89-1478 WMITE - CITV CLERK COUflCll
PINK - FINANCE GITY OF AINT PALTL
CANARV - DEPARTMENT
BLUE - MAVOR File NO.
' u�cil esolution -
. ,�3�.
Presented By
Re rred Committee: Date
Out of Committee By Date
RESOLVED: That application (ID # 652) for the transfer of a Class A
Gambling License by th Department of Minnesota Jewish War
Veterans currently loc ted at 1060 University Avenue, be and
the same is hereby app oved for transfer to 733 Pierce Butler Route.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
��g In Favo
Goswitz
Rettman /,J
s�ne;ne� _ Against BY
Sonnen
Wilson
A�j' � 7 �� For ppr ed b y At ey
Adopted by Council: Date
Certified Yas e ncil S t
"` �"� �
gy,
A►pprov y Mavor: Date ��G � 8 Approved by Mayor Eor Submission to Council
gy BY
PUBLtS�D aU G 2 6 19a9
� � � � ��-����
DiVISION OF LICENSE AND PERMIT AI)MINISTRA ION DATE (�5 � / 7 O� � O 5
INTP,RDF.PARTMFNTAL REVIEW CHECKLIST Appn Pro essed/Received by
i Li Enf Aud
r ,�1� �l'� L��b50� c
Applicant�¢� l�i- M(� �1Q(UIS h �vQ(^ Home Address �o�a� �0�.�, � V� JO
U e`IeVQ�► 5 �3 `J�. - °2�!o Q
Rusiness Name Home Phone /
Eusiness Address �3�j �/eirCe• �y'!f Type of License(s) C�O$S /q —
Business Phone � f( [..�CQ � - (�d k.`�"l0/1 Tr'1"r'
Public Hearing Date � �7 8� License I.D. 4F �(p(y5�,
at 9:00 a.m. in the Council Chambers, N '�
3rd floor City Hall and Courthouse State Tax I.D. 46
llate Notice Sent; q Dealer �� Nl/-�'
to Applicant 8`^l O 9
Federal Fi.rearms �� �f A'
Pub.lic Hearing
DATE INSPEC IUN
REVIEW VERFIED (CO UTER) CUMMENTS
A roved Not A roved
�
Bldg I & D �
N�q�
�
Health Divn.
, ��� ,
�
Fire Dept. �
� NI�' �
i
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Police Dept.
: �'��1�� d K
License Divn. �
�I � I � �
(�.
City Attorney �
g� �� � � o ,�
Date Received:
Site Plan � � p- � C
To Council P.esearch � 0
Lease or Letter Date
from Landlord
CURRENT INFORMATIQI� NEW INFOItMATION %
.
Current Corporation Name: New Corporation Name:
�
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond: .
Warkers Compensation;
New Officers:
Stockholders•
.
. City of' S int Paul //�r�/;r�(�7�,
� Finance and Management Servi es/License & Permit Division �•'r � �
INFORMATION REQUIRED WITH APPLICATION FOR PE IT TO CONDUCT CHARITABLE GAMBLING GAME IN
SAINT PAUL (To be used with the following: ew A & C application, renew A & C
Licenses, and new and renew B in Private Club .)
1. Full and complete name of or anization w ich is applying for license
�� '�rn�.�/-Z�a ,�i�i�� f � -�eL���12 ��Y' ��'��r�,U�S
.
2. Address where games will be held �3 ��--��'—�— 1������� -C� `
Nu er Street City Zip
3. Name of manager signing this applicatio who will conduct, operate and manage
Gambling Games � Date of Birth `
(a) Length of time manager has been mem er of applicant organization � �.�Y-3
4. Address of Manager /�� l, �Y' � �� �� �
Number Street City Zip
5. Day, dates, and hours this application s for �L'�'/1�G�c►�� ��U�� "� •�`���
6. Is the applicant or organization organ zed under the laws of the State of MN? PJ
7. Date of incorporation
8. Date when registered with the State of Minnesota ��` �
9. How Iong has organization been in exis ence? �� �
�'
10. How long has organization been in exis ence in St. Paul? ���`�
11. What is the purpose of the organizati ? �%�/�� -������5 � O
12. Officers of applicant organization:
Name �i! // �P� ' � Name �� ,L/�1^�l��
Address l/ -c�/V Address �� ��� V'
�� � ,,��- -�-' -
Title ' , �Y' DOB f- �� '. Title /�� DOB .����G'S
� �'�G�
Name ��� i �C� J Name
Address��C fL.J' �1G'�/1�� �� . Address
Title � ' ,�- DOB Cf� '! � Title DOB
13. Give names of officers, or any other persons who paid for services to the
organization.
