89-1623 WHITE - CITV CLERK
PINK - FINANCE GITY OF AINT PALTL Council /
CANARV - DEPARTMEN T //B�3
BLUE - MAVOR File NO. 'r
Council esolution ,��--
�
Presented By
Referred To Committee: Date �/�'�/�
Out of Committee By Date
RESOLVED: That application (IQ #3 082) for a State C1ass B Gambling
Cicense by St. Casimir' Church at Schwietz'S Bar, `
956 Payne Avenue, be an the same is hereby approved�e�-i-e�
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
�� [n Favor
Goswitz
Rettman p B
s�he;n�� __ A ga i n s t Y
Sonnen
Wilson
� � � � Form Ap vPd by Ci A rney
Adopted by Council: Date �
Certified Yas- ouncil re BY �
By, _
Approv Mavor. Date
� Approved by Mayor for Submission to Council
By BY
P�BI� ��� 2 � 1989
. • ��-/��3
DEPARTM[NT/OFFICE/COUNdL DATE INITI TED
Fi nance/�i cense GREEN SHEET No. 5Q6 4
�NTACT PERSON 6 PHONE �NITIAU DATE INiTIAUDATE
DEPARTMENT aREGTOR CITY COUNGL
Chri sti ne Rozek/298-5056 � c�rY ArroA� �GTY CLERK
MUST BE ON COUNpL I�C�ENDA BY(pAT� ROUTNIO BUDOET OIRECTOR �FIN.3 MOT.SEFiVICEB DIFi.
9-12-89 au►vop coR�sra�m ��aunci 1
TOTAL#�OF SIQNATURE PA�iES (q.IP AL LO ATIONS FOR SKiNATUR�
ACTION REOUEBTED:
Approval of an application for S te Class B Gambling License. �
Notification Date: $-23-89 Hearin Date: 9-12-89
RECOMMENOATt�18:Approvs(A)a RsJect(R) � �ORT OPTIONAL
_PLANNINO COMhNS310N _GVIL 8ERVICE OOMMI8SION ��YBT PHONE NO.
_qB COMMITTEE _
_3TAFF _ ���'
_DIBTRICT COURT _
BUPPORTS WHlpl COUNpL 08JECTIVE?
INITIATINO PROBLEM.188UE.OPPORTUNITV(Who.�Nh�t,WMn.WMro.NRM:
Jerry Tri on behalf of St. Casim r' Church requests City Council
approval of their application fo a State Class B Gambling License at
Schwietz's Bar, 95b Payne. Avenue roceeds from the pulltab sales will
be used for St. Casimir's Church an School . A11 fees and applications
have been submitted.
ADVANTAOE8 IF APPROVED:
If Council approval is given, St. C imir's Ushers Club will operate
a pulltab booth at Schwietz/s Ba .
DISADVANTAQES IF APPROVED:
DISADVANTIU�ES IF NOT APPROVEO:
Council Research Center.
AUG 2 5 i989
TOTAL AMOUNT OF TRANSACTION = COST/REVENUE StlDQBTED(dRCLE ONE) YES NO
FUNOINd SOURCE CTIVITY NUMBER
FlNANqAL INFORMATION:(EXPWN)
r �
. Ztii l,'' � '
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIOMAL
MANUAL AVAILABLE IN THE PURCHASINO OFFICE(PHONE NO.29&4225).
ROUTINCi ORDER:
Bslow are preferred routinqa for the flvs nwat freq�M typea.of docum�nb:
CONTRACTS (essumss aud'w'lud COUNqL RESOI.UTION (Amsnd� Bdgts./
budgst exbts) Axe�. Grants)
1. Outside Agsncy 1. Dsp�rtmsnt Dinctor
2. Initfating Department 2. 8udpst Dinctor
3. City Attomey 3. (�ty Attornsy
4. Mayor 4. May�odNNetaM
5. Finance 8�M�nt Svcs. Director . 5. qy Council
8. Finar�ce AccouMin� 6. Chisf Mcountent, Fln 8�Mgmt Svcs.
ADMINISTRATIVE ORDER (Budgst OOUNqL RESOLUTION (ell othere)
Revisbn) and ORDINANCE
1. Activity Manapsr 1. IniHatinp DepeRmeM Director
2. DspertmsM/1CCOUritant 2. �Y�►�eY
3. DspartmaM Dfrector 8. Mayori/lalstant
4. Bud�et Director 4. qty CouncU
5. City qerk
6. Chief Accountant, Fin�Mgmt Svcs.
ADMINI3TRATIVE ORDER3 (all ahsrs)
1. Inkiating DepartmeM
2. City Attomey
4: �yor�stant
TOTAL NUMBER OF SIC3NATURE PAOES
Ind�ate the A�of pagss o�wh�h signatures are required and e�roli
each of these pages.
ACTION REGIUE3TED
Dssc�ibe what ths projectlnquest ssdcs to ac;complish In sither chronolopi-
cal order or ader of impoRencs,which�var is most appropriate tor ths
issue. Do not write complste ssntsnces. Begfn each kem in your Nst with
a�rb.
