89-1480 WHITE - CITV CLERK
PINK - FINANCE COURCIl �//1
BLUERy - MAVORTMENT G I TY OF SA I NT PAU L File NO. �-- _/�`� �
��'o cil Resolution �� ;
�
� :
Presented By
Referred To ' Committee: Date
Out of Committee By Date
RESOLVED: That application (ID # 0812) for the transfer of a Class A
Gambling License by St. Peter Claver Social Club currently
located at 1060 Unive ity Avenue, be and the same is hereby
approved for transfer o 733 Pierce Butler Route.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
Long In Favo
Goswitz
Rettman O B
s�he;be� _ A gai n s t Y
Sonnen ,
Wilson �±
AU�7 1 71989 Form A by City orne
Adopted by Council: Date
-� ��
Certified Pas b uncil S ret By
B� �
A�pprov y iNavor. t
� Approved by Mayor for Submission to Council
By
p�� AU G 2 6 19g9
� , . �J��-���
DEPARTMENTIOFFICE/COUNGL DATE I ITIA
� • • Fi nance/�i cense GREEN SHEET No. 4,Nt��
CONTACT PERSON d PHONE DEPARTMENT DIRECTOR CRY COUNqI
Chri sti ne Rozek/298-5056 N� TY ATfORNEY qT1f CLERK
MUST BE ON OOUNqL AQENDA BY(DAT� ROUTI UD(�ET DIRECTOR �FIN.8 MOT.8ERVI�S DIR.
8-17-89 ❑tiu►voRcoR�ss�sr�wn � Council R
TOTAL�i OF SIDiNATURE PAGES (CLIP LL OCATIONS FOR SIGNATUR�
ACT10N FiE�UESTED:
,
Approval of an application fo� t e transfer of a Class A Gambling License.
�
Hearing Date: 8-17-89 � Notification Date: 8-1-89
RECOMMENDATION8:Apprare(IQ or RsJeCt(R) COUN IL MITTEEAiESEARf�i REPORT OPTIONAL
_PLANNINO COMMISSION _dVll SERVICE COIiAM13810N ANALY T PHONE NO.
_CIB COMMITTEE _
COMM NTB:
-STAFF _
-DISTRICT COURT _
8UPPORTS WHICH COUNCIL OBJECTIVE?
INITIATING PROBLEM.ISSUE,OPPORTUNITY(Wlro.VVhat,When,Wlfsre,Wh»:
Evelyn M. Morrissette, on beh lf of St. Peter Claver Social Club, requests
Council approval of her appli�at on to transfer a Class A Gambling License
from 1060 University Avenue tb 7 3 Pierce Butler Route. All fees and
applications have been submit�ed
ADVANTA(iES IF APPROVED:
DISADVANTAOES IF MPROVED: �
DISADVANTAOE8 IF NOT APPFWVED: i
�
Cou��il Research Center,
I
pUG � i�89
TOTAL AMOUNT OF TRAN8ACTION = WST/REVENUE BUDGETED(CIRCLE ONE� YES NO
FUNDING 30URCE ACTIViTY NUMBER
FINANCIAL INFORMATION:(EXPLAIN)
� � �
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIONAL , J ,
MANUAL AVAILABLE IN THE PURCHASIN(3 OFFICE(PHONE NO. 298-4225).
ROUTING ORDER:
Below are preferred routings for the five most frequent rypes of documents:
CONTRACTS (assumes authorized COUNGL RESOLUTION (Amend, Bdgta./
budget exists) Accept.Grants)
1. Outside Agency 1. Department Director
2. Initiating DepaRment 2. Budget Director
3. Ciry Attorney 3. Ciy Attomey
4. Mayor 4. MayodAssistaM
5. Finance&Mgmt Svcs. Director 5. Ciry Council
6. Finance Accounting 6. Chief AccountaM, Fln&Mgmt Svcs.
ADMINISTRATIVE ORDER (Budget COUNCIL RE30LUTION (all others)
Revision) and ORDINANCE
1. Activity Manager 1. Initiating DepartmeM Director
2. DepartmeM Axountant 2. Ciry Attorney
3. DepartmeM Director 3. Mayor/Aaeistant
4. Budget Director 4. City Council
5. C1ty Clerk
6. Chief Accountant, Fin&Mgmt Svcs.
ADMINISTRATIVE ORDERS (all others)
1. Initiating Department
2. City Attorney
3. MayodAssistant
4. City qerk
TOTAL NUMBEFi OF SIGNATURE PAC,ES
Indfcate the#of pagea on which signatures are required and paperc�iP
each of these pages.
ACTION REOUESTED
Describe what the proJect/request seeks to accomplish in either chronologF
cal order or oMer of importance,wh�hever is moat appropriate for the
i�ue. Do not write complete sentences. Begin each item in your list with
a verb.