Name d�'/I�,��� , ��� ' Name ��r�'d �,�2�r�� -
Address ,� G�{�'� Address `j������- f���
Title /Y �' Title �-���`
(Attach separa e sheet for additional names.)
. �. . � �O,c��-/�
14. Attached hereto is a Iist of names and a dresses of all members of the organization.
15. In whose custody will organization's rec rds be kept?
� �/!'l�� ��l�f� _ `�`� �-�ca� ���'2���
Name Address
16. List all persons with the authority to s'gn checks for dispersal of gambling proceeds:
Name �'�C� tP .� �f�''�G�� Name �a1'��� (�tJ��]'�c��
�/ ,
Address °�� • Address ��� f l,I�����"�
Member of Member of ,\ �� �
DOB ���'` - Organization? DOB �-- Organization? 'y��
, �
�
Name � D �� � • Name
Address L c'� /� Address
Member of Member of
DOB �'�;. i-- Organization? DOB Organization?
17. a) Does your organization pay or inten to pay accounting fees out of gambling funds?
yes � no
b) If you do pay accounting fees, to w om will such fees be paid?
Name Address ��� ��/
DOB �.— ��,,.�� Member of Or anization? �
--�-9—
c) How are the accounting fees charg d out? (flat fee, hourly, etc.)
�� . ��
18. Have you read and do you thoroughly u derstand the provisions of all laws, ordinances,
and regulations governing the operati n of Charitable Gambling games?
19. Attached hereto on the form furnishe by 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 have received funds for the preceding calendar
year which has been signed, prepared and verified by ,g���^/����j^���.�y'��
'�'o� � � � -
Address
who is the ' �l �r' of the applicant organization.
Nam
�
20. Operator of premises where games wi 1 be held:
Name � �
�1 ' �
Business Address � '� " � G
Home Address
� � - � ' �.- /N 7�
. . . ��
' 21. Amount of rent paid by applicant organi ation for rent of the hall:
22. The proceeds of the games will be disbu sed after deducting prize layout costs and
operating expenses for the following pu poses and uses:
�:r r
� -��- • '>l-� ;h ��'�/�r.��,Yr C-'����
� ��� * - � ��� - � -- �� ����
23. Has the premises where the games are to be held been certified for occupancy by the
City of Saint Paul? ��
24. Has your organization filed federal for 990—T? � If answer is yes, please attach
a copy with this application. If answe is no, explain why:
� ��3 � � � � � �c�� ,� �
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Any changes desired by the applicant associat on may be made only with the consent of the
City Council.
c
��
anization Na
� <
Date -� � g ; -
y
Manager in ar of game
.
��%�!�/�/ �11�/!X s
Organiza ion President or CEO
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. � V V�V `
Gity Saint Paul �
' � � ' Department of Financ and Management Services ///�
License an Permit Division /��- �-�
20 City Halt �.
St. Paut, Minn ota 55102-29&5056
APPLICATI N FOR LICENSE
CASH CHECK CLASS NO. New Renew
a � � Date �� t9=l..
Code No. Title of License
From 1��To � 19�
a�oZ 4S i�' ��m �j�� n l� ' � ' )
100 � d �j� ' (�1 S� �Cf 1r VP�PYG r1
� `-�S�, yu r Appl can pany Name
100
133�erc� ��-�e�. �
100 Businesa Name
ioo �� �4c,�` �`-,j �t�s
Business Address Phone No.
100
100 Mail to Address Phone No.
100 � L vl(�C, �f ''.. � Q t (J��
ManapedOwner•Name ���
' 100
� �-av Y� �4�-� ��
100 htanagerlGwner•Hom Address Phone No.
4098 Application Fee
Z, 50
Received the Sum of 100 � � (�j ` � � ���
���p �jQ M�nage►Owner•City,State 3 Zip Code
100 Total 100
�
License Inspector L' By: \-� �z"' ' sg ure ot p ant
Bond: �
Company Name Policy Na Expiration Date
Insurance:
Company Na e Poticy No. Expiration Oate
Minnesota State Identification No Social Security No.
