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89-1481 WNITE - CITV CIERK � PINK - FINANCE COl1�1C1I GANARV - DEPARTMENT GITY OF AINT PAUL File NO• '/��/ BL_UE - MAVOR � Co c�l esolution y�� _� Presented By Referre Committee: Date Out of Committee By Date I' RESOLVED: That a lication ID �#1 629 for the transfer of a Class A PP � ) Gambling License by Wler ick Booster Club currently located at 1060 University Aven e, be and the same is hereby approved for transfer to 733 Pie ce Butler Route. � COUNCIL MEMBERS � Requested by Department of: Yeas Nays Dimond Lo� [n Favo Goswitz Rettman D Scheibel A gai n s t BY Sonnen Wilson AUG 1 j � Form Ap by City torn Adopted by Council: Date C Certified Pas e Council S ret By —� gy, Approve y Mavor: Da _ _ Approved by Mayor for Submission to Council y By miat��l AU G 2 6 1989 � � :►� � �' / � . ��"�zQ DEPARTMENT/OFFICE/COUNqL DATE I ITIA D Fi nance/�i cense GREEN SHEET No. � 1 � OONTACT PERSON 8 PHONE INITIAU DATE �INITIAUDATE DEPARTMENT DIRECTOR qTY COUNqL Christine Rozek/298-5056 TvnrroRN�r cm,c�RK MUBT BE ON COUNCIL AQENDA BY(DAT� ROUTI BUDQET DIRECTOR �FIN.�MOT.SERVICES DIR. 8-17-89 wu►voRcoRnssisrnHn � Counci 1 R TOTAL N OF SIGNATURE PAGES (CLIP LL OCATION8 FOR 81GNATUR� ACTION REQUESTED: Approval of an a .lication for} t transfer of a Class A Gambling License. _ - Hearing Date. 8-17-89 Notification Date: -�-�89" RECOAAMENDATIONB:Approve py or Reject(R) COUNC L MITTEEJRESEARCH REPORT OPTICINAL _PLANNINa OOMMI8SION _GVIL SERVICE OOMMI3810N ANALYS PHONE NO. -CIB WMMITTEE _ _�� _ COMME S: _DISTRICT COURT _ I 3UPPORT3 WHlqi COUNqL OBJECI"IVE? INITIATINO PROBLEM,ISSUE.OPPORTUNITY(Who.Nlhet,Whsn,Where,Wh�: I Kevin Martineau, on behalf of �he Merrick Booster Club, requests Council approval of his application to tr nsfer a Class A Gambling License from 1060 University Avenue to 733 ie e Butler Route. All fees and applications have been submitted. I I I ADVANTAGE3IF APPROVED: DISADVANTAGES IF APPROVED: .. DISADVANTAQEB IF NOT APPROVED: o�ncri Research Center - -- - � ___ - _ _ _ _ _ AUG 3 ��89 � TOTAL AMOUNT OF TRANSACTION a � COST/REVENUE BUDOETED(CIRCLE ON� YES NO FUNDINa SOURCE � ACTIVITY NUMBER FlNANdAL INFORMATION:(EXPLAIN) II » , ' _t r ,.,_ � ,- . NOTE: COMPLETE DIRECTION3 ARE INCLUDED IN THE(3REEN SHEE7 INSTRUCTIONAL MANUAL AVAILABLE IN THE PURCHASING OFFICE(PHONE NO.298-4225). ROUTING ORDER: Below are prefened routings for the five most frequent types of documents: CONTRACTS (assumes authorized COUNCIL RESOLUTION (Amend, Bdgts./ budget exiats) Accept. Grants) 1. Outside Agency 1. DepaRment Director 2. InRfating Department 2. Budget Director • 3. City Attorney 3. Ciry Attomey 4. Mayor 4. Maycx/Assistent 5. Finance&Mgmt Svcs. Director 5. Cityy Council 6. Finance Axounting 6. Chief AxouMaM, Fln&Mgmt Svcs. ADMINISTRATIVE ORDER (Budget COUNCIL RESOLUTION (all ott�ers) Revision) and ORDINANCE 1. Activity Menager i. Initiating DepartmeM Director 2. DepertmeM Accountant 2. City Attorney 3. DepanmeM Director 3. MayoNAssfstaM 4. Budget Director 4. City Council 5. City Clerk 6. Chief Accountant, Fin&Mgmt Svcs. ADMINISTRATIVE ORDERS (all others) 1. Inftfating Department 2. City Attorney 3. Mayor/Asaistant 4. Gry Gerk TOTAL NUMBER OF SIGNATURE