89-1145 .V CLERK
. - DEP RT ENT GITY F SAINT PAUL Council -- �
_ - MAVOR File NO. �����
Coun i Resolution ����
; �..
Presented By
Referre o Committee: Date
Out of Committee By Date
�
RESOLUED: That application ( D 5097) for renewal of a Class A Gambling
License by Blessed Sa rament School Board at 1494 N. Dale Street,
be and the same is he by approved��-ect.�
;
,
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond � i�
�� In Fa r
�-�E'se�.+le
�enma° By
�be1�� � Agains
r-�oeee� '
�Ison I
JUN 2 2 � 9 Form Approved by City tt ney
Adopted by Council: Date f �jQ'
Certified Pas e unc'1 S tar By , � Z`� o(
By
A►pp v by iNavor: Da e Approved by Mayor for Submission to Council
1
B BY
POBIISt� J U L ' 11 69
.,
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DEPARTMENTlOFFlCE/COUNCIL DATE INITL4 D
Fi nance/�i cense GREEN SHE T No. 1 8�5
iNmnu � iNmnuon�
CONTACT PER80N 8 PFIONE DEPARTMENT DIRECTOR CITY COUNGL
Chri sti ne Rozek/298-5056 Nu�F R CITY ATTORNEY CRY CI.ERK
MUST BE ON COUNqL AOENDA BY(DATE) ROUTNIO BUDOET DIRECTOR �FIN.8 t�T.SERVICES DIR.
6-22-89 �►Y�c�+� � Counci 1 R
TOTAL#�OF SIGNATURE PACiES (CLIP ALL OC TIONS FOR SIQNATURE)
ACTION REQUESTED:
Approval of an application for en wal of a Class A Ga bling License.
Notification Date: 5-25'89 Hearing Dat : 6-22-89
RECOMMENDATIONS:Approve(ly w ReJeCt(R) COUNCIL C MM EE/RESEARCH REPORT OPT
_PLANNIN(i COMMISSION _GVIL SERVICE COMMISSION ��YBT PHONE NO.
_GB COAAMITTEE _
COMMENTS:
_STAFF _
_DISTRICT COURT —
BUPPORTB WHICH COUNGL OBJECTIVE7
INfTIAT1NO PROBLEM,ISSUE,OPPORTUNITY(Who,What,Whsn,Whsre,Wh»:
Blessed Sacrament School Board t 494 N. Dale St. req ests City Council
approval of its app1ication for wal of a Class A G mbling License.
Bingo sessions are he1d Mondays be een the hours of .1 00 PM and 5:00 PM.
Proceeds are given to Blessed S cr ent School .
ADVANTA(iES IF APPROVED:
If Council approval is given, B1 ss d Sacrament School Board will continue
to sponsor a bingo session at 14 4 . Da1e St.
DI8AOVANTAOEB IF APPROVEO:
DISADVANTAGES If NOT APPROVEO:
TOTAL AMOUNT OF TRANSACTION a COST/REVENUE BUDOETED(CI LE ONE) YES NO
o�;r,cil Research Center
FUNDING SOURCE ACTIVITY NUMBER
FlNANCIAL INFORMATtON:(EXPW N) r p AY � O f a Q Q
rl �r�
�
.
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIONAL
MANUAL AVAILABLE IN THE PURCHASING OFFICE(PHONE NO. 298-4225).
ROUTING OR�ER:
Below are preferred routings for the five most frequent types of documeMs:
OONTRACTS (assumes authorized OOUNGL RESOLUTION (Amend, BdgtsJ
budget exists) Accept. GraMs)
1. Outside Agency 1. DepartmeM Director
2. Initiating Department 2. Budget Director
- 3. Ciry Attomey 3. City Attorney
4. Mayor 4. Mayor/Assistant
5. Finance&Mgmt Svcs. Director 5. Clry Council
6. Finance Axounting 6. Chief AxouMant, Fin 8 Mgmt Svcs.
ADMINISTRATIVE ORDER (Budget COUNCIL RESOLUTION (all others)
Revision) and ORDINANCE
1. Activity Manager 1. Initiating Department Director
2. Department Accountant 2. Ctry Attomey
3. Department Director 3. Mayor/Asafstant
4. Budget Director 4. City Council
5. City Clerk
6. Chief Accounta�t, Fin &Mgmt Svcs.
ADMINISTRATIVE ORDERS (all others)
1. Initiating DepartmeM
2. City Attorney
3. MayoNAssistant
4. City Clerk
TOTAL NUMBER OF SIGNATURE PAGES
Indicate the#of pages on which signatures are required and paperclip
each of these pages.