RECOMMENDATIONS
Complete if the issue in queation has been presented before any body, public
or private.
SUPPORTS WHICH OOUNdL OBJECTIVE�
Indicate which Council objsctive(a)yiwr projecUroqueN supports by listing
the key word(s)(HOUSINCi, RECREATION,NEI(iHBORHOODS, ECONOMIC DEVELOPMENT,
BUDGET,SEWER SEPARATION).(SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
COUNGYL COMMITTEE/RESEARCH REPORT-OPTIONAL AS REQUESTED BY COUNqI
INITIATING PROBLEM, ISSUE,OPPORTUNITY
Explain the situation or conditfons 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 ways in which the Gty of Saint Paul
and its citizens will benefit from this projecUaction.
DISADVANTAGES IF APPROVED
What negative effects or major changes to existing or past prxesses might
this proJecUrequest produce if it is passed(e.g.,treiNsc delays, noiae,
tax increases or assessments)?To Whom?When? For how long?
DISADVANTAGES IF NOT APPROVED
What will be the negative consequences if the promiaed action is not
approved?Inability to deliver service? Contlnued high traffic, noise,
acxident rate? Loss of revenue?
FINANGAL IMPACT
Although you muat tailor the information you provide here to the issue you
are addressing, in general you must answer two queations: How much is it
going to cost?Who is going to pay7
• • . �.. " ���T lJ
. ._ � 318� i � r g �
UiVISION OF LICENSE ANI) P�:RMIT ADMINIST TION DATE
INTERDF.PARTMFNTAL KEVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
' �P r�vcr�, lud �.(J�'�'� /Lj. /Ll orr�sse_7��
Applicant �� �C`K (�C,GUt U 1 Home Address a �./U 3 �.r�nfPttr #'0�0�
Business Name Home Phone
Eusiness Address ���e1�C� �,�Q� � Type of Lic.ense(s) ��Q$5 �} C7arn bl�/�
�
Business Phone �..ICQ/3')S� 'I'1'khS t�r'
Public Hearing Date )7 � License I.D. �1 �(�g �al
at 9:00 a.m. in the Counc'1 C ambers,
3rd floor City Hall and Courthouse State Tax I.D. �� ��q"
llate Nutice Sent; Dealer �� N(�
to Applicant
rederal Fi_rearms 46 N�.�'
Public Ne�.iring
DATE INSPE TIUN
REVIEW VERFIED (CO UTER) CUMMENTS
A proved No A roved
�
Bldg I & D +
N q' ,
Health Divn.
� � �
i
Fire Dept. ; �'
j
i N f� f
i I �Yolice Dept. �/ � �� Q � �QJ
/�
License Divn. � �
� (J/�--
�
,
City Attorney �
g` ' Q /�
'
Date Received:
Site Plan � � g
To Council P.esearch 3
Lease or Letter � �l � ate
from Landlord
� �: .
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders•
• • City o �aint ?aul �,r� ���-�
, _ rinance and Kanagement Se ices%License & Permit Division �/�
INFORMATION REQUIRED WITH :�PPLICaTION FOR ER.�IIT TO CONDCTCT CHARITABLE GAMBLIVG G�.KE Iv
SAI,1T PAUL (To be used with the following. New a & C application, renew :� & C
Licenses, and new and renew B in Private C ubs.)
1. Full and complete name of organizatio which is applying for license
�/
2. Address where games will be held ^
umber Street City Zip
3. Name of manager signing this applicat on who will conduct, operate and manage
Gambling Games - Date of Birth �9-,�LS»„�1y
(a) Length of time manager has been m mber of applicant organization /����p�
4. Address of Manager �_ �- u " 4 �' • � �
Number St eet City Zip �--���y
S. Day, dates, and hours this applicati is for �� ,�,��,.y,✓� ,/ 7�j%� .vz� 9-,� -,� •--
9_�`i�`�
6. Is the applicant or organization org nized under the laws of the State oi MN? �=
7. Date of incorporation - '-
8. Date when registered with the State f Minnesota �����
9. How Iong has organization been in ex stence? �i9l�r
10. How long has organization been in ex stence in St. Paul? /�J � �aq,��-
11. What is the purpose of the organizat on? � iQss.�s�- �1.vA.V�:�/�.
�
i/.G�c✓J
I2. Officers of applicant organization:
vame � 1�.P - •t/ ,tame �- /°f�Ffb.�s�
Address �' � Address ���J � A.v� de/�
-. .
Title ��E�'� ,vZ't DOB - �' Title _S'F�. -r�6=�9,5' DOB G -,,�,,7�
Name Name
Address Address
Title DOB Title DOB
13. Give names of officers, or any othe persons who paid for services to the
organization.
