION, NEIGHBORHOODS, ECONOMIC DEVELOPMENT,
BUDGET, SEWER SEPARATION). (SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
COUNCIL COMMITTEEIRESEARCH REPORT-OPTIONAL AS REQUESTED BY COUNCIL
INITIATING PROBLEM, ISSUE,OPPORTUNITY
Explain the situation or conditions that created a need fo�your project
or request.
ADVANTAGES IF APPROVED
,Indicate whether this is simply an annual budget procedure required by law/
charter or whether there are specific ways in which the City of Saint Paul
and its citizens will benefit from this pro�ecUaction.
DISADVANTAGES IF APPROVED
What negative effects or major changes to existing or past processes might
this projecUrequest produce if it is passed(e.g.,traffic delays, noise,
tax increases or assessments)?To WhomT When? For how long?
DISADVANTAC3ES IF NOT APPROVEO
What will be the negative consequences if the promised action is not
approved?Inability to deliver service?Continued high traffic, noise,
accident rate? Loss of revenue? '
FINANqAL IMPACT
Although you must tailor the information you provide here to the issue you
ere addressing, in general you must answer two questions: How much is it '
going to cost?Who is gofng to pay7
.� . � � � .C,�-�-�--,���
UZVISION OF LICENSE AND P�RMIT ADMINI T TION llATE Z(� � ! / � v�l �
INTERDF.PARTMENTAL REVIEW CHECKLIST pn roc ssed/Received by
Lic Enf Aud
Applicant l.lJ���, �Q � �ny C� b Home Address �5(p t.� oN ��
Rusiness Name � L' �L b Home Phone Z -' Z I a�
Business Address - Type of License s) 1��,�t.ss �-- �l`nb��nG�
Business Phone g������'� �P�J pS� • P�
Public Hearing Date �p (3 � License I.D. 4F 3 /���
at 9:00 a.m. in the Council hauibers ���
3rd floor City Hall and Courthouse State Tax I.D. �
llate Nutice Sent; Dealer �� �" 'J�"
to Applicant �o?��
� rederal Pi_rea ��' �I�'
Pub.lic He<.iring
DATE INS EC IUN
REVIEW VERFIED ( 0 UTER) CUMMENTS
A proved ot A roved
�
Bldg I & D �
�I� ,
Health Divn.
�� �
i
Fire Dept. ; �
j '`��� �
Police Dept. ' S`��� � � ��
� Zc� 8� i � �
�
License Divn. '
�4�zc� �j � o/�
City Attorney �
��as �i �
Date Received:
Site Plan N � --
To Council P..search � 3�
Lease or Letter � Date
from Landlord
+ ��_� . ..
. � : , . ���o��
.i ` FOR BOARD USE ONLY �
MINNESOTA DEPARTMENT OF REVENUE li ense Number
GAMING DIVISIOIy PAID
Mail Station 3315
St. Paul MN 55146-3315 AMT
612/297-5300 CHECK # -
. DATE
GAMBLING UCENSE APPL CA ION
INSTRUCTIONS
A. Type or print in ink.
B. Take completed application to local governing body, tai signature and date on all c pies,and leave 1 copy.Applicant keeps 1
copy and sends original to the above address with a hec .
C. Incomplete•applications may be ret�rned.
D. Enclose license fee with application. •
Type of Application:
� Class A — Fee S100.00(Bingo, Raffles, Paddlewheels Tip oards, Pull-tabs)
t�Class B — Fee S 50.00(Raffles, Paddlewheels,Tipbo rds, Pull-tabs) ake checks payable to:
❑ Cless C — Fee S 50.00(Bingo only) C mmissioner of Revenue
❑ Class D — Fee S 25.00(Raffles only)
Check one: ❑ 1A. Organization has never been license .