ACTION REQUESTED
Describe what the projecUrequest seeks to accomplish in either chronologi-
cal order or order of importance,whichever is rtwst appropriate for the
issue. Do not write complete sentences. Begin each item in your list with
a verb.
RECOMMENDATIONS
Complete if the issue in question has been preaented before any body, public
or private.
SUPPORTS WHICH COUNCIL OBJECTIVE?
Indicate which Council objective(s)your projecUrequest supports by listing
the key word(s)(HOUSING, RECREATION, NEI(3HBORHOODS, ECONOMIC DEVELOPMENT,
BUDGET, SEWER SEPARATION).(SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
COUNCIL COMMITTEE/RESEARCH REPORT-OPTIONAL AS REGIUESTED BY COUNCIL
INITIATING PROBLEM, ISSUE,OPPORTUNITY
Explain the situation or conditions that created a need for your project
or request.
ADVANTAGES IF APPROVED
Indicate whether this is simply an annual budget procedure required by law/
charter or whether there are speciflc wa in which the City of Saint Paui
and its citizens will benefit from this pro�icUaction.
DISADVANTAGES IF APPROVED
What negative effects or major changes to existing or past processes might
this project/request produce if it is passed(e.g.,traffic delays, noise,
tax increases or assessments)?To Whom?When? Fo�how long?
DISADVANTAGES IF NOT APPROVED
What will be the negative consequences if the promised actlon is not
approved? Inability to deliver service? Continued high traffic, noise,
accident rate? Loss of revenue?
FINANCIAL IMPACT
Although you must tailor the information you provide here to the issue you
are addresaing, in general you must answer two questions: How much is it
going to cost?Who is going to pay?
� ii�
� _ �
; ,� -- , �-- � � �
DiVISION OF LICENSE AND P�RMIT ADTIINI T TION llATE J �y- �� � ��-�.
INTERDF.PARTMENTAL REVIEW CHECKLIST App Processed/Received by
ic Enf Aud
/�'1c�� Se���'�
Applicant JUI2SSE'd S(iC►�e►�t1!n,l' ��_k.o- � Home Address l',�l��A lltf � ���
Rus ine s s Name �r Home Phone `� � + �'J��3
�;:
Business Address � '1��� N• 1�C{ �-e- Type of License(s) l.- �Q�.; �--f �)ri� �����y
Business Phone L i (,�.y-, � '� "'",eQ/�eL<i�� !
Public Hearing Date � � ��, License I.D. 46 ,Z ��:, � ��
at 9:00 a.m. in the Council Chambers,
3rd floor City Hali and Courthouse State Tax I.D. �t �11�'
llate Nutice Sent; Dealer 4� l�i f/-�"
to Applicant �oZ.��"$9
rederal I'i.rearms �� N l�
Public Hearing
DATE IrSPE TI N
REVIEW VERFIED (CO U ER) CUMMENTS
A roved No A roved
�
Bldg I & D , � ,
ti���4- ; '
Health Divn. '
���- '
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Fire Dept. � �
I �/'� �
� Se�E- f t�, �z,� .
Police Dept. �/�� � � / ��
'
License Divn.
;
5�a�{ �j i o�
City Attorney �
��as � � ��� ��
Date Rece'ved:
Site Plan � �� ��� �- �0 G
To Council RPSeareh �J 0
Lease or Letter � �� �c� Date
from Landlord � `~'
,.,..�. , ..
� � J�Y s.��� P� a� �7
Department of Fin and M�sg�n�nt Senri�es � �
License a Pennit Divisfon ��C�-�/�S
clty Hau .
