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89-1360 WMITE - CITV �LERK PINK - FINAN�E G I T F SA I NT PA U L Council CANARV - DEPARTMENT BLUE - MAVOR File �O. �_/��� � a cil Resolution 3� Presented By ��=� � Referred To � Committee: Date Out of Committee By Date RESOLVED: That application (ID #92287) for the transfer of a Gambling Manager's License cu rently held by Sheila Smith DBA Highland Flockey Associatio a Joses' , 825 Jefferson Avenue, be and the same is hereby ap ro ed for transfer to Susan M. Purvis DBA Highland Area Hoc ey Association at the same address. COUNCIL MEMBERS Yeas Nays Requested by Department of: Dimond �� In av r Goswitz Rettman � __ A a n s t BY sche�n�� g Sonnen Wilson _ Form Approv d by City Attor ey Adopted hy Council: Date - - Certified Passed Council Secr ry BY � /� � By � App ov y Mavor. Date _ Approved by Mayor for Submission to Council By - BY PUBl.lS#ED ��G 1 . 19 9 �,' - �-�q- /�� �, , DEPARTMENTIOFF.t�JCOUNCIL DATE ITL4 D �i nance/�i cense GREEN SHEET No. 4 3 7 3 INITIAU DATE INITIAUDATE CONTACT PERSON&PHONE �DEPARTMENT DIRECTOR �GTY COUNqL Chri sti ne Rozek/298-5056 �M CITY ATTORNEY �CITY CLERK MUST BE ON COUNqL A(�ENDA BY(DAT� NO �BUDOET DIRECTOR �fIN.8 MOT.SERVICES DIR. 8-1-89 �MAYOR(OR ABSISTMIT) �GnunriL Re TOTAL A�OF SIGNATURE PAQiE8 (CLI AL LOCATIONS FOR SIGNATUR� ACTION REQUESTED: Approval of a transfer of a G mb ing Manager's License. Notification Date: 7-12-89 Hearin Date: 8-1-89 RECOMMENDATION3:Approve(A)a Re�ect(R) COU CIL MMITTE[/RE8FARCH REPORT OPTIONAL _PLANNIN(i COMMISSION _CIVIL SERVICE COMMISSION ANAL ST PHONE NO. _CIB COMMITTEE _ —�� — COM ENTS _DISTRICT OOURT — 8UPPORTS WHICH COUNdL OBJECTIVE9 INITIATIN(i PROBLEM,138UE,OPPORTUNITY(Who,Nlhat,When,Whers,Why): Susan M. Purvis DBA Highland re Hockey Association at Joses' , 825 Jefferson Avenue requests Co ncil approval of her application to transfer the gambling manager s icense currently held by Shiela Smith at the same address. All fee a d applications have been submitted. All required divisions - Poli e nd Licensing have given their approval . ADVANTAOES IF APPROVEO: DISADVANTA(3ES IF APPROVED: DISADVANTAOES IF NOT APPROVEO: Cour;cil Research Center JUL 17 iQ89 TOTAL AMOUNT OF TRANSACTION a COST/REVENUE BUDGETED(CIRCLE ON� YES NO FUNDING SOURCE ACTIVITY NUMBER FINANCIAL INFORMATION:(EXPWN) '� �� � �c�i i��o DiVISION OF I.ICENSE AND PERMIT AD IN TRATION llATE � � CI p� / 7 3 J � INTERDF.PARTMFNTAL REVIEW C:HECKLIS Appn P oc ssed/Rece ve by Lic Enf Aud ► , 1 Applicaut Jl.(SGl rl � � �U�(Ut S Home Acldress /(p S� (..�/C�t Sprl Business Name ► K � Home Phone �q �0 'Sa �v Business Address Ov�J��� �S r1 U� Type of License(s) �Gcm�j�lnc� ��j�- 1 ✓unS�✓� Business Phone Public Hearing Date U � 0 License I.D. 4� -! `3` `� � 7 at 9:00 a.m. in the Counci C auib rs ��� 3rd floor City Hall and Courthous State Tax I.D. �t llate Notice Sent; Dealer 41 �'A to Applicant — a— I'ederal P'irearms 4� �� Public Hearing DATE NS EC'TION REVIEW VERFIE ( OMPUTF.R) CUMMENTS A proved ot A roved � Bldg I & D � �.J,f} , Health Divn. � � � i Fire Dept. � i N (} � Police Dept. � `�� � ���� I � � License Divn. � I � nl �z biL City Attorney �I(�� � Q !