RECOMMENDATION3
Complete if.the issw in question has been preaented before smr body, pub8c
or privats.
SUPPORTS WHICki COUNdL OBJECTIVE?
Indicate which Coundl objscxive�e)your project/request aupports by listing
Me key word(a)(HOU31NCa,RECREATION, NEI(�HBORHOOD3, ECONOMIC DEVELOPMENT,
BUDGET, SEWER SEPARATION).(SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
COUNCIL COMMITTEE/RESEARCH REPORT-OPTIONAL A3 REOUE3TED BY COUNCIL
INITIATING PROBLEM, 183UE,OPPORTUNITY
Explain the aituatbn or oondiGOna that created s need for y�our project '
or reqt�eat.
ADVANTAt3ES IF APPROVED
Indicate whether this is simpy an annual budget procedure requirod by law/
chaRer or whsther thsrs are spscNic wa in which the City of 8aiM Paul
and ita citizens will bsneflt from thia pro�ecUaction.
DISADVANTA(iES IF APPROVED
What negative effecta or major charpes to sxisting or paat processas might
thia projecUrequest produos if it is peped(e.g.,traffic delays. noiae,
tax incresaes or asaeesmenta)?To Whom?When1 For how bng4
DISADVANTAGES IF NOT APPROVED
What will be the negative consequences ff the promised action is not
approved? Inabiliqr to deliver service?ConUnued high trafffc, nolee,
acddent rate? Loas of revsnue�
FlNANqAL IMPACT
Althou�h you must tailor the informetfon you provide here to the issue you .
are addr�aing,in pensral you must anawer two questions: How much is it
qoing to cost?Who is going to pay?
� � � � ���-��-� 3
DIVISION OF LICENSE ANI) P�:RMIT ADTIINIST TION DATE � �!a C� / � �l p y
INTERDF.PARTI�fENTAL REVIEW GHECKLZST A.ppn Processed/Receive by
Lic Enf Aud
•_�., � (�
Applicaut ��yN � r''� _ Home Address %��.P , ps�, �,�eJ
T`
Ru s ine s s Name ���• C/�S���'1 i i S U"1 u✓,�/� Home Phone ��� —'�5 �Z
Business Address SC h WI��ZS ��'' Type of License(s) ��C�,� �--
Business Phone �s�O �a���� �t,�2� C1qt-rib��,-,�, �h�JPS�• fie�
Public Hearing Date ��lZ�g�j License I.D. 4{ 3 �� ga---
at 9:00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �� ���
llate A'otice Sent; Dealer 4f IJ�A
to Applicant ____��/ "''
rederal Firearms 4� � I�
Public He<iring
DATE TNSPECTI N
REVtEW VERFIED (COfiIPU ER) COMMENTS
Approved Not A roved
�
Bldg I & D �
� � ,
Health Divn. '
; ►�(� '
�
Fire Dept. � �
; Nla I
+ f
Police Dept. �,r�
6�?-,I�y i
�
License Divn. !
�I��I� ; ���
City Attorney �
�I�-�I�� � ��
:
Date Received:
Site Plan ti `�} '
' To Council P.esearch g c�,J`� ��_
Lease or Letter Date
f rom Landlord f-��f�'
� - .. � . � . . .. . �' .i�{':
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
�
Stockholders:
. . - . �;��y=��,�.�
Citq o Saint Paul
Department of Finan e and Management Services
� Division of Licens and Permit Registration
INFORMATION RE IIIRED WITH APPLICATION FOR ERMIT TO CONDUCT PULLTAB/TIPBOARD SALES IN
SAINT PAUL (Class B Gambling License in L uor Establishments - New Application)
1. Full and complete name of organizatio which is applqing for license
' S Cj �,���
2. Does your organization meet the defini ion of a "large" organization as outlined in
the November, 1988 revision of Sect�on 409.21 of the Legislative Code? �f� _
Attach to this application pertinent f nancial and/or organizational information. to
support your answer to this question. NOTE: Only 5 large organizations will be allow-
ed to open pulltab operations under th revised city ordinance. If more than S organi-
zations apply, qualified applicants wi 1 be selected randomly by the City Council.
3. Address where games will be held �� 1- � �j. ` ' �l/
N ber Street City Zip
4. Name of manager signing this applicati who will conduct, operate and manage
Gambling Games ���E� � ! Date of Birth �-/� �' .3.3
(a) Length of time manager has been mem er of applicant organization / 7 Y,�,S.
5. Address of Manager S i � c, - ���
Number Street City Zip
6. Day, dates, and hours this application s for�,i;�,f� 7',�,y�,�/ ����,�QA� -/O.'�D�iN Tv/��
7. Is the applicant or organization organi ed under the laws of the State of MN? �S
8. Date of incorporation � ` Lt
9. Date when registered with the State of innesota /�F`�p
10. How Iong has organization been in exist ce? j Q�i �/„�'
11. How long has organization been in existe ce in St. Paul? /O tj y,ES
1Z. What is the purpose of the organization? ,�G/G�od S
13. Officers of applicant organization:
Name GEN� //�S��tK N�e ED GLi.S'k-�
Address /� �� G,Q�S�f,Qjy� Address �(o�,l c�. 7'/1�/.GD ST.
