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89-1654 WHITE - C�TV CLERK PINK - FINANCE G I TY O F A I NT PA U L Council � CANARV - DEPARTMENT BLUE - MAVOR File NO• �` C uncil esolution "�~` �q Presented By � Referred To Committee: Date Out of Committee By Date RESOLVED: That application (ID #1 035) for a State Class B Gambling License by Phoenix Lear ing Services, Inc. at Joseph's Bar, 537 State Street, be an the same is hereby approved��'. COUNCIL MEMBERS Requested by Department of: Yeas Nays Dimond I.o� [n Favor coswitz Rettman O B �hQ1�� Against Y Sonnen Wilson s'�P � :f �9�� Form Ap roved by Cit Attorney Adopted by Council: Date . � h�/ �� Certified Pa s d y Council cre By . gy, A►pprov �Nav • SEr � � �8� Approved by Mayor for Submission to Council B�\ � o o J� � By � P�{� S�P 2 31989 : � �-,�� DEPARTMENT/OFFlCEICOUNqL DA INI TED Finance/�icense GREEN SHEET No. 5��8pA� OONTACT PERSON R PHONE a pEPARTMENT DIREGTOR �CITY COUNqL Chri sti ne Rozek 298-5056 � �CITY AITORNEY �CITV q.ERK MUBT BE ON COUNCIL A4ENDA BY(DATE) �BUD(iET DIRECTOR �FIN.d MOT.SERVICES DIR. 9-14-89 ❑w►voR coR nsssisr,�wn Q '1 R TOTAL#�OF SIONATURE PAGE8 (CLI A LOCATIONS FOR SIGNATURE� ��E���pproval of an appl i cati on f r State Cl ass B Gambl i ng Li cense. Notification Date: 8-31-89 Hearing Date: 9-14-89 �ECOMMeNOnnoNS:nva►ow W a ayscC(p� COU IL MITTEE/RESEAiiC11 REPORT OPTIONAL _PLANNINO OOMMISSION _CML�RVICB COMM18810N ANAL PM10NE NO. _GB WMMITfEE _ _BTAFF _ OOMM NTS: _DISTRICT COURT _ SUPPORTS WNICN COUNGL OB,IECTIVE7 INITIATIPKi PROBLEM.18SUE.OPPOATUNIIY(Who.What,Whsn,Whers,Wh»: Kathleen J. Blachfelner on be a1 of Phoenix Learning Services, Inc. requests City Council approva1 of thei a 1ication for a State C1ass A Gambling Licen�se at Joseph's Bar, 537 State Str et. Proceeds from the pulltab sales will be used to benefit deve1opmental1y dis bl d persons in areas where funding for community opportunities is not available 11 fees and app1ications have been submitted. ADVAN'fAOES IF APPHONED: If Council approval is given, ho nix Learning Services, Inc. will operate a pulltab booth at Joseph's Ba a 537 State Street. asaev�wrnc�es�nr�ovEO: DISADVANTAOES IF NOT APPROVED: Council Research Center S E P 11989 TOTAL AMOUNT OF TRANSACTION COST/REVENUE StlDOETED(CIRCLE ON� YES NO FUNDING SOURCE ACTIVITY NUMBER FlNANGAI INFOHMATION:(EXPWN) . . ��.��s� DiVISION OF LICENSE AND Pk;RMIT A.I)MIN STRATION DATE � �'� (��/ 7 � 7 � / INTERDF.PARTMENTAi, REVIEW CHECKLIST A.ppn Proc ssed/Received by , ► ��-hleen ���Gh-�e�fn�r Applicant �oen�x. Lea,rrl�� �Vtfd Home Address a7� �. Shell�n�! Rusiness Name p }1,S �Q�' �� Home Phone CQy� �9a u3 ' Business Address �5�� Type of License(s) �� �( �j � � � ) Business Phone ���` ��� C`"1C(,/71b�1�'wj �� �/n,S� � NP Public Hearing llate 1 �y 1 a � License I.D. 46 1 � � � at 9:00 a.m. in the Council Chambers, 3rd floor City Hall and Courthouse State Tax I.D. �t N�A' llate Notice Sent; Dealer �� � '�' to Applicant o��� a rederal Firearms 46 N /� Public He�.�ring DATE INSP CTIUN REVIEW VEKFIED (C UTER) CUMMENTS A roved N A roved � Bldg I & D � u��r Health Divn. ' �I� , i Fire Dept. � � ; NI� I ! Se n.-� I�/ � � g� Police Dept. I ��3� q �� � License Divn. � gl�I�`I i 0 �L City Attorney � g I2�1`�± ��. Date Received: Site Plan � i�" —�`� C To Council P.esearch ( Lease or Letter Date from Landlord � '� City of Saint.Paul ���/�'y� Department of Fin nce and Management Services Division of Lice se and Permit Registration INFORMATION RE UIRED WITH APPLICATION 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 organizat on which is applqfng for license , Phcenix Learning Services, Inc. 2. Does your organization meet the defi ition of a "large" organization as outliaed in the November, I988 revision of Secti n 409.21 of the Legislative Code? Attach to this application pertinent financial aad/or organizational information to support your answer to this question NOTE: Only 5 large organizations will be allow- ed to open pulltab operations under he revised city ordinance. If more than 5 organi- zations apply, qualified applicants ill be selected randomlq by the City Council. 