Vehicle Information:
Serlal Number Plsts Number
Other.
THIS IS A REC IPT FOR'APPLICATION
THIS IS NOT A LICENSE TO OPERATE.Yow application for Ifce se will either be granted or rejected subject to the provisions of the zoniny
ordlnanCe and completion of the inspections by the Heaith, Fir ,Zoning and/or License InspeCtors.
.
$15.00 CHARGE FOR ALL RETURNED CHECKS
,
d K� I OC�c��an - t(�(� �lh t�✓s,��
. � ��C� G����
..P��%��2�� �—a 7z� I�.�.° `Q� "
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DF,PARTMENT/OFFICE/COUNdL . " ' ' °"�'"'T'"TE GREEN SHEET NO. 4 41 2
' Finance/License ,Nn,,�,oA� INITIAUDATE
CONTACT PERSON 6 PHONE DEPARTMENT DIRECTOR �GTY COUNqL
Chri sti ne Rozek/298-5056 �� cmr nrro�er 0 cmr a�K
MUST BE ON COUNCIL AOENDA BY(DAT� ROUTING BUDQET DIRECTOR �FIN.d MQT.SERVICEB DIR.
H-17-H9 MAYOR(OR AS8ISTANT) � ` �1 R
TOTAL�OF SICRNATURE PAGES (CUP ALL L CA IONS FOR SIONATUR�
ACTION REWESTED:
Application for transfer of a C1a s Gambling License.
Hearing Date: 8-17-89 No ification Date: 8-1-89
REOOMMENDATIONS:Approw(A)a Rejsct(R) (;pUN(,y� M EIRESEARCd1 REPORT OPTIONAL
_PUWNINO COMMISSION _qVIL 8EHVICE COMMI3610N �ALYST PHONE NO.
_CIB COMMITTEE -
COMMENTS:
_STAFP -
-DISTRICT COURT _
SUPPORTS WHICH COUNCIL OBJECTIVE? II
INITIATIN(i PROBLEM,138UE,OPPORTUNfTY(1Nho,What,Whsn,Where,Why): ',
i
Michael Liebgot, on behalf of the �De artment of Minnesota Jewish War
Veterans, requests Council approv 1 f his app1ication to transfer a
Class A Gambling License from 106 U iversity Avenue to 733 Pierce Butler Route.
All fees and applications have be n ubmitted.
�
ADVANTAOES IF APPROVED:
1 �
DISADVANTAQES IF APPROVED:
�
DIBADVANTAOES IF NOT APPROVED:
I
� ; �ow^c�i R�s�arch Center
,
� ��� 3 i�89
�
TOTAL AMOUNT OF TRANSACTION s I. OST/REVENUE BUDOETED(CIRCLE ON� YES NO
FUNDING SOURCE TIVITY NUMBER
FlNANCIAL INFORMATION:(EXPWN) I
i
!,
, .
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIONAL
MANUAL AVAILABLE IN THE PURCHASING OFFlCE(PHONE NO.298-4225).
ROUTING ORDER:
Below are preferred routings for the five most frequent types of documenta:
OONTRACTS (assumes suthorized OOUNqL RESOLUTION (Amend, BdgtsJ
budget exiats) Accept. Grants)
1. Outside Agency 1. DepertmeM Director
2. Initiating Department 2. Budget Director
3. City Attomey 3. Gty Attortiey
4. Mayor 4. MayoNAssistant
5. Finance&Mgmt Svcs. Director 5. City Council
6. Finance Accounting 6. Chief Accountant, Fin&Mgmt Svcs.
ADMINISTRATIVE ORDER (Budget COUNqL RESOLUTION (all others)
Revisfon) and ORDINANCE
1. Act'nrity Manager 1• Inidating Department Director
2. Department Accountant 2. City Attorney
3. Department Director .3. Maycx/Assistant
4. Budget Director 4. Ciry Council
5. Gty Clerk
6. Chief Accountant, Fn 8�Mgmt Svcs.
ADMINISTRATIVE ORDERS (all others)
1. Initiating Department
2. City Attomey
3. Mayor/Assistant
4. Ciry Clerk
TOTAL NUMBER OF SIC3NATURE PA(iES
Indfcate the#of pages on which signatures are required and paperc�IP
each of these�a�.