:� 1 B. New site—Give base license numbe -C?092- C 1
O 1 C. Renewal of existing license—Give c mpl te license number. 0 - 0 � 0
D 1 D. Change in class of an existing licens — ive complete license numbe . � � � - 0
[3 Yes ❑ No 2. Has organization ever received a Lawf I G bling Exemption Permit fro the Board7 If yes,give complete
permit number �-G2E�'i2-�?0 i
QYes ❑ No 3. Have Internal Controls been submitted pre 'ously on a form provided by he Board? If no,please attach copy.
4. Applicant�Official, legat name of organization) 5. Business Address of 0 ganization
,. . -..,_,� �, -,� ,� o �� d.
6. City, State,Zip 7. County 8. Business Phone Number
*�^ '� :1 T� P :IZ �..9�-i9L:
9. Type of organization: OFraternal �Veterans OR ligi s Qpther nonprofit
G�Yes ❑ No 10. Is organization incor orated as a non fit rganization?If yes,give nu ber assigned to Articles or page and
book number: � � ttach copy of certificate.
. •
Yes ❑ No 11. Are articles filed with the Secretary of tat 7
R Yes ❑ No 12. Is organization exempt from Minnesot or eral income tax?If yes,pl se attach letter from IRS or
� Department of Revenue declaring exe ptio .
❑ Yes C3�No 13. Has license ever bee�denied,suspend o rewked�If yes,check all th t a I :
❑ Denied ❑ Suspended ❑ R k Give date: - -
14. Number of active members 15. Number of yea in xistence ote: Attach evidence of
�0 7 ° r5 9 �[O� . three years existence.
16. Name of Chief Executive Officer(Cannot be 17. Name of treasurer o person who accounts for other
Gambling Manage_r� ,,,,� ,�n � � �rQvenues of t�orga .iz�ii (Cannot be Gambling Manager►
p••� l�.�,, V ' �....�{ �� � ��.7.!��%�',i;-��-.. �� � .
Title � Title �f�
?r�si�en� Treasur r
Business Phone Number Business Phone Num er �:
,y �. , - -...,---
l51� 1 Li 2 9-�9 2 5 612 `�ri�?.; ti 9�'.-- y�, " '..�...;,.....��
18. Name of establishment where gambling will be cond ed 19. Street address(not O. Box Number)
Dutc'� Bar 899 Rice St
20. City, State,Zip 21. County(where gamb ing premises is located)
S t. "a u 1 , i�fr.. R�==� f'-1
CG-0001-03(3/89) White Copy-Board Canary-Applicant Pink-Local Gaverning Body
Pa 1 of 2
.._ � �.... -M.�.��J�...���r+!-�\. .r....'��..... . _..i .. .F � -. ...R . /. y...f�' i P ,. 'r . ! .
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. . .� .i� �r�
., rv .....v .�....,.�v�.�. ...-..
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�_�--�r� = � � [�_�'%-io�Ol�
_ -. � �:,,..i{., i . .
Gambling License Application
, T e of A licatian: ❑ Class A Class B D Class C � Ciass
Yes ❑ No 22. Is amblin remises located within c li its7
�1 Yes ❑ No 23. Are all gambling activities conducted t th premises listed in#18 of th s applicationT If not,complete a separate -
a lication for each remises exce t affl as a se arate license is r uired for each remises.
❑Yes)f] No 24. Does organization own the gambling em es7 If no,attach copy of th lease with terms of at least one year,
and attach a sketch of the premises i dic ing what portion is being le sed.A lease and sketch are not required
for•Class D a lications.
25. Amount of Rent Per 26. Do you plan on conduc 'ng ingo with this license?If yes,give days and times of bingo occasions.
Month osBirrgorE3eessivrr �aY im Day Ti e Day Time
s��CU . �O
X] Yes ❑ No 27. Has the S10,000 fidelit bond re uire b innesota Statutes 349.20 en obtained?
28. Insurance Company Name(not agency name) 2 . Bond Number
� ???S 37b8�i
5tate ��ur�ty �o .
