89-1358 WHITE - CITV CLERK COUIIClI �/r��('/
PINK - FINANCE
BLUERV - MAVORTMENT GITY��� F SAINT PAUL File NO. `�V
u i Re olution G��
Presented By
Referr o Committee: Date
Out of Committee By Date
RESOLVED: That applicati n ID #28338) for renewal of a State Class B
Gambling`Licen e y Rice Street VFW Post #3877 at 1134 Rice Street,
be and the sam i hereby approved/denied. with �he follOWing
stipulation:
1) Paymen t the gambling manager will not exceed
$50.0 pe week.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
� I Fa or
Goswitz
Rettman �
s�ne;nei _ A ain t By
Sonnen
Wilson
A�' — i Form Approved by City Attorney
Adopted by Council: Date '
Certified Passe y Council Secr r By � � '
By
Approv by �Vlavor: Date Approved by Mayor for Submission to Council
By
PUB[�.� �'�U G 1 1989
e , . . � . . ���/..�
•
DEP/1RTMENT/OFFICFJCOUNqL DATE IN A� GREEN SHEET No. 4���2
Finance/License
CONTACT PER30N 6 PHONE 29$_ �DEPAR'TMENT DIRECTOR �CITY COUNqL
Christine Rozek/5056 � �CITY ATTORNEY �qTY CLERK
MUS7 8E ON COUNGL AOENDA BY(DAT� �BUDOET DIRECTOR �FIN.3 MOT.BERVICEB DIR.
8-1-89 �MAYOR(OR ABSISTANT) � Cnun r i 1 Re
TOTAL�OF SIGNATURE PAGES (CLIP L CATIONS FOR SIGNATUR�
ACTION REQUESTED:
Approval of an application or renewal of a State Class B Gambling
License. �„
Notification Date: 7-18-89 Hearing Date: '`
RECOMMENDATIONB:Approw(/q or RsJect(Fry COU L MITTEEIf�SEARCH REPOqT OPTIONAL
_PLANNING COMMISSION _CIViI SERVICE COMMISSION ANALY PHONE NO.
—GB COMMITTEE _
OOMM TS:
_STAFF —
_DISTRICT COURT —
SUPPORTS WHICH COUNCIL OBJECTIVE7
INITWTINO PROBLEM,ISSUE,OPPORTUNITY(Who,What,When,Whero,Why):
Henry Koplin on behalf of ic Stxeet VFW Post #3877 requests
City Council approval of t ei application for renewal of a
State Class B Gambling Lic ns at 1134 Rice Street. Procee.ds
from the pulltab sales are us d for youth and veterans programs.
All fees and applications av been submitted.
ADVANTAOES IF APPROVED:
If Council approval is giv n, the Rice Street VFW Post #3877
will continue to operate p ltab booth at 1134 Rice Street.
as,wv�wr�aes iF��ov�:
DISADVANTAOES IF NOT APPROVED:
Council Research Center
J UL 2 01989
TOTAL AMOUNT OF TRANSACTION s COST/REVENUE BUDOETED(CIRCLE ONEj YES NO
FUNDINO SOURCE A4TIVITY NUMBER
FINANCIAL INFORMATION:(IXPLAIN)
! '� - � •
♦
�
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE GREEN 3HEET INSTRUCTIONAL �
MANUAL AVAILABLE IN THE PURCHASING OFFICE(PHONE NO.298-4225). �
ROUTING ORDER:
Bebw are preferred routings for the flve moat frequent types of documents:
CONTRACTS (assumes suthorized COUNCIL RESOLUTION (Amend, BdgtsJ
budget exists) Accept.GraMS)
1. Outside Agency 1. DepartmeM Director
2. Inkiating Department 2. Budget Director
3. Ciry Attomey 3. City Attomey �
4. Mayor 4. MayodAssisteM
5. Flnance&Mgmt Svcs. Director 5. City Council
6. Flnance Accounting 6. Chief Axournant, Fln&Mgmt Svcs.
ADMINISTRATIVE ORDER (Budget COUNCIL RESOLUTION (all others)
Revision) and ORDINANCE
1. Activity Manager 1. Initiating DspartmeM Director
2. DepartmeM AccouMa�t 2. City Attorne�►
3. Department Director 3. Mayor/Assietsnt
4. Budget Director 4. City Council
5. City Clerk
6. Chief AcxountaM, Fin&Mgmt Svcs.
ADMINISTRATIVE ORDERS (sll others)
1. Initfating DepeRment
2. City Attorney
3. MayoNAssistant
4. City Clerk
TOTAL NUMBER OF SI(3NATURE PAGES
Indicate the#of pages on which signatures are required and p_�lie
�ch of these pages.