� Date Receive : Site Plan � I� G To Council P.esearch � r? 0 Lease or Letter NI(� ate from Landlord r� ' � ' C'ty of Saint Paul (,�4 7 ���� Department of in nce and Management Services . Division of L ce se and Permit Registration . INFORMATION RE UIRED WITH APPLICATIO FO PERMIT TO CONDUCT PULLTAB/TIPBOARD SALES IN SAINT PAUL (Class B Gambling License in Liquor Establishments - New Application) 1. Full and complete name of organ at on which is applying for license T�RE A �GK 5 �A'i 2. Does your organization meet the ef nition of a "large" organization as outlined in the November, 1988 revision of ct on 409.21 of the Legislative Code? h.cT� ON� Attach to this application pert e financial and/or organizational information to support your answer to this que tio . NOTE: Only 5 large organizations will be allow- ed to open pulltab operations u er the revised city ordinance. If more than 5 organi- zations apply, qualified applic ts will be selected randomly bq the City Council. 3. Address where games will be hel �j J�. 5'�'• � tOa Number Street City Zip 4. Name of manager signing this ap li tion who will conduct, operate and manage Gambling Games Sv�SO„h '[Yl. VI Date of Birth (� . �2� • lk9 (a) Length of time manager has ee member of applicant organization �,f� 5. Address of Manager '�. Q l � Number Street City Zip 6. Day, dates, and hours this appl ca ion is for M�.. -t=,�� 3-/ae. - n�_ 7. Is the applicant or organizatio o ganized� under the laws of the State of MN? � 8. Date of incorporation 9. Date when registered with the S at of Minnesota m�c,i ly, /973 10. How long has organization been n xistence? �9,$"!� . � 11. How long has organization been n xistence in St. Paul? /9SS 12. What is the purpose of the orga iz tion? � • �t,�et� 13. Officers of applicant organizat on Name Name ��2. � P"�1��,�1 Address (, �2�� Address /7�/ ��I�ii7 �r_ Title �E,�/p� DOB Title �ls�G � DOB /�-/a-�g' Name Name �-�o�R..�kcrn I_`e.P�,tn2 Address Address 1 �� ��l Title DOB Title ��►�1'S�1,iP.�(L DOB ('i9-a3 . .�� , (��i-i��� 14. Give names of officers, or any o he persons who paid for servfces to the organization. , Name DT Name Address Address Title Title (Attach sep ra e sheet for additional names.) 15. Attached hereto is a list of nam s nd addresses of all members of the organization. Ov Gt1,t 16. In wEiose custody will organizati n` records be kept? � Name �. � � Address /�s"$��q��a��J� 17. List all persons with the author ty to sign checks for dispersal of gambling proceeds: � Name Name �LSQ,v� u,rq,�l S Address �jQ,V�, Address �n5� (�g�3�p�� �tU� Mem of Member of DOB �2 a, � �-�;� Organization? DOB � -��-�.�j Organization? �/�� ��— Name Name Address Address Member of Member of DOB Organization? DOB Organization? I8. Hane you read and do qou thoroug 'ly nderstand the provisions of all laws, ordinances, and regulations governing the op ra ion of Charitable Gambling games? V ES 19. Will your organization's pulltab op ation be operated/managed solely by members of your organization? yes n� � 20. Has your organization signed, or o it intend to sign, a consulting agreement or a managerial agreement with any pe so or company to assist your organization with the pulltab sales and/or recording k p g? yes no _� . If answer is yes, give the name d ddress of the person and/or company contracted. Name Address Name Address If answer is yes, how will such a' co sultant be paid? (percentage, flat fee, gambling funds, general funds, etc.) Atta h copy of said contract to this application. 