ACTION REQUESTED
Deecribe what the projecUrequest seeks to accomplish in either chronologi-
cal order or order of importar�ce,whichever is most appropriate for the
issue. Do not write complete seMences. Begin each item in your list with
a verb.
RECOMMENDATIONS
Complete if the Issue In questlon has been presented 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, NEIGHBORHOODS, ECONOMIC DEVELOPMENT,
BUDC�ET,SEWER SEPARATION). (SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
COUNCIL COMMITTEFJRESEARCH REPORT-OPTIONAL AS REQUESTED BY COUNCIL
INITIATINCi PROBLEM, ISSUE,OPPORTUNITY
Explain the situation or conditions that created a need for your project
or request.
ADVANTAGES IF APPROVED
Indicate whether this ia simply an annual budget prxedure required by law/
charter or whether there are specfflc ways in which the Gty of SeiM Paul
and its citizens wfll benefit from this projecUaction.
DISADVANTAGES IF APPROVED
What negative effects or major changes to existing or past proce�es might
this proJecUrequest produce ff it is pesaed(e.g.,traffic delays, noise,
tax increaees or essessments)?To Whom?When? For how long?
DISADVANTAGES IF NOT APPROVED
What will be the negative consequences if the promised action is not
approved? Inabilihr to deliver aervice?Continued high trafflc, noise,
axident rate?Loss of revenue?
FINANCIAL IMPACT
Although you must taibr the information you provide here to the issue you
are addressfng, in general you must answer two questions: How much is it
going to cost?Who is going to pay?
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'� >1IYNE��TA ? Y �DElR'IFiCA:IOY vL^19EA � r��/({7�
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' ' Pursuanc to Lavs oE `ilnnesota, 198G, Chapt r 502. Article 8, Section I (270.'2) �'ax C1ear-
'• anee; (ssuance of Llcenaes), lieensing aut ocitiee ar� req��ired to provide to ch�e `tinnesota
Coaunissioner of Ravenue Che Minneaota busi ese ta�c identifieselon rtumber and t:e soclal
seeurity �umbec oE eaeh 1lcenee applieanc.
Undec th• lllnneeota Government Data Praet ee Aet and the Federal Privaey Act oE 1974, v�
ar• reQuired to advia• you of th� follwi regarding the ua• of th1� infonution:
l) TAis infocmation sar be ueed to d�ny h� isauance or r�nwal oE your 1leens• Ln ch�
�v�nc you ov� Minnesoea aal��, employ r'a vithholdiag or aotot vehiele e:elee cax�a;
2) Upon receiving th!• Lnformacioa, th� ieen�ins auehority vill wpply it only to eh•
Ninn�eoCa D�pacta�nt of R�venu�. Hov ver, und�c eh� Fed�ral Exehangs o[ lafoesation
Agr��sent eh� D�patts�nt ot Revanu� r suppl� thl� inforsatloa to che Internal It�veeue
Secvlcr,
J) FAILURE TO SUPPLY TFIIS INFORMATION VI L JEOPA8DI2L OB DELAY 'fBL PROCESSI}IG OC YOUR
LLCENSE LSSUANCE OR RENLWAL 11PPLLCA? N.
Ninn�soca Tax Ind�ntiticatlon Nusbers (5 l�a 3 Us� iax Nwb��) sa� b� obtalned [ro� [h�
Stat• ot NSnnesota - Susin�a• fl�eord� De rta�nt - Rao� C90 C�nt�anial Suildin� - 65e C�d�c
Str��t. (tvo bloelu �ouch�ase o[ tM St c• CapltolT Phon�: 296-2l63
Apylieants La�t l/uu� Fir�t N� Niddla Initlal
Applle�nts Addees� C t�, Statt, Zip Cod� lhon� No.
Applleants Soeial S�eurltr No. Po�ition (Otfic�r. Pusn�r, •te.)
lu�in�t• Nas�
lu�in��• Addr��• it�, Stat�, iiP Cod� lhon� Mo.