ACTION REQUESTED
Describe what the project/requ�t aeeks to accomplish in either chronologi-
cal order or order of importance,whichever fs most eppropriate for the
issue. Do not write complete sentences.Begin�ch item in your 8st with
a verb.
RECOMMENDATIONS
Complete if the issue in question has been presented before any body, public
or prfvate.
SUPPORTS WHICH COUNCIL OBJECTIVE?
Indicate which Council obJective(s)your proJecUrequest supports by listing
the key word(s)(HOUSING, RECREATION, NEIGHBORHOODS, ECONOMIC DEVELOPMENT,
BUDGET, SEWER SEPARATIOI�.(SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
COUNCIL COMMITTEE/RESEARCH REPORT-OPTIONAL AS REQUESTED 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 prxedure required by law/
charter or whether there are speciffc ways In which the City of Saint Paul
and its citizens will benefit from this proj�ct/action.
DISADVANTAGES IF APPROVED
What negative effects or major changes to existing or past processes might
this projecUrequest produce if it ls passed(e.g.,traffic delays, nase,
tax increases or aseeasments)?To Whom?When?For how long7
DISADVANTAGES IF NOT APPROVED
What will be the negative consequences if the promised action is not
approved7 Inabiliry to deliver service?Continued high tratfic, noise,
accident rate? Loss of revenue7
FINANCIAL IMPACT
Although you must tailor the information you provide here to the issue you
are addressing, in generel you must answer two questions: How much is it
going to c�t?Who is going to pay?
. . . . � , �-����'
DIVISION OF LICENSE AND P�:RMIT ADM NI RATION llATE �I'� �� / � /� o �
INT�,RDFPARTMEI�TAL REVIEW CHECKLIST Appn Pr cessed/Receive by
Lic Enf Aud
Applicant ��(�, �Y�Q;�,-� UF� � 7 Home Address
Rusiness Name (CQ..S � V�'W �77 Home Phone
Business Address �13� IuG¢� S + Type af License(s) C�55 /3–
Business Phone � , L �ti.�
Public Hearing Date � License I.D. �{ a�3�j�
at 9:00 a.m. in the Counci haui e s,
3rd floor City Hall and Courthouse State Tax I.D. �l 1�'�-
llate N�tice Sent; �G Dealer 4� �I�'
to Applicant 7 (� �"1
rederal I'i.rearms 4� u /4
Public Hearing —�
DATE T SP CTIUN
REVIEW VERFIED (C MPUTER) CUMMENTS
A roved N t A roved
Bldg I & D
N��I-
Health Divn.
�1�
i
Fire Dept.
I ���
� r'jPrt t Z �� ��
Police Dept.
''1�J J � O�L
License Divn. �'wI
D/L
City Attorney
� ��) � o ��
Date Received•
Site Plan N(A�
C
To Council P.esearch � � 1
Lease or Letter ate
from Landlord fJ �'
0 w�n '{-�ro�✓
t
• . . � Cit o Saint Paul /�G/'�����
Finance and Management Se vices�License & Permit Division � ��y
� I:VFORMATION REQUIRED WITH APPLICATION F R ERMIT TO COVDUCT CHARITABLE GA:�tBLIV'G G:a.�!E LZ'
SAI:VT PAUL (To be used with the follow ng ti'ew A & C application, renew � 5� C
Licenses, and new and renew B in Privat C ubs.)
