89-1730 WHITE - CITV CLERK COIlI1C11 \/� / � /��
PINK - FINANCE
CANARV - DEPARTMENT GIT OF SAINT PAUL �� , l
BI.UE - MAVOR File NO. �� v
--� ,Co, cil Re�y.l�tion , _ ..-�
� ,, ���
Presented By �
; � �._- . _ .. .-
Refer d To Committee: Date
Out of Committee By Date
RESOLVED: That applicatio (ID #28774) for renewal of a State Class A
Gambling Licens by North End Boxing Association at
1079 Rice Stree , be and the same is hereby approved/��
COUNCIL MEMBERS
Yeas Nays ^ Requested by Department of:
Dimond `�� ;
�� [ Favor �
•6eavi�a
�� � _ A ainst BY
Sc6eibel
Sonnen
Wilson
Adopted by Council: Date �� � � Form Approved by Cit Attorney
Certified P . by Coun ' S t BY -�� ���
By,
Approved by � vor: ate _ � � � � Approved by Mayor for Submission to Council
i
gy � ° `�_..... �-� � BY
p�t��!� G G T 1989
. � , � �- g� i�30
DEPARTM[NT/OFPtCE/COUNdL TE INITIATEO
Fi nance/�i cense GREEN SHEET No. 5041
OONTACT PERSON 3 PHONE INITIAU OATE INITIAUDATE
DEPARTMENT DIRECfOq �CITY OpUNpI
Chri sti ne Rozek/298-505 � cm nrro�EV 0 ciTr c�RK
MUST BE ON(�UNCiI AOENDA BY(DAT� �BUOOET DIRECTOR �FlN.8 MOT.BERVI(�8 DIR.
9-26-89 �tiu►va+coR nesisr,�wn ��au.a�i 1
TOTAL#�OF SIONATURE PAGES ( P ALL LOCATION8 FOR SIQNATUR�
�cT��ou�o: .
Approval of an applicat on for renewa1 of a State Class A Gambling License.
Notification Date: 9-8 89 Hearin Date: 9-26-89
�oo�on :�»t�►��� aa�r+�o�r o�oN�u.
_PWVNINO�AMYM88bN _CIVIL SERVIC�COMMIBSI AlVBT PHONE I�.
_CIB COMMIITEE _
_STAFF ( _ MENT8:
_DISTRICT OOURT _
8UPPORTS WFNCH OOUNdL OBJEC71VE9
INfTIATiNfi PFiOBLEM.ISBUE.OPPaR7'UNITY(Who�What�YVINn� � ):
Frank Murawski on beha1 o the North End Boxing Association requests
City Counci1 approva1 o t ir app1ication for renewal of a State Class A
Gambling License at 1079 Ri e Street. Proceeds from the pul1tab sales are
used to promote amateur ox ng. A11 fees and applications have been
submitted.
ADVANTAOES IF APPROVED:
If Council approva1 is g've , North End Boxing Association will operate
a pul l tab booth at 1079 i c Street. RECEIVED
SEP 131989
TY CLERK
DISADVANTA(3ES IF APPROVED:
OISADVANTI�ES IF 1�T APPROVED:
Cour�cil �tesearch Center
SEP 12 i°89
TOTAL AMOUNT�TRANSACTION : COST/REVENUB BUOOETED(qRCLE ONE) YES NO
FUNDMKi 80URCE ACTIVIT1f NUMSER
FlNANpAL INFORMATION:(EXPWN)
� , � . . . � �Q-/73o
DIVISION OF LICENSE ANI) PERMIT A INISTRATION DATE � �� � ! / g j7 �
INTERDF.PARTMFNTAL REVIEW CHECKLIS Appn rocessed/Receiv d by
Lic Enf Aud
Applicant �V(��� � I�J� � In �-SSOC— Home Address ��� g CUvn�/ IG�► �
Rusiness lv'ame p,� ��� n ��� Home Phone ��"l� � �pS v�
Business Address 16 9 �Ci� Type of License(s) C� �QSS/� '
Business Phone Glimbl�►^q �h t�C�S�� �e�
Public Hearing Date q Z(o g License I.D. 4i a ,�7��
at 9:00 a.m. in the Council C am rs,
3rd floor City Hall and Courthous State Tax I.D. �� �� 7 ��Z�°
llate A�tice Sent; Dealer �1 �I/�
to Applicant -`�8
rederal Fi_rearms 4� �
Public Hearing
DATE 'SPECTIUN
REVIEW VERFIE (COMPUTER) CUMMENTS
A proved Not A roved
�
Bldg I & D �
N �-
Health Divn.