S� Paul. in ta 5810Q-29bSOSa
APPLICA 10 FOR LICENSE
:i.Ca CN� CLASS N�. �w � -
X
. . oe�e J`" �� ,��
�. �e No. . nt�o���. F � a3 ,��Ta �,��0
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/ " �� ����.� �c:r�;�1P�1�' �JCi��� 1`��.�.
��-�c :�.1,J�...� ApplteantlCompsmr Name
100
l u' G 4" �t.; , ��.(p S��.e�.�
�oo e�.��N�m. --
�ao 5� � {�Q C�� � �� rl _
BusfMSS Addnss Phane No.
100
100 Msil to Addrass Pnone No.
, •
00 �V�Q✓ �I C+C�.1 C1 1 _
ManapnlOwnK 1 Nsme <��'�-�0-
I � Z�p�p (.� I U1 rl 'i V�
( �1
00 �1�rK�wna•Home Address Ptrone No.
4098 AppNeatlon FN
Received th� urt�of � 2 0/�0 �,�e�C, • --�' '�C C�,� r�� �� �.����C
�(� ' , v Man�pKlOwn�r•City,Slate 3 2ip Code
100 Tot 00 �,
. .�` � ,
J .�
LiC@n38 IltSp�CtO� BY• � � Signature of App ieant
Bond• I
Compaoy Name Policr No. I Expi�ation Date
Insurance•
Company NsnN PoMCy No. ExpiraUon Date
Minnesota State Identification No. Social Security No
Vehicle Infom�atiOn• .
gMial NumpN at� umb�r
Other '
THIS iS A REC IP FOR APPLICATiON
THIS IS NOT A LICENSE TO OPERATE.Your applicatfon for Iice se ilt eithu b�qnnted a re�scted subject to the p�ovisions of the zoning
ordlnane�and compl�tio�ot th�insp�ctions by tA�M�alth, Fir Zo in�andfor Uca�s�Insp�ctors.
�15.00 CHARGE FOR AL RETURNED CHECKS
�������-���'9�° 7 /
� . C���/�`�s
,�
Charitable Gambling Control Board For eoerd Use On
�;, Rm N-475 Griggs-Midway Bldg. �Y
1821 University Ave. Paid Amt:
= St. Paul, MN 55104-3383 Check No.
:. .... (612)642-0555 oate:
GAMBLING LICE SE RENEWAL APPLICATION ,
LICENSENUMBER: h-9M93-�O2 /EFF. DAT : �S�aIj83 /AMOUNTOFFEE: 1 .i
1.Applicant-Legal Name of Organization 2. Street Address
BIESSED �AC9RMEMI SCHOOI BOARD 36l1 R�es ��-e
3.City, State,Zip 4. County: 5. Business Phone
St Pau1, �N [5119 Raasey 5t2 ;35-.i6)5
6. Name of Chief Executive Officer ,�., 7. Business Phone
^.dnd:�. <;a:e ,;; � ',, �g1�
8. Name of Treasurer or Person Who Accounts for Revenues 9. Business Phone
;)p�a :ve:it? �t� `?:-?b%.
10. Name of Gambling Manager 11. Bond Number 12. Business Phone
Aary _i�i! ;i;n1^� : ;1_ �5!-��`�a;
13. Name of Establishment Where Gambling Will Take Place 14. Counry 15. No.of Active Members
ideal i,;ii ;�: �a��+. Za�say 1�8
16. Lessor Name 17. Monthly Rent:
Ja�a;;:, .��-;.:;v: .� ',,a3
18. If Bingo will be conducted with this license,please specify days d ti es of Bingo.
Days Times Days Times Days Times
� ,!„�_ �. .r.•, � . -.
19. Has license ever been: ❑ Revoked Date: S pended Date: ❑ Denied Date:
20. Have internal controls been submitted previously? �Yes ❑ No(If"No,"attach copy)
21. Has current lease been filed with the board? �l Yes ❑ No(If"No,"attach copy)
22. Has current sketch been filed with the board? Yes ❑ No(If"No,"attach copy)
� GAMBLING ITE UTHORIZATION
By my signature below, local law enforcement officers or agents of th Boa d are hereby authorized to eMer upon the site,at any time, gambling is
being conducted,to observe the gambling and to enforce the law for y u authorized game or practice.