PAGES Indicate the#of pages on which signatures are required and paperclip each of these p�es. ACTION REQUESTED Deacribe what the pro)ecUrequest seel�to ac;complish in either chronologi- cal order or order of importance,whichever la most appropriats for the issue. Do not write complete senten�s. Bepin esch item in your Iist with a verb. RECOMMENDATIONS Complete if the issue in question has been presented before any body, public or private. SUPPORTS WHICkI COUNqL OBJECTIVE? Indicate which Council objective(s)you�project/request supports by listing the key word(s)(HOUSING, RECREATION, NEIGHBORHOODS, ECONOMIC DEVELOPMENT, BUDGET, SEWER SEPARATION).(SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.) OOUNGL COMMITTEE/RESEARCH REPORT-OPTIONAL AS REQUESTED BY COUNCIL INITIATING PROBLEM, ISSUE,OPPORTUNITY Explein the situation or conditions 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 specific wa s in which the City of Saint Paul end its citizens will benefit from this pro�ecUaction. DISADVANTAGES IF APPROVED What negative effects or major changes to existing or past processes might this proJecUrequest produce if it is pasaed(e.g.,treffic delays, noise, tax increases or asseasments)?To Whom?When? For how long? DISADVANTAC3ES IF NOT APPROVED What will be the negative consequences if the promised action is not approved?Inabflity to deliver service?Contlnued high traffic, noise, accideM rate? Loas of revenue? FINANqAL IMPACT ARhough you must teilor the information you provide here to the issue you are addressing, in general you must answer two questions: How much is it going to crost?Who is going to payt , • , • . �FO �J--I�� DIVISION OF I.ICENSE AND PERMIT ADMINISTRA ION DATE � 31 p / 4 � INTF,RDF.PARTMF.NTAL KEVIEW CHECKLIST Appn ro essed/Rece v d by Lic Enf Aud �e I� �j s�e C� � a�e�i�a.r�s� Applicant f! Cl� d �' (,( �J Home Acldress � Rusiness Name ' Home Phone ?�� ja�v � Business Address �33 f�ie�r��rA't"� ype of License(s) �,�� ' '�G.�� Business Phone (�l (l1.�SQ, �qhS�P�'" Public Hearing Date I� License I.D. 4{ � y�a� at 9:OQ a.m. in the Council Cham ers, 3rd floor City Hall and Courthouse State Tax I.D. �t IU /�^ llate Notice Sent; Dealer 4f NJ� to Applicant Federal Fi_rearms �� '�/ Public He�.�ring , DATE INSPEC�TIU REVtEW VERFIED (COM!PUT R) CUMMENTS A proved Not! A roved Bldg I & D I � i �� ; � Health Divn. ' I� , � �� ! i i Fire Dept. � � � �' �In I N,�. � Police Dept. � I �� du �,[� License Divn. � � ' I � � t� City Attorney �./ � iS � � � � Date Received: Site Plan � � � I To Council Research � � � Lease or Letter O D te from Landlord l� � . i , CURRENT INFORMATION NEW INFOItMATION Current Corporation Name: New Corporation Name: Current DBA: New DBA: Current Officers: Insurance: Bond: Workers Compensation: New Officers: Stockholders• City f Saint Paul `' f • , • Fi�iacice anci htanagement S rvices/License & Permit Division �[�'l . - �� INFORl�tATION REQUIRED WITH APPLICATION FOR PERAIIT TO CONDUCT CHARITA.BLE GAtSBLING CAt1E LN SAINT PAUL (To be used with [he followin : New A fi C application, renew A & C Licenses, and new and renew B in Private C ubs.) 1. Full and complete name of organizatio which is applying for license Merrick Booster Club 2. Address