89-1149 — CITV CLERK /'�
..K— — FINANCE GITY OF AINT PAUL Council (/1/^,� / '//}
CANARV — DEPARTMENT y (,�.�-//y-y
BLUE — MAVOR File NO. !1 6 l c /
o nci esolution �`;3�'��
; �
Presented By �
Referred T Committee: Date
Out of Co ittee By Date
RESOLVED: That application (ID # 70 2) for a State Class B Gambling
License by St. Bernard s hild Care Center at Ron's Bar,
879 Rice Street, be an t e same is hereby approved�d�e�edT-
COUNCIL MEMBERS
Yeas Nays Requested by Department of:
Dimond �'
�� �� [n av r
�-�e�w+�
Rettn'a" B
Scheibel � A g i n s Y
�
Wilson
JUN 2 2 Form Appr ed by City A torne
Adopted by Council: Date -
Certified Pa s d y un il S ta BY � ���-�y
gy,
A►ppro� d by Wlavor: Date _ ��N 3 9 Approved by Mayor for Submission to Council
By BY
PUBttSl�9 J L ' 1 1 89
� .- . C����
DEPAHTMENT/OFFICFJCOUNqI DATE IN �o GREEN SHE T No. 18 2 3
Finance/License
IN DATE INITIAUDATE
CONTACT PERSON 8 PHONE DEPARTMENT DIRECTOR �CITY COUNCIL
Christine Rozek/298-5056 N� CRYATTORNEY cmcxERK
MUBT 8E ON COUNqL A(�ENDA BY(DAT� ROUTINO BUDOET DIRECTOR �FIN.fl MOT.SERVtCE3 DIR.
C)�ZZ-H9 MAYOR(ORASSIST � Counc�l R
TOTAL#�OF SIGNATURE PAGES (CLIP AL L ATIONS FOR SIGNATUR�
ACT10N REGUESTED:
Approval of an application for a ta e Class B Gambling License.
Notification Date: 6-6-89 Hearing Da : 6-22-89
RECOMMENDATIONS:Approvs(/U a Rejsct(R) COUNCIL M ITTEE/RESEARCH REPORT
_PLANNINQ COMM�SSION _CIVIL SERVICE COMMISSION ��YST PNONE NO.
_q8 COMMITfEE _
_8TAFF _ COMM
-DISTRIC'T COURT _
3UPPORTB WHICH CIXJNdL 08JECTIVE7
INITIATINO PR08LEM.ISSUE.OPPORTUNITY(Who.What,Whsn.Whs►e,Wh�:
Deborah Zschokke on behalf of St. Be nard's Child Care C nter requests
City Council approval of her appl ca ion for a State Cla s B Gambling License
at Ron's Bar, 879 Rice Street. P oc eds from the pullta sales will be used
for education and child care.
All fees and applications have be n ubmitted.
ADVANTAOEB IF APPROVED:
If Council approval is given, St. Be nard's Child Care w 11 operate
a pulltab booth at Ron's Bar.
DISADVANTAOES IF APPROVED:
�
DISADVANTAOE8 IF NOT APPROVED:
Cot�r�cil Research Center
J UN �'7 i�89
�
,
TOTAL AMOUNT OF TRANSACTION a COSTlREVENUE BUDOETED( ON� YES NO
FUNDINQ SOURCE ACTIVITY NUMBER
Flwwa�u iNwRNU►now:�u►�N�
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DiVISION OF I.ICENSE AND P�;RMIT ADMIN ST TION DATE I a �� r/ � b o �
INT�,RDF.PARTMENTAL REVIEW CHECKLIST A.�pn rocessed/Recei ed y
Lic Enf Aud
��� L�erria rds —
Applicant �,'�. ��Q✓hCC✓�S Ch i a� C��Home Address �y � (.c�� �1���'n�4h'I
Rusiness Name n �2 Home Phone
Business Address ��� IC�(�, �- Type of License(s) l. IGI�S �"
Business Phone �G.V►"1 b��r�G, ��'1l)�S� • r-2.
Public Hearing Date �P / ��- g / License I.D. �{ g 7C�3�
at 9:OQ a.m. in the Councitl Chambers
3rd floor City Hall and Courthouse State Tax I.D. �C � ��
llate Nutice Sent; Dealer �� ��74"
to Applicant � --
Pederal Pi.rearms �6 N I�}
Public He�.�ring
DATE ITS EC' ION
REVIEW VERFIED ( 0 UTER) CUMMENTS
A roved ot A roved
�
Bldg I & D �
� �
Health Divn. '
�
i
Fire Dept. �
I � �- �
! se�t Sj�I �
Yolice Dept. �
S�,ZI�,' o,�.