Name Name
Address Address
Title Title
(Attach separa e sheet for additional names.)
� � . . �-�-�y��
�14. � Attached hereto is a Iist of names and ddresses of all members ot the organizaticn.
I5. In whose custody will organiza[ion's re ords 5e kept?
Name "�u_ p- Address ��Sl� �_• �iq�idf/�Eu.�
16. List all persons with the authority to sign checks for dispersal of gambling proceeds:
' Name � Name /�pA.✓r'.=� �l��/��iSs.cf�E
Address . / Address ��t�sl,� �=. �i�- „� �--,�i-_�t,�
Member of Member of
DOB 9�,7d-�� Organization? DOB ��l -�/ Organization? ��S
Name � Name ,t�/�F�.�a�/ G . 1�i�-/,�i/-.-�5�
Address " C � �►d �� Address ���� ���/�,��,�
Member of . Member of
DOB _ _,�,1!-,,.�j Organization? i= DOB fj'=f!S - ,�� Organization? �'�-�
17. a) Does your organization pay or inte d to pay accounting fees out of gambling funds?
yes }� no
—�
b) If you do pay accounting fees, to hom will such fees be paid?
Name � �• J Address �9�y i���c�p�7 ��• _�/�i4.tr/
�
DOB i_ � �� Member of 0 anization? � ��
c) How are the accounting fees char ed out? (flat fee, hourly, etc.)
—
18. Have you read and do you thoroughly nderstand the provisions of all Iaws,, ordinances,
and regulations governing the operat on of Charitable Gambling games? y��'
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 �aell as all organizations o have received funds for the preceding calendar
year which has been signed, prepare , and verified by /f��
Address
who is the of the applicant organization.
Nam
20. Operator of premises where games wi 1 be held:
Name � Q �
Business Address �
Home Address �� "' -s �/
i
� � � - ���-���d
� 21. ���mount of rent paid by applicant orga ization for rent of the hall:
� �._ �J27 G l d�
22. The proceeds of the games will be di ursed after deducting prize layout costs and
operating expenses for the following urposes and uses:
c ,c�- .7� /�"J c
F /� c
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.
d N �d d
�.R,/�.�CS'F�T'
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 orm 990-T? y�s If answer is yes, please attach
a copy with this application. If an wer is no, explain why:
Any changes desired by the applicant asso iation may be made 'only with the consent of the
City Council.
�� ��-��.� c�.�-,J�..� �. c'��
Organization Name
►
Date By:
ager in charge of game
,
.
Organizat 'on President or Cc0
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✓ - City of 'aint Paul
. Department of Finance nd Management Services /� �_/,/�Q
� License and ermit Division � `�
203 ity Halt
St. Paul, Minnes ta 55102-29&5056
APPLICATIO FOR LICENSE
CASH CHECK CLASS NO. New Renew _
a � na 2 R
Date � ✓� 19� �
Code No. Title of Ucense x �
From R � t9_To � �� 19��
��� ' H - C.� cn,Y, ��• � -(_
�- � �T• ��'K� ��Q ciP� SGrra�C�L<<
�a r1 S �?r— ApplicantlCompany Name
'� 3
7 3 �i���e. �c�-� ��r-
100 Buslness Name
1
,00 S�- �G �.�, l� �
� Busi�ess Address Phone No.
100
100 Mail to Address Phone No.
,00 Ve �i ��-1 rr�S`:���lp.
ManaQerlOwner•Name
• 100
p� �� �� 3 �G ✓,pP r� �'�Gt y- ��D�
, 100 AtanagerlGwner•Home Address P�o�e No.
4098 Application Fee , 50 �r/
Received Ihe Sum of .T ,� L� + (,, 1 ,S�• i U L�/, �� � s���j Ci
�_'�• -- �� f�`�' �� Manage�lOwner•City,Slale 3 Z�p Code �
/ �.j 100 Total 100 �
✓LL ! � �
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License Inspector By; "' � Signature of Applicanl
'('y � -� �s�;.�
Bond: ' � � �
. j �i��t- Company'Name Policy No. Expiralion Date
Insuranoe:•%~L-`'� � '
Company Name Policy No. Expiration Oate
Minnesota State Identification No Social Security No.
Vehicle Information:
� � rt �;
Serlal Number Plate Number
Oth@f:
THIS IS A. PT FOR APPLICATION
THIS IS NOT A LICENSE TO OPERATE.Your applic�tt�rt�0�}ifC6�F wtttgfther be granted or rejected subject to the provisions o(thezonlnQ.
ordlnence and completion of the inspections by the Health, Fire Zoning andlor License Inspectors.
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$15.00 �GE FOR LL RETURNED CHECKS
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