where games will be held 73 Pierce Butler Rd, St. Paul, �Mn 55104 umber Street City Zip 3. Name of manager signing this applicat n who will conduct, operate and manage Gambling Games Carl Falkocaski Date of Birth 3/7/23 (a) Length of time manager has been me ber of applicant organization 8 yea rs 4. Address of Manager 364 Cttarles S - . , St. Paul, MN 55103 Number Street City Zip 5. Day, dares, and hours this application is for Sundays year round 1 : 00-5 : OU p .tn. 6. Is the applicant or organization organ ed under the laws of the State of MN? yes 7. Date of incorporation 1 6 86 8. Date when registered with the State of innesota 1/6/86 9. How long has organization been in exist nce? 9 years 10. How long has organization been in exist nce in St. Paul? 9 years 11. What is the purpose of the organization. To raise funds for equipment, events , anc� ro rams for mel�tall retarde adults . I2. Officers of applicant organization: Name Ro�ert L'aricv Name Betty Jean Falkowski Address 350 Cedar St . #555 , St . Pa 1 Address 364 Charles, St. Paul, Mn 55101 55103 Title president DOB 11/15/26 Title Secretary DOB Name Ralpil Stouffer Name Kevir� Martineau Address 6065 N� h1eKiriley St . Friclle MNAddress 1728 Gervais , Maplewooc�, r1N 55432 551U9 Title Treasurer poB 11/29/41 Title CEO DOB 4/20/51 13. Give names of officers, or any other pers ns who paid for services to the organization. Name N/� Name Address Address Title Title (Attach separate shee for additional names.) 14. Attached lie:reto is a list of names and ddresses of all members of tlie organizatio�i. 15. Innwfioseecus[ody wi�r organiza[ion's re ords be kept? ��j-��/ Name Kevin Martineau Address 1728 Gervais 11ve . , Maplewooa r�N 55109 16. List all persons with the authority to ign checks for dispersal of gambling proceeds: Name Carl I'alkowski Name Kevin �9artineau Address 364 Charles St . , St. Pau , MN Address 1728 Gervais , Maplewood, MN rlember of SS1U3 Member of 551U9 DOB 3/7/23 Organization? yes DOB 4/20/51 Organization? eY s _ Name Robert Faricy Name Address 350 Cedar St . #555, St . aul, Address Member of MN 55 Ol Member of DOB 11/15/26 Organization? es DOB Organization? 17. a) Does your organization pay or inten to pay accounting fees out of gambling funds? yes no X It did in 1988 but will not in 1989 . b) If you do pay accounting fees� to w om will such fees be paid? � Name Address DOB Member of Org nization? c) How are the accounting fees cha'rge out? (flat fee, hourly, etc.) Ici 1988 a flat tee Lor re rin or ar�izational tax returri for IRS . 18. Have you read and do you thoroughly un erstand the provisions of all laws, ordinances, and regulations governing the operati of Charitable Gambling games? yes 19. Attached hereto on the form Eurnished y the city of Saint Paul is a Financial Report which it .emizes all receipts, expense , and disbursements of the applicant organiza- tion, as well as all organiaations wh have received funds for the preceding calendar year which has been signed, prepared, and verified by Kevin I�fartineau 1�728 Gervais Avenue, Pla 1 wood, �1N 55109 Address who is the C EO of the applicant organization. Name 20. Operator of premises where games will be held: Name rtilitary Order oE tlie Pu le fieart C}ia ter #5 � Business Address 208 Veterans Bu ldin , St . Paul riN 55155 Home Address N/11 . :• - �Z�� „ Amount .of rent paid b a licant or anizat on for rent of the tiall: �� Y PP g $650 . 