30. Lessor Name 31. Ad ress 32. City,State,Zip
n ' o �7
.. *�., �. 7� .a.-� a t-, <� '� ' '�`
33. Gambling Manager Name. y 34. Ad ress 35. City,State,Zip
R �" ;11 ��rC r �.�. � ' ' t'p Tlo j�tn 'lG' Z.1
36. Gambling Manager Business Phone 37. Date ga bli g manager became
,7 .. ,.;� ��, �, membe of rganization: Month R Year �?�
0 Yes O No 38. Has the license termination form bee co leted?Attach co
❑ Yes ❑ No 39. Has the com ensation schedule been a ed b the or anizationl A ach co
40. List the da and time of the re ular meetin of the o an zation. Da Time
41. Bank Name 42. Ban Ad ress 43. Bank Account Number
GAMBLI G ITE AUTHORIZATION ,
By my signature below, local law enforcement officers or age ts of the Board are hereby a thorized to enter upon the site at any
time gambling is being conducted to observe the gambli a to enforce the law for any nauthorized game or practice.
BANK R CO DS AUTHORRATION ,
By my signature below,the Board is hereby authorized t ins ect the bank records of the ambling bank account whenever
necessary to fulfill requirements of current gambling rul s a d law.
I hereby declare that: OATH
1. I have read this application and all information sub itte to the Board;
2. All information submitted is true,accurate and com lete
3. All other required information has been ful�y disclos d;
4. I am the chief executive officer of the organization;
5. I assume full responsibility for the fair and lawful op rati n of all activities to be cond cted;
6. I will familiarize myself with the laws of the State of Min esota respecting gambling nd rules of the Board and agree, if
licensed,to abide by those laws and rules, includin am ndments thereto;
7. Membershi list of the or anization will be available wit in seven da s after it is re u sted b the board.
44. Official, Legal Name of Organization 45. Sigaature_(must b signed by Chief Exe�utive Officer)
��
X Fc�� �''. �„� .r�. ,�-.� (;
Title of Signer Date 4-1 -89 + •�+
�resident
ACKNOWLEDGEMENT F TICE BY LOCAL GOVER ING BQQY
I hereby acknowledge receipt of a copy of.this appGcation By cknowledging receipt, I adm having been served with notice that this
application will be reviewed by the Charita'b1e Gambling ont ol Board and if appraved by t e board,will become effective 60 days
from the date of receipt(noted belaw)unless a resolution of t e local governing body is pa ed which specifically disaltows such .
activit and a co of that resolution is received b the C arit ble Gamblin Control Board ithin 60 da s of the below noted date.
46. Name of City or County(Local Governing Body) If site is located within a ta�vnship, item 47 must be completed,
-,,,r �., in addition to the coun y signature. If tawnship is not organized,
`._;,,+,;'• - v''� ���;�� �� count must si n.
Signature of pelson receiving application 47. Name of Tvwnshi
.�.r • ^ � � .
X �'-. .:..� ✓ �": '� :�.
Title Date�eceived(60 day per d Signature of person re eiving application
y ` - begi�s from,this,date)r_.�
�� � t �-. . �•, . � ,i • X
48. Name of person delivering application to Local Gbver ing ody Title
CG-0001-03 (3/89) White Copy-Board Canary-Applicant Pink-Local Governing Body
� . . �(r,I,���oro�
C'ty f Saint Paul
Department of in ce and Management ervices
� Division of L e e and Permit Regis ration
INFORMATION RE IIIRED WITH APPLICATION 0 PERMIT TO CONDUCT IILLTAB/TIPBOARD SALES IN
SAINT PAUL (Class B Gambling Licease in iquor Establishmen s - New Application)
1. Full and complete name of organi t n which is applyin for Iicense
��.'';�ite Pear Boxin� C?u .� c .
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 Le islative Code?
Attach to this application pert nt financial and/or o ganizational information to
support your answer to this quest o NOTE: Only 5 la ge organizations wi11 be allow-
ed to open pulltab operations und r he revised city or inance. If more than 5 organi-
zations apply, qualified applica s ill be selected r damly by the City Council.