�
License Divn. '
� IZ,� ! �/�
City Attorney �
� 4�� + � �
Date Received:
Site Plan � � / � I F 5
To Council P.esearch �9 I��
Lease or Letter Date
from Landlord (v �}'
� � � Cit o Saint Paul �� ����
Department of Fi n e and Management Services
Division of Lic ns and Permit Registration
INFORMATION RE IIIRED WITH APPLICATION F R ERMIT TO CONDIICT PULLTAB/TIPBOARD SALES IN
SAINT PAUL (Class B Gambling License i L quor Establishments - New Application)
1. F'ull and complete name of organiza io which is applqing ''for license
; ; f 1 ,�• i '"�%' !�,^ + .I�. , l�- ,� 7� t� ,
�' � �/�(,.�. ' �/;
2. Does your organization meet the de in tion of a "large" arganization as outlined in
the November, I988 revision of Sec io 409.21 of the Legislative Code?
Attach to this application pertine t inancial and/or orgianizational iaformation to
support your answe� to this questi n. NOTE: Only 5 la�ge organizatioas 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 randomlq bq the City Council.
� ,^ I '� _ ..5�/!w
3. Address where games will be held � '• <�� ' '�: ('"c'�Gl�l.
umber Street City� Zip
4. Name of manager signing this appli at on who will conduct, operate and manage
�', �±� � ' -
•' ' �-
Gambling Games -`L:��.�` � ~ �' �t�'.� i fC C�.�"" Date of Birth � ' -� ,
_-. ,-- -.
(a) Length of time manager has bee m mber of applicant organization %'� ` ' �'✓
5. Address of Manager 8� � � � �. ��� ����-�. ,' �! .'/�� ::� �% ��
Number Stzeet City Zip
6. Day, dates, and hours this applica io is for %� ,�r� - .::��,� -%"" '��
7. Is the applicant or organization o ga ized under the laws of the State of 1�IId? �
8. Date of incorporation � / �' - y1
9. Date when registered with the Stat o Minnesota - � `�l' -_; �Q �
� :� �.� �
10. How long has organization been in xi tence?
11. How long has organization been in xi tence in St. Paul? � �., ' ` Lt�
, , ,. . ., .
12. What is the purpose of the organiz ti n? ^ ;.; '.�.'�?.r'�l,�f�i' � �r�-�-`-��-� ' -•=:� ��
13. Officers of applicant organization ,�
/ � ,' /� �• ��� (/ �
Name / l � Name �.,!.t H ' �(,t.���.-C-k� C./'
�` ,��
Address
/ }� r Address ��QQ ��i��i�/ /Vd���-E:�
. ,%
Tftle DOB , J Title '�s:r_ys f�' ��.-' DOB l�o����
. � ,,.,,-� ,
Name ` n -..�5 ��',� ' ` Name
, �
Address �� /�" �- ��'� Address
�. '
Title ! ', : : � �DOB � -� � , � Title DOB
- : � ��y����
14. Give names of officers, or any ot r ersons who paid for services to the
organization.
Name Name
Address � ' Address
Title Title
(Attach separ te sheet for additional names.)
15. Attached hereto is a Zist of names an addresses of all members of the� organizatioa.
16. In wiiose custody will organizatio 's ecords be kept?
,� .�� �, ntt� � : �j t ' ', ` I :' 1 r ,^., r , •'I.r .
Name t' r �a �l�.,����°°'..,� _ w Address �f;;j;.! ,.G` ' �-�, . �..,:�C�!� r i
. ��.
17. List all persons with the authorit t sign checks for dispersal of gambling proceeds:
� , y , . .r i ' .
� /� i, � ;' ) �a�t.�`r�/C.r �S J
Name �rb`,,C..a� � '_.4/' � J ^ Name ,f;:.0 v°;.�- p�i' .ti: �{ '�C�.t'_� �:,E ,`; .
Address � 'j �{,�, � • `' • Address ���`� �.�(Lr�%i� ;�-L.. E''�.:�.�.,-
�B _l„ � Member of „ Member of
�
�- n Organization? �,1 `�� DOB ��' �(i ` � Organization? i�
� � J
Name '��.�`�' °' l J i : 1 .� ::� ::': � Name
Address r "I /� �- ,� � Address
be of . Member of
DOB - - Organization? DOB Organization?
18. Have you read and do you thorough derstand the provisions of all laws, or1dinances,
and regulations governing the ope t n of Charitable Gambling games?
i
19. Will your organization's pulltab o e t n be operated/managed solely by members of
your organization? yes no
20. Has your organization signed, or es it intend to sign, a consulting agreement or a
managerial agreement with any per n r company to assist your organization with the
pulltab sales and/or recording ke i ? qes no
If answer is yes, give the name dress of the person and/or campanq contracted.