BANK RECO DS UTHORIZATION
By my signature below, the Board is hereby authorized to inspect the ank ecords of the General Gambling Bank Account whenever necessary to
fulfill requirements of current gambling rules and law.
OA H
I hereby declare that:
1. I have read this application and all information submitted to the Bo d;
2. All information submitted is true, accurate and complete;
3. All other required information has been fully disclosed;
4. 1 am the chief executive officer of the organization;
5. 1 assume full responsibility for the fair and lawtul operation of all act itie to be conducted;
6. I will familiarize myself with the laws of the State of Minnesota res tin gambling and rules cf the board and agree,if licensed,to abide by those
laws and rules, including amendments thereto.
23.Official Legal Name of Organization Signature(Chief E ecut e Officer) Date Tttle
�,_. ;` /; �-- - _
- � : � � � ;' r � _ ,� ,,,: ,�. �,
, -
ACKNOWLEDGEMENT OF N !C BY LOCAL GOVERNING BODY
I hereby acknowledge receipt of a copy of this application. By acknowl gin receipt, I admit having been served with notice that this application will
be reviewed by the Charitable Gambling Control Board and if approved y th Board,will become effective 3Q days from the date of receipt(noted
below), unless a resolution of the local goveming body is passed which peci ically disallows such activiry anc�a copy of that resolution is received by
- the Charitable Gambling Control Board within 30 days of the below not dat .
24.C�iry/County Name'�Local�Clo�verning Body) • T nship: If site is located within�township,please complete items 24
�.�,��o � T�cLt�v� a 25:
Signature of e�n Receiving Application: 2 Signature of Person Receiving�Application
'._�`~L.`..�,U�1�,�-v� j�� �f�.��k_ �
Iitle � jDate Rec�1eived(thi�d�t9 begins 30 da perio Tit :
�� ,{�:i;;�,�n ;q �' --Y' C� Y-f� ` �. ��1 � ,
Name of Persod Delivering Applicatiorr�to Local Governing fitody: To nship Name
CG-00022-01 (5/8� W ite py-Board Canary-Applicant Pink-Local Governing Body
. , �
' City of Saint Paul ���`�
• Finance and Management e icesiLicense & Permit Division
INFORMATION RE UIRED WITH APPLICATION FO P IT TO CONDUCT CHARITABLE GAMBLIVG GAME Iv
SAINT PAUL (To be used with the followi g: New A � C applicat�oa, renew A & C
Licenses, and new and renew B in Private C1 s.)
1. Full and complete name of organizat n hich is applying for license
�3lessed Sacrament School
2. Address where games will be held 14 4 N. Dale St., St. Paul, MN 55117
N ber Street City Zip
3. Name of manager signing this applica io who will conduct, operate and manage
Gambling Games Mary Seidl Dat$ of Birth 3-30-45
(a) Length of time manager has been em er of applicant organization 9 Years
4. Address of Manager 1266 Galvin ve , West 5t. Paul, MN' S5118
Number Stzeet C�ty Zip
� 8-1-t�9 -
5. Day, dates, and hours this applicati n for Monday, 1:UU' p.m. - 5:00 7-31-90
6. Is the applicant or organization org ni d under the laws of� the State of MN? Yes
7. Date of incorporation I
8. Date when registered with the State o nnesota
9. How long has organization been in exi te ce? 33 Years
10. How long has organization been in exi te ce in St. Paul? 33 Years
11. What is the purpose of the organizati n? To Provide a Cattwlic Education for the
Child ren.
I2. Officers of applicant organization:
Name C� a Name ��7.cf�.��l �.�.��.rs
Address Address .�,f ��q�z�/� l'��=�-,� �.