3. Address where games will be held o n= .. c t , c`, g�,�_ �5117
Number v Street City Zip
4. Name of manager signing this appl'ca ion who will condu t, operate and manage
Gambling Games '�bert F. Bt: t� � Date of Birth �-5-�`
(a) Length of time manager has be n ember of applicant organization �= Y r� .
5. Address of Manager �403 ;�.si; S :�'i:ite ?:�r�� L:.. �`'liG
Number Street City Zip
i�:ay I�t. I989 to i�:ay ist. 19a0
6. Daq, dates, and hours this applic ti n is forMon thrv. iri �-12 : ?0 Sat-Sar, 12-i2 : 3TC+�
CJI�:
7. Is the applicant or organization rg nized under the la of the State of MN? �:��.
8. Date of incorporation ,Ti,ly�Q� , g g i
9. Date when registered with the Sta e f Minnesota ��;., , ;_C ��8�
10. How long has organization been in ex stence? �; � �.
11. How long has organizat ion been in ex stence in St. Paul? ti•;P �.-�r� a,f f i t t i a.t�:�. -:i t:�.
�t. P�ul sinc� J��.1� '0, ?G�l
12. What is the purpose of the organi at on? m +-'� �ct 'vi t i es.
^�.c primary' _•m�hasis is he �rair�inc cf a. .,ateur boxer� . A fucility
r — � � � i }�+c; •�
13. Officers of applicant organizatio :
Name � i � - Name r �
JJ7G C�r�t2r�t?11E Rc� . �� * �-1 �'�c�1 �iv� .
...��a ti�, . � �� � �
Address �.� �t �- � � i Address4.�T�.;� p, �• -��� -
Title Presicent Dpg 7-1"'-� Title �Ir..cter D�B ���V�JJ
Name �En Carlson N�e Ro. ert ��:t��rs
1 i Lcr�vaoc: �� uo ., .. . ,. L-� , .
Address �t. �au1 ,Nn. 55i27 Address
Title �,ss* . Directa�08 9-1 _- 6 Title ��!N� �n_� �i��;r . Dpg �-�-°�
� � - (�,,��r��G�
14. Give names of officers, or any ot er persons who paid fo services to the
organization. !.;u n3 Fi
Name Name �
Address � Address
Title Title
(Attach sepa at sheet for additio 1 names.)
15. Attached hereto is a list of name a d addresses of all embers of the organization.
16. In whose custody will organizatio 's records be kept?
Name ,a Address �.,
I7. List all persons with the authori y o siga checks for d spersal �of gambling proceeds:
Name p z : Z - -, Name t m
Address G� T, Address �
�
Member of Member of �
DOB �_13_�c Organization? . DOB ?-� -5 g Organization? �r��
Name Name
Address Address
Member of Member of
DOB Organization? DOB Organization?
18. Have qou read and do you thorough y nderstand the provi ions of all laws, ordinances,
and regulations governing the ope at on of Charitable G bling games? Yes
19. Will your organization's pulltab pe ation be operated/ naged solely by members of
your organization? yes . � no
20. Has your organization signed, or oe it intend to sign, a consulting agreement or a
� managerial agreement with any per on or companq to assis your organization with the
pulltab sales and/or recording ke pi g? yes no no
If answer is yes, give the name d ddress of the perso and/or companq contracted.
Name Address
Name Address
If answer is yes, how will such a co sultant be paid? (p rcentage, flat fee, gambling
funds, general funds, etc.) Atta h copy of said contr ct to this applicatian.
21. Operator of premises where games 1 be held:
Name o
Business Address
Home Address L tan St. St . �avi
.- . : . G���--io�
22. a) Does your organization pay or nt nd to paq accountin fees out of gambling funds?
yes �> no
b) If you do paq accountiag fees, to whom will such fees be paid?
Name Vierlin�, Karasov & S h cht�,�ess ,
DOB Member o 0 ganization?
c) How are the accounting fees c ar ed out? (flat fee, hourly, etc.)