Name Address
Name Address
If answer is yes, how will such a o ultant be paid? (percentage, flat fee, gambling
funds, general funds, etc.) Atta copy of said contract to this application.
21. Operator of premises where games 1 be held:
Name � •
Business Address 0 / , -^��
�� P_
,�,� ^1 I
Home Address �� ���-���- .�.� w'`�-�._ :..(.��r ��i.
. - . l.°G��r�9
22. a) Does your organization pay or i te d to pay accounting fees out of gambling funds?
yes no '
b) If you do pay accouating 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 you 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 hall:
/� �; , `"t ' IC.'-�: --%��'
24. The proceeds of the games will be is ursed after deducti�g prize layout costs and
operating expenses for the followi g urposes and uses:
M ' .L� �
,
, . x
, . ,. , 1 � � �/
d:-• � , � , � �4
�. � ,. �� ���.. d� C ,r�✓L ��� �rGL-- �
25. Has the premises where the games a e o be held been certified for occupancy bq the
�
City of Saint Paul? �?=�"
26. Has your organization filed federa f rm 990-T? IZO If answer is yes, please attach
a copy with this application. If ns er is no, explain why:
Any changes desired by the applicant as oc ation maq be made oaly with the consent of the
Citq Council.
A r
,
�I/'��GI,�'�I����:.J ��_L, ,�,i.X�C�G 't. �45�c.�.'
Organization Name
Date �""v�� — ,�'7 B r
Y� � � ' )
Maaager f charge of game
, �
ganization President or CEO
�703a-
. • ity f Saint Paul
Department of Fin nc and Management Services /� r�,_���Cf
Licens an Permit Division l. d 7
20 City Hall
St. Paul, inn ota 55102•298-5056
APPLICA I N FOR LICENSE �
CASH CHECK CLASS NO. ew Renew
a � a Date °�" 19��
Code No. Title of LiCense /�
.
From "� °�� 1�T ^a 19�
.�?3 � �-r�aai � , �� �� , � ,
.� , ,� _ � .�.� �: - '�.� C�.�.� ./_��
`-�yL-�, ����r � ApplicanUCompany Name
100 �
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100 Buaineas Name
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�oo � ,t,n.� 1'1'
Business Address Phons No.
ioo / �!7 �' • � r
100 Maii to Address + Phone No.
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,00 ���,�-��..� �'r1��--�
- ManaperlOwner•Name /j�
100 �"'L+�'� j�Y�"c(.1J1 �
,
100 blanagerl wner�Home Address Pho�e No.
4098 Applfcation Fee 50 �' �
,` /�'
Received the Sum of 100
3 S ���� �
ManagedOwner•City,State 3 Zip Code
. 100 Tot I , 100
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+ � � ' _ _ �''.`. �' �'\'•• � ti �.'. �
License Inspector v �"^ By: � � ' Signature ot npp�iwnt `
�--'��. -
; �L
Bond•
Company Name Policy No. Expiration Oate
insura�ce•
Company Name Poliey No. Expiration�ate
Mtnnesota State Identification No S ��� Social Security No.
Vehicle Information:
Serlal Number Plate Number
Oth6r
THIS IS A RE EIP FOR APPUCATION
THIS IS NOT A LICENSE TO OPERATE.Your application for lic nse will either be granted or rejecbed subject to the provisions of the ioninq
ordinance and completion of the inapections by the Health, F e,Z niny and/or License Inspectaro.
$15.00 CHARGE FO A L RETURNED CHECKS
� ��� � 7. l Cli
- - � . ��ir�
TO 6 C MPLETED BY
ORGANIZATION PRES DE T AND GAMBLING MANaGER
I understand and will uphold Sa'nt Paul Ordinance 409, Sections 409.21
and 409.22 relating to pulltabs an tipboards in bars.
. Further, I understand that my j rb r must meet city standards; that 10%
of the net profit from pulltab al s must be returned to the City-Wide
Youth Fund on a monthly basis; ha monthly financial statements must be
filed with the City; and that 5 � f net proceeds must remain in St. Paul
or be used to support St. Paul es dents.
� , �
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�i.-� �f:'�..C.�-� '',^l,�,l�� �C,�'c..�
ignature - Manager
`� � :.; '� �,/
ignatur - Organization Presid nt
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y-� �r . ( , � .. +.. _ . ,
. rganization ame -
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� Li/ •��,/ �, . .• .
' { ..V��� `., 'ti.�l.,.
Gamb ing ocation
. ..�� ._. r .. .. •;..^f .
� _
Date
Please retain the at ached ordinance for your records.
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