21. Operator of premises where games il be held: Name E. �C:,� '�' Business Address G� ZS� flome Address ✓}' � . ��-���� 22. a) Does your organization pay or in end to pay accounting fees out of gambling funds? yes �_ no b) If you do pay accounting fees t whom will such fees be paid? r �t'.�.4.u-�1 Name Address (�9� ,�r �„ � ,��AS DOB �2-2l -��o Member f rganization? Ue,_� �— c) How are the accounting fees ha ged out? (flat fee, hourly, etc.) d) Wh do yo anticipate will e our average monthly deduction for accounting fees? ��DO. o b 23. Amount of rent paid by applicant 'or anization for rent of the hall: � � 24. The proceeds of the games will b d sbursed after deducting prize layout costs and operating expenses for the follo in purposes and uses: � �� 25. Has the premises where the games ar to be held been certified for occupancy by the City of Saint Paul? 26. Has your organization ed fede al form 990-T? p�p If answer is �yes, please attach a copy with this application. I a swer is no, explain why: � Any changes desired by the applicant ss ciation may be made only with the consent of the City Council. i��c�►HLAN�� ��� �K�y �soc.�as�o� Organization Name Date By: , � , Manager in charge of game � • w� Organization Presi ent or CEO ����� • � ' C�tv vt Saint Paul Depanment f�F ance and Management Services Li en e snd Permit Divislon �9��� 203 City Hell ' St. Pau Minnesota 55102•298-5058 APP IC TION FOR LICENSE C� CHECK ClASS N�. N�ew Rea �x� Date � �9 t9�.. Code No. Title of Lice�se From —�9 1�To .��� ���. i � :�,6 �.� � ' m _ � . , � ��-�.�.,.�- .,�;'��-w'��--; `�f, � Applfwet/ComPany Name / 100 ^ ��� � ��� i/ - - OC:�Gd..l1-(1i�G��'��`�.�"�'i'� �.�G�/. ' 100 � Ge�us�nesa Name �1 ,, �/'' Ga ,00 �a�' �����x�.�r� Busine�6 Addre7s Phone No. �oo `� i ` �.- � / / ,o%%��C� //T�h� �/iG�-Lct-�71/ �. r 100 Mail to Address Phone No. �' , 100 _��� `// . � �,Gf�I� Msneper/Owner•Name 100 l ��Gl� /E � !��!�1� 100 Atana9eNGwnar•Home Address Phone No• 4098 APPIiCation Fee 2. 5p - ;: � }� Received fhe Sum of 1� ��'�•` �(.L� ////if . ManapsrlOwnsr•City,Slate 6 2ip Code 100 tal 100 � � LiCBnse InspBCtOf ` By: _ Sipnature ol Applicant Bond: Company Name Policy No. Expiration Dale Insurance: Cort,a�y Na,ne POticy No. ExpiralfOn Date Minnesota State ldentificatio�No Social Security No Vehicle Information: ate Numbsr $alal Numbe� Other• THIS 1S R CEIPT FOR APPLICATION THIS IS NOT A LICENSE TO OPERATE.Your applicatfo for icense wflt eithe�be flranted or rejected Suttject to the provisfons ot the zoning ordlnancs and completion of the inspectfons by the H Ith, Fire,Zoninp and/or Licanse Inspectors. $15.00 CHAR � F R ALL RETURNED CHECKS (�-" ,,�yl -��'� �' ��,,2l�t � / ,�: . r-'� .r_ -�; � .�-• � f�l.i'. _ ��� _ _ �• -✓ _ �� L: ' ' " � ' /3-�� _ ���. T B COMPLETED BY ORGANIZATION P SI ENT AND GAMBLING MANAGER I understand and will uphold ai t Paul Ordinance 409, Sections 409.21 and 409.22 relating to pullta s nd tipboards in bars. � Further, I understand that my ja bar must meet city standards; that 10� of the net profit from pullta s les must be returned to the City-Wide Youth Fund on a monthly basis, t at monthly financial statements must be filed with the City; and that 51 of net proceeds must remain in St. Paul or be used to support St. Pau r sidents. C/� Signature - Manager Signature - Organiza on Pres de t /7`��'sH[,Q�tJi — d c. rganization ame � �osc s � Gamb ing Location 0 S" 9� Please retain t e ttached ordinance for your records.