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i
Fire Dept. � I
i � �
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Police Dept. I �n� �l� I o � �/�
� � Z g5 �/L
License Divn. , �I�I�
i
' �/�.
City Attorney �
(� ,� , 6�c,
Date Received:
Site Plan � 0 � � C� Q
To Council Research ��
Lease or Letter � D te
from Landlord � � ��
. . . . Gt-� S-�'l-/ 73 O
' ' City of Saint Paul
Finance and Manag ment Services%License & Permit Division
INFORMATION REQUIRED WITH APPLICAT ON FOR PERMIT TO CONDUCT CHARITA.BLE GAMBLI�G GA,KE I:1
SAINT PAUL (To be used with the f llowing: New A & C application, renew A & C
Licenses, and new and renew B in P ivate Clubs.)
l. Full and complete name of org nization which is applying for license _
,��.� ��C� SS ' '�r
g � f�,�C� �It"e�� S,� � .�Si/�7
2. Address where ames will be h ld � 9 rn� �
Number Street City Zip
3. Name of manager signing this pplication who will conduct, operate and manage
Gambling Games � ,� Date of Birth % "�`�/
(a) Length of time manager ha been member of applicant organization ✓
4. Address of Manager � -- S ', 91,= s� /
Number ' Street City Zip
5. Day, dates, and hours this ap lication is for � )C?C!� �t�� ;J /'� ' ���.G�
6. Is the applicant or organizat ' n organized under the laws of the State of MN? �
7. Date of incorporation -/ � �O�
8. Date when registered with the tate of Minnesota / �� �.�
9. How Iong has organization been in existence? ��-
10. How long has organization been in existence in St. Paul? ��(�
,�� � l�,
11. What is the purpose of the org ni2ation? K�O�i
7
12. Officers of applicant organiza ion:
�-c�w , /
Name , ��✓� Name �� C�/ Z 'f�
Address �T� 7 �C /C�' � Address /�()q t��1�j[�//'�
;�1 c �y /
Title DOB 9 �- 3 Title f ►'Q����.(� DOB O `v�/�b�
Name Name
Address j/Q 9 n-�d��/� Address
Title �iCe�(1(�5.�/P,,,�DOB '���3� Title DOB
13. Give names of officers, or any other persons who paid for services to the
organization.
Name Name
Address Address
Title Title
(Attach se arate sheet for additional names.)
� � . . �' S�-/7�30
14. Attached hereto is a list of es and addresses of all members ot the organization.
15. In whose custody will organi2 ion's records be kept?
Name �/ .ti�� � ,S Address ���� ���/'��'�'��,,�
16. List all persons with the auth rity to sign checks for dispersal of gambling proceeds:
'Name �irQ,+'�C �t-cX2tR:,� Name
Address � ���.t.�'1 b�'( — , .•� Address
, Member of Member of
DOB ��,��-�...� Organizatio ? � DOB Organization?
Name � �-� .l3 �n Name
Address �� nl�,e ` ,/�, Address
Member of Member of
DOB ��� � �� Organizatio ? ��� DOB Organization?
17. a) Does your organization pay r intend to pay accounting fees out of gambling funds?
yes )C no
b) If you do pay accounting fe s, to whom will such fees be paid?
Name _ �G�S�T'j Address ��o�U ��-�'�C r'plsj'e �J��i�l�.