�
d) What do you anticipate will b y ur average monthly eduction for accounting fees?
$ 240 . 00 a non.
23. Amount of rent paid by applicant rg nization for rent f the hall:
$�00.00 �or boot?1 spac
24. The proceeds of the games will be di bursed after deduc ing prize layout costs and
operating expenses for the foli ng purposes and uses:
For th� Purch�.sin� of o in' equipm�nt �or our yout'� '�o,cinc clv.�
and doi.ations �o the t . Paul GolGen Glo e Bor�inr Club anc for
trav2l expens�s for b xi � tournaments
25. Sas the premises where the games re to be held been ce tified for occupancy by the
City of Saint Paul? Y�s
26. Has your organization filed feder 1 orm 990-T? f answer is yes, please attach
a copy with this application. If an wer is no, e�p$lsain why:
Any changes desired by the applicant so iation may be made only with the consent of the
City Couacil.
�n'hit Bear BoxinG Club
� t Organization Name
Date �-17-89 By: '�
' ger in charge of game
� l� ' ��'C.
Org nization President or
. . . . . . . . . . .. .
3 9 �s/
C y of Saint Paul �G /O��
Department of ina ce a�d Management S nrices �O ��
Lice sa nd Permit Division
203 City Hall
St. Pa I, M nesota 55102•298-5056
APPLI A ION FOR LICENSE
CASH CHECK CLASS NO. ew Renew
0o a
Date � 19�
Code No. Title of License From ` � 1�To � 19 ��
".�i r�-� ,n �r� -C� �?� 3�f � p
� �oo '� h�`� I��i� �Y�r� C��i��h�
ApplicanUCo pany Name
100 / �11n / f
l.t� � `f� �(1� � - ���1 !�nC
100 Buslness Na e
�oo C(�' �-�. ...�(`T�� ��-/L
Busineas Add ess PAO��Na
100 ,C.� C� �
r
r�
�, � � � � � S ,
100 Mail to Addre s._.i , ��r�C / I �� r�� Phone No.
100
ManaqerlOwn r•Name � ��,..�
,� _ -.� y,:.
� .� C� �e���v,� �<�. d-i� '�
100 AlanagerlGw r•Home Address Phone No.
4098 Application Fee 2, 50 I
Recefved the Sum of ��110Q,� ` � �+ ��1 i� �'��2 f'
��'`� ManagerlOwn r•City,State 3 Zip Code
t00 ota t00
`j �'� !` � i �� I,`L,.(/'n
� I !
LiCense InspeCtOr v By: �� Signa of Appliwnt
Bond•
Company Name Policy No. Expiration Oats
Insurance•
Compsny Name Policy No. Expiration Oat�
Minnesota State Identification No � a��s�I Social Security No.
Vehicle Information:
Suial Number late Numb�r
Other: '
THIS IS A R C IPT FOR APPLICATION
• TNIS IS NOT A LICENSE TO OPEAATE.Your application for Iice se will either be granted o�rej ted subiect to the provisiona of the zonin�
ordlnance and compleNon of the inspoctions by the Hsalth Fir Zoning and/or Licenss Insps tora.
$15.00 CHARGE R LL RETURNED CHECKS
o��'�o� �02/�9 � �: ,�' �
- - - (��i�c�G
TO E OMPLETED BY
ORGANIZATION PR I NT AND GAMBLING MA AGER
I understand and will uphold in Paul Ordinance 40 , Sections 409.21
and 409.22 relating to pullta a d tipboards in bar .
Further, I understand that my 'a ar must meet city tandards; that 10�
of the net profit from pullta sa es must be returne 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 mu t remain in St. Paul
or be used to support St. Paul re idents.
X �. � i �
Sig a�u e - Manager
� Z� �
Signature - Organization Presi en
T D v i rr �
rganization ame J
Dutch Bar 89° Rice St. . * . P�uI , '��n.
Gamb ing Location
April 17 th 1°89
Date
Please retain th a tached ordinance f r your records.