Title �' ,q,_a��K�,,,! DOB - _ Title ,C DOB �->,�,�,�
Name � 6- Name ��/C E ��E u�,vc z-
Address /��o ,v �- Address �D- ��r s.,xz
Title ��- ��j,��� DOB _ - Titl�� s�' � DOB �iy-yo
13. Give names of officers, or any other p rs ns who paid for seryices to the
organization. �
Name None Name
Address Address
Title
Title I
(Attach separate he t for additional names.)
. �� ���9-ii��
14. Attached hereto is a Iist of names nd ddresses of all members of the organization.
15. In whose custody will organization' r ords be kept?
Name Jo ce Klevence Address »��n m„� e.,o.. St. Paul
16. List all persons with the authority to ign checks for dispersal of gambling proceeds:
Name Mar Seidl Name Jovice Herzo�
Address 1266 Galvin Ave. Address 571 W. 3utler
Member of Member of
DOB 3-30-45 Organization? Ye DOB 4-5-34 Organization? yp�
Name Name
Address Address
Member of Member of
DOB Organization? DOB Organization?
17. a) Does your organization pay or int nd to pay accounting fees out of gambling funds?
yes no X
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.)
18. Have you read and do you thoroughly nd rstand the provisiot�s of all laws, ordinances,
and regulations goveming the operat on of Charitable Gambling games? Yes
19. Attached hereto on the form furnishe b the city of Saint Paul is a Financial Report
which it .emizes all receipts, expens s, and disbursements of the applicant organiza-
tion, as well as all organizations w o ve received funds for the precediag calendar
year which has been signed, prepared a verified by Mary Seidl
1266 Galvin Ave., West St P ul
Address
who is the Ganbling Manager of the applicant organization.
Name
20. Operator of premises where games wil be held:
Name Joseph Perkovich
Business Address 1494 N. Dale, St. au I
Home Address 297 Maria, St. Pau �
,
• • �j. �/��
.
21. Amount of rent paid by applicant or an ation for rent of the hall:
$175.00 per four hour ses io
22. The proceeds of the games will be d sbu sed after deducting prize layout costs and
operating expenses for the followin pu oses and uses:
All Proceeds are given directly to Blessed Sacrmnent School to assist with the
the support of the school. Mos of the funds are used for the athletic ro rams.
23. Has the premises where the games are to be held been certified for occupancq by the
City of Saint Paul? Yes
24. Has your organization filed federal 0 990-T? Yes If answer is yes, please attach
a copy with this application. If an we is no, explain why:
Any changes desired by the applicant asso ia ion may be made 'only with the consent of the
City Council.
Blessed Sacr�nent Sc hool
Organ zation Name
, r
�u ` tic�c.�1
Date S-/S- �7 Bq: �.�c.C�� _.:�2..�.�
' ager in charge of game
�
g zation President or CEO
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- ' C eq E Saint Paul Page 1 ���,`�
Department of ina ee and Management Sarvicea `f�
Di�ision of Li ens and Passit Administration
.
� UNiFORli CHAAI LE GAlmLINC FINANCIAL RZPOIt?
G
Data T -
1. Rm of Organization �"� " � a'
2. Addres• wher� Charicabl� Cublin is eonducead /�/� ,/U ��,��1'-�-
3. B�post Lor period co�arias 19 thsouslt �-�/,_19�
,
4. Total number of days playsd
S. Cros• receipts for abm►� p�riod ; ,�,�7%7�
6. Grosa priz� payouta for abws pa iod (ineluda cuh short) ; � %,`. /. !/ /'/
' 7. Nat receipts - Iin� S ninus lin� 6 � _ � ..�+/��
8. Exp�n��s ineusred in conductiag ad parating gaa: '
A. Gro�s vasss paid. Attaeh vo ksr liat vith .
nam�s. addresses, ;ro�s vage . a �r of hoors � � ����%�.