1. Full and complete name of organiza io which is applying for license
F t,J o S 7
2. Address where games will be held 3 -�. Sf v SS
umber Street City Zip
3. Name of manager signing this appl ca ion who will conduct, operate and manage
Gambling Games �{ ti1 � � n� Date of Birth /0 - L - Z L
(a) Length of time manager has be n ember of applicant organization 8�RS
4. Address of Manager .L I S �, v Sf Pq � � SS f I 7
Number Street City Zip
�,, �, c�-�v s �
S. Day, dates, and hours this applic ti n is for � � �� ��L :��= ___ .
6. Is the applicant or organization rg nized under the laws of the State of MN? ��
7. Date of incorporation RP� i � l9yy
8. Date when registered with the St te f Minnesota cT✓ '�� �98 �
9. How Iong has organization been i e istence? ' NS Yk .S ,
10. How long has organization been i e istence in St. Paul? Ms� R c h/ •�. / �9YJ�
11. What is the purpose of the organ za ion? f{���� .p B,rNe F �f- �,E�E�.srNS
A
12. Officers of applicant organizati n:
Name {- �F- S� F b �L Name v� R o �r+ E i''1 � �-K�JS
Address 7 �o � �11 �t Address �/ � 8 ,� Ec-� ��e n1 Ns •
Title [> „e d F2 D�B _ Title Q � DOB ,o � ,�_,,,c
Name ,TR c K %"� A-�'--�" E 'v s Name
Address �a �7 �R� �' S a� Address
Title SR• I/� �� DOB d ' /3 _ Z'f Title DOB
13. Give names of officers, or any th r persons who are paid for SeY'ViCeS t0 the
organization.
Name f�I E N R O• o � Name �J�c �.o � E n'l!G rE'c/S
Address 8 �. f s' �. ✓A N Address // 6 8 Gc> E S T�R_N No�
Title (,.',�M,C��L�A1 � � Title Q . /'h •
( ttach se ar te sheet for additional names. )
� � - � � - ��=�.��
14. Attached hereto is a list of name a addresses of all members ot the organizat�cr..
15. In whose custody will organizatio 's records be kept?
Name �, �/� o c�a Address 8 � f S�r � � A �
16. List all persons with the authori y o sign checks for dispersal of gambling proceeds:
Name S'�f o E �- Name T F�e o � E /��c KvS
Address 7 � o Q�C A�� Address /I6 8 w/�: s t�= ��✓ �o •
Member of Member of
DOB 8=3 �•Z / Organization? Y s DOB �o -,I -u Organization? �ES
Name iv re Name
Address gz � /J Address
fp_,� . i L Member of Member of
DOB Organization? Y S DOB Organiaation?
17. a) Does your organization pay or in end to pay accounting fees out of gambling funds?
yes X no
b) If you do pay accounting fees t whom will such fees be paid?
Name ? Address
DOB Member f rganization?
c) How are the accounting fees ha ged out? (flat fee, hourly, etc.)
?
�
18. Have you read and do you thorou hl understand the provisions of all laws, ordinances,
and regulations governing the o er tion of Charitable Gambling games? � yES
19. Attached hereto on the form fur is ed by the city of Saint Paul is a Financial Report
which it .emizes all receipts, e pe ses, and disbursements of the applicant organiza-
_, tion, as well as all organizati ns who have received funds for the preceding calendar
�� year which has been signed, pre ar d, and verif ied by �� n1,� Y O� �a f��i�
�
/( 3y �icE
Address
who is the G �+i+' %�� "� 9 ' of the applicant organization.
N e
20. Operator of premises where gam s ill be held:
Name E Nk O•/� o �-� N
Business Address �� 3`� � '�-�
Home Address 8� � � G vAN
, , ' ��� ` ���
L1. Amount of rent paid by applicant or an zation for rent of the hall:
o�i1
22. The proceeds of the games will be d'sb rsed after deducting prize layout costs and
operating expenses for the followi p rposes and uses: �
��rES t t � o ER � �osp��- AC s o uN��
S E ✓ C N s� 9� /J'�N F F' t� ✓E f E R �1�s' �
23. Has the premises where the games a e o be held been certified for occupancy by the
City of Saint Paul? E 5
24. Has yoccr organization filed federa f rm 990-T? No If answer is yes, please attach
a copy with this application. If ns er is no, explain why:
Any changes desired by the applicant a oc ation may be made only with the consent of the
City Council.
��c � S-F. �/F u� Po s f 38 7 7
Organization Name
Date 6 - /�- g /� BY� l��7 4 � ��—
M nager in charge of game
,
�
Organ ion President or CEO
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� ' ity of Saint Paul �����
Department of in nce and Management Services /�
: Lic ns and Permit Division /r����
203 City Halt ��
St. P ul, innesota 55102•29&5056
. APPLI A tON FOR LICENSE
CASH CHECK CIASS NO. ew Renew
� � � �
C
Date � Z t9 � ,
Code No. Title of license —
From � 1 To 19
3 _ , r., �y. �5
�� �► � S-�v�� C� � � �3�'i
� � r � � � AppllcanUCompany Name
,00 I ' J � ,e� cz S�l'�� i
100 Business Name
•�-
,00 � 1 G �c �. � ��
.