00/ month '.. The proceeds of the games will be disburse after deducting prize layout costs and operating expenses for the following purpo es and uses: Purcliase oF equipmeclt , everits and programs for mentally retarded adults to acquire vocational and community skills . . Has the premises where the games are to b held been certified for occupancy by the City of Saint Paul? Y es �. Has your organization filed federal form 90-T? N� If answer is yes, please attacti a copy with this application. If answer s no, explain whv: Merrick Booster Club Liles a 990 wl�icll is on file with city. y changes desired by the applicant associati n may be made �only with the cansent of the ty Council. � rlerrick Booster Club Organiza Name te 1/23/89 gy; Carl Falkow �te��' ,�,i • M ge a e o game . Organization President or CEO � � ^ � = z ^ = _ •, �. - � � � � _ :� � � � _ „ � ? n .+ ro '* S � '7 � � 7 (9 A � �1 .7 � ^ v � �. . , '0 " 't : • y �+ � � ,,� n 3 �e c n .. r+ � � 3 J 7. � r �.. C � -� 3 D C �e �o .+ r- n �-- "+ ; n 9 •a T � 3' S � � -� � � . � y j ,� -� � 3 7 n T a � � r� 3 n n ( ,,,� O � '� . •� . � , 3' A � I ' � � ^ . � �C � � )1 7� D d � �! � � r n 7 3i C .-► � r0 7 � ^ � 3 � = .. � .o m •9 9 � ; � ( , .,�� v v v 9 '!7 �< � ` � ! I n ^� -�7 „I :� � 7 �. '� I p ►�. � � � � .r a 1f ►•� ^t � /� 1+ f0 '� V = . I j � � � ^► n n �``�e I Y � -' I_ � ( � �- � n � ' a � :- � r - � � � � : 1 � � A ' , � I ^w 1\�� i 3 j � � � � _' � I q � r► � S S �'�� }l - n � I n � , � _ �a e � r -- r� 9 �1 � � y 7 e � a — Z I , � I � � � 7 m I �0 1 7 ^ � 1 C A 7 . � � 7 .� ' l � I 7 .. 1 1 -- --- . . . ...._ . : -:eqw� r N-.. .. - - , i�d�.9 � ' City Saint Paul � Department of Financ and Management Services /��/(f�r License an Permit Division C 20 City Hall St. Paul, Minn sota 55102•29&5056 APPLICATI N FOR LICENSE CASH CHECK" CIASS NO. New Renew a o . o < Date 3 19� � Code No. � Title of license From 19'�To ' 19� � C.�455t� ' �►�bl-� � . r ,00 }�P�r� L� E�os �r C�r�b �( � �T'r'1�1� ,(,Y � ApplicanUCompany Name ,o0 733 �r e��e� �c��Gr,� 100 Businesa Name ,� � ► . �awl� � � Business Address Phone No. 100 100 Mait to Address Phone No. �oo ]�P � r �� Gt r --��;t.oa c� ManaperlOwner•Name " 100 � ��~ �(; a� C�� ,s �a�v � 100 Alanager/Gwner•Home Addreas Phone No. 4098 Application Fee Received the Sum of 2Q100 � • + �((,� ( � sld �p{�p. g L) ManaflerlOwner•City,State 6 Zip 100 Tota 100 � . n ,`� LiCen3e InSpeCtor By: ( � Signature of Applicant Bond• ' Company Name Policy No. Expiration Oate Insurance: Company Name Policy No. Expiration Date . Minnesota State Identitication No. .3 ��0 Social Security No. Vehicle Informatio�: Serlai Number Plate Number Othef: THIS IS A RE EIPT FOR APPLICATIOM THIS IS NOT A LICENSE TO OPERATE.Your application for li nse will either be granted or rejected subject to the provisions of the zoning ordfnanCe and comptetion o(the in pections by the Healih, F re,Zo�►inq and/or License InspeCtor�. $15.00 CHARGE F ALL RETURNED CHECKS v �U�� h c �vs�� . rY� �733 �rer« ��`�(�f2,, �—��q � �i /