vorked� aad amount paid par our
• B. Rent for veeks � t! �l. , • , c��� , f c.r,e��r•` "
C. Licease fee ; � v
D. Inaurance S •✓�l�
E. Bond = ��
!. Dishoaocsd checb not recove ed i � �_
G. Aceountiag Expense :
H. Emplo��rs F.I.C.A. ; _ ���
. I. Pulltab Tax Paid to D�part�e t o Reveavs ; �// �
J. tiinn. U.C. Su =
1C. P�deral Facciae Sa: 6 Sta�p� y � `�� � �'�`�d
.c%t���
� L. Stat� Gasbliag Ta�c i .l J�/
H. Miaaellaaaoua Fspansss. Zd� tif eha a�ount
. and to vdos paid. ___
a . -___ -..__--�
1.�� J`�►�c C' j s'��' .�� ; l � li •
2..5 �` `��'``'� ;
'•����c�G-iac�� -
�.- ���.� : � :�
�. :
9. ioe.i �.a..: rornr. : �L d?.z
10. N�t Incoa� - lin� 7 sinu• lia� 9 i �� 7'�/
�
11. Cheekbook balanc• be;innin` ot p ri i , � ��
. tz. zoc�i of isn. io ,aa ti s .�L 'l.:i d
' 13. Total concribucions (froi attuh rbh�at) ; 1����
14. Cheekbook balane� end of raport g p iod - � -�. ��� �
' lin+ 12 Isss liaa 13
� .. a� �T,�.-�-.��
� � ..V..:. ��.�•
�. � i r �� . rnu�
� UNIFORM CHARITAB E MBLING FINANCIAI REPORT ���/�,5�
� � LAWFUL PURPOSE C N IBUTIONS - WORKSHEET
Line �13 - Total Lawful Purpose C nt ibutions. S 54,000.00
List below all ct�ecks writte f qambling funds which are
charitable lawful purpose co t butions. The total dollar
amounts of these checks mus ma ch the amount claimed in
line #13. Use additional sh e as netessary.
CNECK # DATE ' PAYEE CHECK AMOUN PURPOSE
1. 1510 2-22-tiF3 Blessed 5acrament Sc ool $1,000.00 Al�l proceeds are given to
�3lessed Sacrament School to
Z. 1529 3-14-88 3,000.00 a$sist with Catholic education.
In Particular these funds are
3. 1547 4-11-r38 2,500.00 u�ed to assist with the
athletic program. As the
¢. 156t� 5-9-t3�3 2,000.00 school does not have a gym
it has to rent space at Ames
5. 15259 6-6-83 1,500.00 school and Hazel Park play-
ground.
6. 1611 7-1t3-8ts 1,o0u.U0
�. 1640 ti-15-z3rs 2,OOO.UU
$. 1670 9-12-8t3 5,000.00
9� 1690 10-10-8t3 . 7,000.00 .
10. 1714 11-7-t38 . 3,OOU.00
21. 1735 12-12-St3 3,500.00
I2. 1755 1-9-t39 • 4,OOO.UO
1776 2-6-i�9 6,000.�0
13. 1794 3-6-89 5,500.00
1t316 3-3�-89 7,000.00
TOTAL CHEC UNT S 54,000.00 ,
NOTE: These expendjtures Nill be pro id d to Ccu�cil Members at your Council hearing.
Be sure that your financial re or is cort�lete and ac�urate.
. „ � r 3 . .. '�:
' ♦ � • r � � ' s " w '��e =
T + � i w a • � .�i s a�
" • ! � 1 n •� y 1� • ��
� : � ` � + � e � �a
� > > � .j . '.� � � � � O!
s • • � v • s • � ��
' � w .� � s s s
A `� � � � � A f � ; T�. � 7� _
� � • � � � r � � 1 r !
� � � n a • � � � .� 0 �s
� � ; � � • . . ; � ; �a
. . � � � : � � � ' � 3^
A � � � O � � 1 •9
� ,� • � � ! A � .r�v i �
� w � r • •r '� ,� � i ! � � 4 ,��i
' > > � � s w • 1
i i .� w r � = �� v � • �r
,! � � s �..
: a � � + .
� r =
. � � � � w + �
• • i I � �
� " z� � � i
r w � �
+ 7 � w1 � � '
-� � ; ` � i -
i � �. �;
� � `� �
i �
, i