3. Address where games will be held 53 State St. , St. Paul, I�i Number Street City Zip 4. Name of manager signing this applica ion who will conduct, operate and manage Gambling Games Kathleen J. Blachf lner Date of Birth 8/5/44 (a) Length of time manager has been mber of applicant organization 9 years 5. Address of Manager 1771 Janet Ct. Arden Hills, I�A1 55112 Number Street City Zip 6. Daq, dates, and hours this applicatio is for 7 days/wk� 11:30a - 9:30p 7. Is the applicant or organization orga ized under the laws of the State of MN? Yes 8. Date of incorporation 4/22/71 - 9. Date when registered with the State o Minnesota 4/29/71 10. How long has organization been in exi tence? 18 years 11. How long has organization been in exi ence in St. Paul? 18 years 12. What is the purpose of the organizatio ? To create projects and opportunities for the benefit of developmentally d'sabled persons to provide a "second chance" 13. Officers of applicant organization: Name Sandra Bjornstad N�e KathleEii BiacY:feln�r Address 1729 Hague Ave - St. Paul, t�Il�i Address 1771 Janet Ct., Arden Hills, Nt�i Title �'es/Treas �B 1/]..7/55 Title � Me�er D�g 8/5/44 Name �rol Peitzman N�e Elizabeth Henderson Address 1255 N. Dale, St. Paul, tMT �d1eS8 2438 Grand Ave. S., Mpls, NR�1 Title �D Member D�B 10/11/59 Title �D Member DpB 7/21/61 � � �����Gy� 14. Give names of officers, or anq oth r persons who paid for .services to the organization. � Name Name Address Address �Title Title (Attach separ e sheet for additional names.) 15. Attached hereto is a list of names nd addresses of all members of the organization. � 16. In whose custody will organization' records be kept? Name �thleen J. Blachfelner Address 1771 Janet Ct., Arden Hills, NIDi 17. List aIl persons with the authority to sign checks for dispersal of gambling proceeds: Name Kathleen J. Blachfelner N�e Sandra Bjornstad Address 1771 Janet Ct, Arden Hills, NII�i Address 1729 Hague Ave, St. Paul, NIDI � Member of Member of DOB 8�5�� Organization? eS Dpg 1/17/55 Organization? Yes Name Name Address Address Member of Member of DOB Organization? DOB Organization? 18. Have you read and do you thoroughly derstand the provisions of all laws, ordinances, and regulations governing the operat n of Charitable Gambling games? Yes 19. Will your organization's pulltab oper tion be operated/manag�d solelq by members of your organization? yes no X 20. Has your organization signed, or does it intend to sign, a consulting agreement or a managerial agreement with any person r company to assist your organization with the pulltab sales and/or recording keepin ? yes X no � If answer is yes, give the name and a dress of the person and/or company contracted. Name Phil Ravitz Address 179 E. Robie� St. Paul, NIlV Name Address If answer is yes, how will such a cons ltant be paid? (percentage, flat fee, gambling funds, general funds, etc.) Attach a opy of said contract to this application. Flat fee from gambling funds 2I. Operator of premises where games will e held: Name Dor►ald Joseph Business Address 537 State Street, S . Paul, N11V Home Address 615 Front St., Huds , WI 54016 . . � ����5� 22. a) Does