Business Address Pho�e No.
100
100 Mail to Address Phone No.
r �
�oo y� y t� �O 11 r'1 ( � �
Manaper/Owner•Na e
� ,o0 1 I� � �r(?� StYPPL
100 hlanagerlGwner•Home Address Phone No.
4098 Application Fee 2, 50 �(,/�
Recelved the Sum of 100� �T, �G L( I� ( / �
���,,,) ManageNOwner-City.State 3 Zip Code
100 To al 100
`, � '
License Inspector ` � By: � ' Sig ture of Applicant
Bond•
Company Name Policy No. Expiration Oate
Insurance:
Company Name Poticy No. Expiratio�Date
Minnesota State Identification No. Social Security No.
Vehicle Information:
Serial Number Plale Number
Other:
THIS IS A RE EIPT FOR APPLICATION
THIS IS NOT A LICENSE TO OPERATE.Your application or li �ense will either be granted ot rejecied subject to the provisions of the toning
. ordlnance and eompletion of the inspections by the Hea th, ire,Zoning andlor License Inspectora.
$15.00 CHARG F ALL RETURNED CHECKS
�o �� -�9 � �, / .
�. - . � Ci y o Saint Paul Pag• 1
� Departm�nt of F nan e snd Managsunt Semiees ��f—�,�
Divi�loa of Lie nsa aad Persit Adainistzation
UNIFORH CHARIT LE AMELING FINANCLIL REPORT
. Dau Tv N E d r 48 9
1. Naaa of Orgaaization t E S� (�o f � S 7 7
2. Addssss vh�rs Charitsbls Ca�blin i� onduetad !1 3 y R� c E S-f '
3. xaport fos p�riod eovaria` 19__ Chioufh �/ ' �9 19_
4. rotal numbar of days playsd
5. Crou receipt� fot sbov� p�riod ; 7 S (o�, 3 � 8_!o O
6. Cross priz• payouts fos abov ps iod (includ� e�ah ahort) S S 7� `�' � `� � o a
7. Nac rsc�ipts - lia� 5 ainus liae 6 i � 8 f y 6 y � O D
8. Expsnse� iacurrsd in eoaductiag nd perstina `a�:
A. Cros� va;ea paid. Attach vo ker 11st vith
namu. �ddresaaa. `ro�s vage � a �r of hour� i �,,� 9 S `/ � �D
vorksd, and amount paid p�r our
• B. Rent for f� wesks 7��' � �r2 d 0 _-�
._ ._.., �� 3 !So 67 � 3 ? SL $ 77
C. License fee �`� p ,o fp . o O ; •
D. Insurance i %�GU. O-D
E. Bond : �� ' °�
T. Dishoaored ehecks not rscov red � "'�
. G. AccountiaQ Expensa = "' p ! .
H. Employ�rs P.I.C.A. � "' � �
. I. Pulltab Ta�c Paid to D�parta nc i Rsvsau� i � ` i '�' � 7 ' � � ��`�c%
' ... O......
J. Kina. U.C. Taz =
• [. Fsdaral Excis• Tas 6 Staop f � y 3 3 � � �
L. State Caablin� Tax ;
M. Miscellaasous Expsa�ai. Id uti y tAa amount -
' . and to vhoa paid. t • �� S� S� /f � P v�E �' •
�. �o yi,r �Ze R s� o �� f
►� s!N�`,:� �.�RK. ' t 1 9 8• o 0
t„, C� e�
� z• p�KUcw.��f ,� _ ��3�� � � S � 6 z �, 3 �
(�a sf o'f� 2 a c. � . ,.
3,y �; r�'�i�`���°�`J .�H 4�S/. 87
� 4. �`r' �� ;
9�. $ S I �3 '� ..
9. Tocal Facpan��s T�� � �.
L0. N�t Ineo�a - lias 7 diws lin� 9 ; 9' 0 G / 2 , 8 7 - .
- �
11. Chackbook balane� b�`laain� of p�r od i _ 3_ 3 y.Z: .T..Z._. -
12. Total of lina 10 and 11 i 9 3 4„�S_L!�_ �
' , 13. Total coacributiona (froa atta hsd vorbh�st) _ � � ? y� ` �O Z '
14. Checkbook balsnc• end of rspor in� pasiod = -
' lins 1T lsss liaa 13 ; ��_�' ��'�a�'
��:... /��r�,�,,Gr�Ye� '�i"`".`�Q�°
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