DOB ( (b Membe of Or anization. �����' m�i
U� �4-�l g ' �
c) How are the accounting fee charged out? (flat fee, hourly, etc.)
(.�C ��.�
18. Have you read and do you thoro ghly understand the provisions of all laws, ordinances,
and regulations governing the peration of Charitable Gambling games? t../��.
19. Attached hereto on the form fu nished by the city of Saint Paul is a Financial Report
which it .emizes all receipts, xpenses, and disbursements of the applicant organiza-
tion, as well as all organizat ons who have received funds for the preceding calendar
year which has been signed, pr pared, and verified by �(�v'�i�.�'('7�; C1�Lu�f"
�cc..r' r i �� -� ✓�'1 (l:j S�
dd ss
who is the �LC�_O� �� of the applicant organization.
Name
20. Operator of premises where gam s will be held:
Name ('� �� . �M V l._.���._ h-i v�F'.y«-��`�av✓�
Business Address ��� C � e�- ��• � � �
Home Address
� . - . . . � 8`�- ��.�o
"L1. Amount of rent paid by appli nt organization for rent of the hall:
�G ��' �S i U
22. The proceeds of the games wil be disbursed after deducting prize layout costs and
operating expenses for the fo lowing purposes and uses:
, G � � �'' �r �'�,
� � �
23. Has the premises where the ga es are to be held been certified for occupancy by the
City of Saint Paul?
24. Has your organization filed f deral form 990-T? � If answer is yes, please attach
a copy with this application. If answer is no, explain why:
�)'_ '� ` V�t2 � ! ��-t� ' f 2J 2_i/l t.l E��f' C�� 1 I✓'-EL,.��
F� � (� � C�. U 4� N�
Any changes desired by the applica t association may be made only with the consent of the
City Council.
�CRT�► �/V'�l lf:�ax��v c-- R ssn:
Organization Name
Dat e -�1'- I `7�� �9 By����'��� (� �hi_t���c,u..,�4..:
M ager in charge of game
� �,(�,
n
Organization President or CEO
,\
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City of Saint Paul
Department f Finance and Management Services
cense and Permit Division � S9- /7 3 (�
203 City Hall
S Paul, Minnesota 55102-298-505&
. AP LICATION FOR LICENSE
CASH CHECK CLASS NO. New Renew
a � o � _
Date 19.�
Code No. , Title of License �?1�
From ��'/T 19�To 19�
i ^� +
, �
� ��
' , �'I ��t�!(�� ApplicanUCompa�y Name � .
100
�� /'�:��
- 100 Buslness Name
100 i
Busin ss Address Phone No.
100
�//,� ����.-�'��,��, �7
100 T tviailloAddress —�PhoneNo.
`� �I�9-a�.,�...� .
� � �
,00 --�Y/��-:�'� � �r/��!.�iS-�C-G�e�- .-��
ManagerlOwner•NaJn
�� v
(Ki�l��/�l C-rY �—
100 A�anagerfGwner•Home Address Phone No.
4098 Application Fee 2, 50
Re�eived,the S of 100
��(,,�l.Q���Yo����.Gt[.�j2..Q �t� � ManagedOwner•City.Stale S Zip Code,�
. 100 Total 100
/� 1 i
. �� J �'.�.�/) J/k,Gc,�oG�
LiCense Ins ector 8 . �f
P Y' �� Sig�ature of Applicant
Bond:
Company Name Policy No. Expiration Date
Insurance:
Company Name Polity No. Expitati0n Dafe
Minnesota State Identification No. � Social Security No.
Vehicle Information:
Serial Number Plate Number
Other:
THIS IS RECEIPT FOR APPLICATION
THIS �S NOT A LICENSE TO OPERATE.Your applicatio for license will either be granted or rejected subject to the provisions o!the zoning
ordlnanCe and completion of the inspections by the He Ith, Fire,Zoning andlor License Inspectors.
$15.00 CHARG � FOR ALL RETURNED CHECKS
.� 8/����9 � 7-� ��- .