your organization pay or ntend to pay accounting fees out of gambling funds? yes X no ' b) Zf you do pay accounting fees, o whom will such fees be paid? Name Peter LeNeau Address 7124 Grimes Ave N., Brooklyn Ctr, NIDT �DOB 1/19/54 Member of Organization? X c) How are the accounting fees ch rged out? (flat fee, hourly, etc.) Flat fee d) What do you anticipate will be your average monthly deduction for accounting fees? Approx. $100 for annual audit 23. Amount o rent paid by applicant o anization for rent of the hall: $600/month ��Q Q fl n 24. The proceeds of the games will be d sbursed after deducting prize layout costs and operating expenses for the followin purposes and uses: To benefit developmentally disabl persons in areas where funding for community opportunities is not ava'lable; ie. sports, art, recreational, scholarships, etc. 25. Has the premises where the games ar to be held been certified for occupancy by the City of Saint Paul? Yes - 26. Has your organization filed federal orm•990—T? � If answer is yes; please attach a copy with this application. If an wer is no, explain why: Our gross receipts have consistentl been under $25,000 Any changes desired by the applicant asso iation may be made only with the consent of the City Council. Phoenix Learning Services, Inc. Organization Name � � �- � � � �-- � � „ Kathleen J. B°lachfelner Date By: Manager in charge of game _ � zation President or CEO .. . ._ _ . -,_' ` , '. �,,'-�-`"'- . �z' -., '?b. '�Fnv� ,a>w_'.:-_ . .. . . .. ._. .., . � � /�3S ity of Saint Paul Department of Fin nce and Management Services /a�/G� Licens and Permit Division (�/`'' 203 City Hall St. Paul, innesota 55102-29&5056 APPLICA ION FOR LICENSE CASH CHECK CLASS NO. ew Renew 0 � 0 ^�� Date 19� Code No. , Title of License From —� 19�To —�� 19� „ � ` 3 �. - ' � 1� hven� x ✓y��r�� �.Y�IJ�(P� �� ��Z�. ApplleanUCompany Name ,00 � ��.Z 100 8usiness Name ,� ,�—�� �?�� �'� d� Business Address Phone No. 100 ` � � • 1 �r�l.t� I ILl �1 100 Mail to Address r Phone No. ,� ���-(h l�,; .J. �[G�.1�-�:l��r-- ManaperlOwner•Name / (�� �� • �� �� o�� f�J. �Y1e���n�/ qa �3 100 Alanager/Gwner•Home Address Phone No. 4098 AppliCatfon Fee Z � Recelved the Sum of 100 S'-"�• �'�'G(,� � � ��� r�C7� .ManapedOwner•City,State d Zip Codn- _ 100 Tota 100 � ) ' . a=� t�.,, �� ,��*-c LiCBnse InspeCtOr � By: v � Signature of Appli�ant Bond• ' Company Name Policy No. Expiralion Date Insurance: Company Name Policy No. Expiratlon Oate Minnesota State identification No. Social Security No. Vehicie Information: ' Serlal Number P►ate Numbar Other: THIS IS A REC PT FOR APPtICATiON THIS IS NOT A LICENSE TO OPERATE.You►appiication for Iice e will either be granted or rejected subject fo the provisions of the zoning. ordfnance and completion of the inspections by the Health, Fire Zoninq andlor license Inspectora. $15.00 CHARGE FOR LL RETURNEO CHECKS .� 7 a ?�P9 � � / � 0,� . ������ TO E COMPLETED BY ORGANIZATION PRE IDENT AND GAMBLING MANAGER � � I understand and will uphold Sa'nt Pau1 Ordinance 409, Sections 409.21 and 409.22 relating to pulltabs and tipboards in bars. Further, I understand that my j rbar must meet city standards; that 10% of the net profit from pulltab ales must be returned to the City-Wide Youth Fund on a monthly basis; hat monthly financial statements must be filed with the City; and that 5 % of net proceeds must remain in St. Paul or be used to support St. Paul esidents. � ���,�.�.. �� Signature - Ma ger Sign tur ' r� anization Presid t /G�/ti►+�t �!/f�� � rganizat�on ame � .�3� ��� �f_ �f p� r-� � Gamb ing Location � -��s' �9 . Date Please retain the tached ordinance for your records.