Title P/�SiaC,r�f DOB /C9��v 3 Tit1eT,Qc��t.e�TL DOB �-��i�
T'
Name o23� ��GA�Du/S�/ Name �c-2�2� T2/
Address //.�/ SE�J�"s /�►YC_ Address ��� �. �C�'.s.�i�i�t
Title y,c,c: �,�s, DOB '7-��-a?7 Title�/�A/dL1�+G �i�iLl DOB �i-/l0--3.3
' � ��j--/(�.?.3
14. Give names of officers, or any other ersons who paid for services to the
organization.
Name Name
Address Address '
�Title Title
(Attach separate heet for additional names.)
15. Attached hereto is a list of names and addresses of all members of the organization.
16. In whose custody will organization's r cords be kept?
Name �E T Address 9�.,< �. �'c�/3�J.�c,rf �i/C
17. List all persons with the authority to sign checks for dispersal of gambling proceeds:
Name � i S C Name �G�c �i�.Si cl K
Address �/ C � � Address 1�2�-�;, G�2��/f/1/�'j
Member of Member of
DOB JO-�r .j� Organization? c S� DOB ,�? -�j0 -�,j Organization? Y�S
Name .�C,Q„e T i Name
Address ,S' /.t� � ' . Address
Member of Member of -
DOB �j-/(d^�3 Organization? c.%S DOB Organization?
18. Have you read and do you thoroughly und rstand the provisions of all laws, ordinances,
and regulations goveming the operation of Charitable Gambling games? Y�S
19. Will your organization's pulltab operat on be operate managed olely by members of
your organization? yes i� no
20. Has your organization signed, or does, it intend to sign, a consulting agreement or a
managerial agreement with any person or ompany to assist your organization with the
pulltab sales and/or recording keeping? yes no �"
If answer is yes, give the name and addr ss of the person and/or company contracted.
Name Address
Name Address
If answer is yes, how will such a consul ant be paid? (percentage, flat fee, gambling
funds, general fuads, etc.) Attach a co y of said contract to this application.
21. Operator of premises where games will be eld:
Name � . SG'.N�i � Z
Business Address � A� � c . •�� � � .s a ia
Home Address o ' '.� n� G Ll�ff/ c cfi� N_ �i/d
� -..--+—-. s� r-+�e- : . -.,y-�.-.a-�s.-�s�:wLTa`ass�'_w..� �-_- . . ._r .._ .__ '—___.-.-�..e,.-. . .--...-r- -.a. . _ . .__ , -�.. .. .. - ._ _
Cit of Saint Paul �o � "�
Department of Finan e and Management Services C����'Z.3
License a d Permit Division
2 3 City Hait
Si. Paul,Min esota 55102-29&5056
APPLICATI N FOR LtCENSE
CASH CHECK CIASS NO. Ne Renew� �
a c� .. - : � : � �.� � : . / � � _
_ , � Oate- ���I� 19�
, . . . .
. _ �����
� 22. a) Does your organization pay or inte to pay accounting fees out of gambliag funds?
yes no
b) If you do pay accounting fees, to om will such fees be paid?
Name Address
�DOB Member of Org nization?
c) Sow are the accounting fees charge out? (flat fee, hourly, etc.)
d) What do you anticipate will be pou average monthly deduction for accounting fees?
23. Amount of rent paid by applicant organ zation for rent of the hall:
� �
G`� c_�' �c
24. The proceeds of the games will be disb sed after deducting prize layout costs and
operating expenses for the following p poses and uses:
G'lfct2G il//l �S"G�.�c�trt�.
25. Has the premises where the games are to be held been certified for occupancy by the
. City of Saint Paul? c'S�
26. Has your organization filed federal fo 990-T? �Q_ If answer is yes, please attach
a copy with this application. If answe is no, explain why:
�7' /yJr S Tff � t ��tS
Any changes desired by the applicant associat on may be made only with the consent of the
City Council.
e5'T• L-,i�Si.►�i•es G���u/
Organization Name
.
i
Date "�`f"cyj' By: �-�,
Man er in charge of game
, ,r��/
" rganization President or CEO
�
. .
' ��-/�z 3
State of Minnesota )
� ss � .
Count of Ramsey ) . .
��
e ng dul orn, say _that e_is
(are) the petitioner _in the ove appli-
cation; that he has read he forego-
ing petition and know the conten s thereof;
that the same is true of _h_ o knowledge.
Subscribed and sworn to before m this
/(o � day of (,l.u--� 19 �
���
`""` Alice I�. Jansen
r
. (=�'��f^.�:
��NOTARV PUBLIC-M�NNESOTA
' �+a�y.;._':
. Y�
-�`,r.„,:.•+° WASHINGTON COUNTY
MY COMMISSION EXPIRES APR. 2S, 199Z
l .�,�,.i.i..v..
Q�A K ,
Notary Public, Ramse County, Miniesota
My commission expires � • �.