Minn�soca ia�c Id�oeStication nu�b• :
(Lf a dinaesota ia�c Id�ntlfieatioo Nwb�e i� not r�q r�d Los t6�
Ausin��• b�las op�rat�d. Lndleat• ehat br plaeia� an I !n eM bos.) �
•,►���s�a�*���i,►:�wn��*����wr�nr�iiw�r� iaww***i�*:i*e*a������r�*r+*��i:e�+���rr�*r����,►n�
Wi0 ' COlRQISAi10N
Pur�uant to ehe Minaesota St�t� G�is atur� br Chapt�t 3�2. Seetion 47, Law of 1987, �v�ry
stat• aad local li��nsla� a�sner is r quir�d to vitMold tA� l��ne• oe c�awal o[ •
lie�a�• or p�r�it to op�tac• • bu�ln� • in Minn�wta uatil tA� splieant presto[s aec�pt-
�bl� ��id�ae• of eoqllaae• rith eh� rk�r�' eo�p�n�atioa inaraee• eov�rap r�quiru�at•
ot Seeelon 176.1e1. Subdi�l�ioa 2.
'fhi� infoe�ation 1� rynlr�d S� lav. nd lie�a��� and o�r�it� to oy�rae• a busln��� sar not
b� l��u�d oe r�e�wd i! it 1� aot pr id�d �ed/oe i� tal��l� r�prt�d. lurts�ner�. lI th�
infors�clon i• noe pre�id�d �/or ta ��1� e�poee�d. it w� r��ult in s IL.000.00 p�nalc�
a������d a�ala�t eh� applieaat br th Ca�i��ion�r o! th� D�pareaMt of L�bor and lndw er�
p�rabl• to tlu Sp�eial Co�p�euaeion d.
Upon r�au��t. 1leeo�ia� suthoriti�• • r�qnir�d eo furni�h wrkees' eo�p�nsatioa in�urane•
cw�esp infonation to th� D�parta� o[ Laboe and Iadwtr7r to e6�ek tas ea�pllane• ritfi
Mlm�tota Statut• S�etion 176.1s1, S bdivl�ioa 2.
11� qu��tiow r�;ardin� vork�rs' eo �esation •hould b� dir�eud te th� Ml��ota D�pacemeaC
of L�boe aad Indwtz� - Sp�eial ivad S�etion - 297-�7�7.
Ia�urane• Cory�n� NaM
(NO? eh� ln�urane• apnt) •
Polie� Nu�b�r or Self-Ia�uranc• P� t Nu�A�r Q 0
D�c�• oE Cov�rag• Cif�ctiv�: (/ 8 E�SS�tloas Q
- OR -
2 a� noc r�quir�d to hav� wr4�r�' o�p�n�aeion liabllit� cov�rap b�ew��:
( ) I hav� no �ylo���� cmr r�d sy th� lav.
( ) Oth�r (Sp�eity)
L HAVC RGD AND UNDtitSTAND !R RICNT AND 06L2GAtI0NS fILTB RtCARD TO lUSIMCSS L2CLNSC3.
YCRMISS. AUD YORiERS' COlREIfS 20N RAG CERT P! 'LB�'! SQ IUt'ORMA2I011 PdOVLDm
IS TRUL AND CORRE
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' � �._= o-�, ' � � CITY OF SAINT PAUL
`�� �� DEPARTME T OF FINANCE AND MANAGEMENT SERVICES
• •�
; ��ii a ;�
,� „ DIVISION OF LICENSE AND PERMIT ADMINISTRATION
'y ���� � Room 203, City Hall
Saint Paul,Minnesota 55102
George Latimer
Mayo�
August 1, 1989
Michael Liebgot
Department of Minnesota
Jewish War Veterans
7220 York Ave. So.
Minneapolis, MN 55435
Dear Mr. Liebgot:
A review of the investigations w ich were made in connection with your
application has been completed. It will be my recommendation that your
license(s) be approved if a sign d lease is submitted prior to the
hearing date.
A hearing on your application fo the transfer of a Class A Gambling
License(s), ID �t56652, will be h ld before the Saint Paul City Council
on August 17, 1989 at 9:00 a.m. n the Council Chambers, third floor of
the City and County Courthouse.
This date may be changed without the License & Permit Division`s consent
and/or knowledge. Therefore, it is suggested that you call the City
Clerk's Office at 298-4231 to co firm this hearing date. Your presence
is required at this hearing in o der to respond to any questions that
may arise.
The City Council may have and/or receive other information which I am
presently not aware of that may ause them not to follow my recommend-
ation.
Very truly yours,
Joseph F. Carchedi
License Inspector
JFC/j 1