. _ . . �' S`l- /73a
City of Saint Paul Page L
Oepa ment oE Finance end Hanagement Services
Divi on of Licenee and Permit Administration
(7NL CNARItABLE GAMELING FLNANCLAL REPORT
oaee 8/10/89
1. Name of organization ORTH END BOXING CLUB
2. Addcese vhere Charitab Cambling in conducted
NORTH EiVD IMPROVEMENT CLUB
3. Report for period cove ing NOV 1 l9 88 through JULY 3� 19 89
4. Total number of days p ayed 4�
S. Croee ceceipte for abo e period S 134� 088 . 15
6. Gross prize payouta fo above petiod (includa cash ehort) � 1 1 3 ,4 3 9 .��
7. Net receipts - line S inue line 6 � 2�, 649 . 1�
8. Expensee incurred in c nduceing and operating game:
A. Gross wages pald. Attach vorker liet vith 4862 . 98
names, addresses, roes vages, number of houie �
vorked, and amount paid pec hour.
B. Rent for ae ks z 3135 . 00
� 100 . 00
C. License fee -
b. Lnsurance S 3 3 5 . 7 2
E. 8ond ; 1�� • ��
. F. Dishonored checks ot recoveted ; �9 j .��
G. Accounting Expense = 700 •��
H. Employere f.L.C.A. IN GROSS WAGES ;
I. Pulltab Tax Paid t Deparement o[ Revenua ;
812 .70
1. Hinn. U.C. Tax IN GROSS WAGES ;
. (C. Pederal Exciae Tauc b Stamp ;
L. State Cambling Tax ; ?567 .74
H. Hiecelleneoua Expe eee. Identifr tha amount
and to vhoe paid.
t.ADVERTISIN S 58 . 86
Z.EQUIP. &�1AI T . s 48 . 53 _
3, ItVVENTORY ; _ 645 . 94
a.MISC . SUPP IES = 19 . 61
9. ?otal Expeneee
tornL ; 12 , 9 8 2 . 0 8
/ = 7 , 667,.07
L0. Net Incooe - line � �i s lina 9 �
. = 7 , 864 . 35
Ii. Checkbook balance begi ning oE period
, • ; 15 , 531 . 42 .
12. Total of line 10 and i
s 4 , 534. 71
" 13. Total conttibutions (f ooi attaehed vorkshaet) —
14. Checkbook balance end f reporting period - = 1 Q , 996 . 7 1
line 12 leaa Iine 13 .
. � �.l l l UI �1 . I rVL � �7� /7�O
� � 'UNIFORM HARITABLE GAMBLING FINANCIAL REPORT � � ' `''
LAWFUL P RPOSE CONTRIBUTIONS - WORKSHEET
Line �13 - Total Lawful P rpose Contributions. $ 4 , 534. 71
� List below all check written from gambling funds which are
charitable lawful p ose contributions. The total dollar
amounts of these ch ks must match the amount claimed in
, line #13. Use addi onal sheets as necessary.
CHECK # DATE � PAYEE CHECK AMOUN PURPOSE
1� 2320 il/07 RICE STR ET GYM 3000.00 SUPPORT OF GYM A1�TD PROGRAM:
2• 2321 11/07 CITY OF T. PAUL 15 . 55
3. 2348 12/09 CITY OF T. PAUL I3 .82
4. 2385 1/11 CI'I'Y OF T. PAUL 27 .73
5 , 2386 1/11 CITY OF T. PAUL 61 . 56
6, 2414 2/10 :�IIKE ' S P 0 SHOP 416 .05 PURCHASE OF EQUIP. FOR CLU_
7, 2463 4/10 RICE STR ET GYI�f 1000.00 PURCHASE OF EQUIP. FOR CLUB
8.
9. .
10.
11.
12. .
13. �
TO AL CHECK AMOUNT $ � � �z
NOTE: These expenditures wil be provided to Co�h4i e�ers at your Council hearing.
� Be sure that your fina cial report is com�l�e�n� accurate.
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