89-2138 wHITE - Cirr CLERK COlIt1CiI A
PINK - FINANCE G I TY OF SA I NT PAU L
CANARV - DEPAitTMENT �/
BI.UE - MAVOR File NO.
' �� n " Resoluti n
; �-{a ;
: �,
Presented By ��- ' - � � �' ��
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID 16967) for a State Class B Gambling
License by Como Area outh Hockey Association at Ted's Rec,
1084 W. Larpenteur, b and the same is hereby approved/
denied.
COUNCIL MEMBERS
Yeas Nays Requested by Department of:
����
"'�' [n Favor
Goswitz
Sc6ebel � _ Against BY
Sonnen
��
�EC � �(� Form Approved by City Attorney
Adopted by Council: Date
Certified a ed by Council Secret y BY '/—/+�
By � � `
t�pproved b vor: D
�i[ �, `_ • ` Approved by Mayor for Submission to Council
B BY
p��� D E C 16 1989
. , ���a�.��
UtVISION OF LICENSE AND PERMIT A.DMINIST TION DATE �� a 3 8 9 � �� a3 �
INTERDF.PARTMEhTAi, REVIEW CHECKLIST Appn roc ssed/Rece ved y
Lic Enf Aud
��}V� �h d,Q✓S O�
Applicant COy1�p �ct� �'1'�C �1�� Home Address �yg 7 Co{��cn so�
1—
Rus ine s s Name I e d 5 �,v ('i Home Phone -
Fusiness Address /DS� L�� pon'tcU Type of License(s)
�
Business Phone
Public Hearing Date �� � � � 9 License I.D. �{ j� 9 � I
at 9:00 a.m, in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. 4� ���
llate fiotice Sent; Dealer 4� � ��'
to Applicant
rederal Fi.rearms 46 u�/q
Public He�.�ring --�
DATE INSPEC IUN
REVIEW VERFIED (CO UTER) COMMENTS
A roved Not roved
�
Bldg I & D �
N�/� ,
Health Divn. '
��� '
� �
Fire Dept. i �
I � �� �
! S e n� I �o(a �5�
Police Dept.
'►�l3l�y a�
License Divn. ,
Il �31�1 i 0�.
City Attorney �
f�I, � � ± ���
Date Received:
Site Plan /��a3�0 �7
—� To Council Research ��` 3— � �
Lease or Letter G Date
f rom Landlord Q� o�3 0
� . . City f Saint Paul C��"a�3�
� Department of Fina ce and Management Services
�� , � Division of Licen e and Permit Registration
INFORMATION RE UIRED WITH APPLICATION FOR PERMIT TO SELL PULLTABS & TIPBOARDS IN Se�ItiT ?AUL
(Class B Gambling License in Liquor Estab ishments - Renew)
1. Full and complete name of organizati n which is applying for license
� �� � u �o�� s soe .
2. Address where games will be held r 8�. L !Z Jv ve, �5'l C7
Number Street City Zip
3. Name of manager signing this applica ion who will conduct, operate and manage
Gambling Games �J'� � L-... . h9D��pA� Date of Birth 2�Z I^"�
(a) Length of time manager has been ember of applicant organization
4. Address of Manager ? �p�! A��E �� /�',►�/G /''//� ' ��11�]
Number Stre t City Zip
5. Da , dates, and hours this a licati n is for S�
y pp 1�EC�, . l � i 1-ttZU �0�1 .'�� � t9 9'b
6. Is the applicant or organization org nized under the laws of the State of MN? �
7. Date of incorporation � !�"J
8. Date when registered with the State f Minnesota �- Z 8 - 1��j0
9. How long E�as organization been in ex stence? � y� S-
10. How long has organization been in ex stence in St. Paul? � �iJ,L S' •
-�
11. What is the purpose of the organizat on? �J2QJ1.(Q'�� �QC�TN
�a � ,� com �,��� .
12. Officers of applicant organization:
/��e�2C..t /� (�
Name /"''�}JZ.Z'f'+�U� Name �O�lr 1\�Q,��JTK�L-,.
Address �✓?C'/ ? Ol'YJO Address ���o�j ��A�J�
Title � - DOB �-C'p •. Title U . 1-fZ�S'. DOB �-�3 4"�
Name K p12 �} L... Name ��t3�.b_'�TAYl.o2 '��oK�-�►
Address 8�� ��Z�-lA���70� Address ��8� �.�E,S�SAM I►JE �'i'.
Title Ti?CS, Dos 3 -2ro Title S�c,;. nos �/ -22-�2.
13. Give names of officers, or any other ersons who et^e paid for ServiCeS t0 the
organization.
1 ^�
;iame O � Name
Address Address
Title Title
(Attach separate sheet for additional names.)
� � � . ���-a�3�
� .
. �
� 14.� Attached hereto is a list of names and addresses of all members of the organization.
15. In whose custody will organization's r cords be kept?
�y�G� 13 87 � �v
Name Q V1.) Address M� �
�
16. List all persons with the authority to sign checks for dispersal of gambling proceeds:
•Name V 1� 1-- . � rLSO4.� Name
Address � ! �D�1L�3� Address
Member of Member of
� � DOB �.� - O Or anization? DOB Organization?
Name lx}�t2 �J ��'.1'EL Name -
address g% ��-1���"-'' Address
Ilp Member of Member of
DOB .3-oZ.�O--S'O OYganization? DOS Organization?
17. Have you read and• do you thoroughly und rstand the provisions of all laws, ordinances,
and regulations governing the operation of Charitable Gambling games?
18. Attached hereto on the form furnished b the city of Saint Paul is a Financial Report
which itiemizes all receipts, expenses, and disbursements of the applicant organiza-
tion, as well as all organizations who ave received funds for the preceding calendar
year which has been signed, prepared, a d verified by �Av t � h • N D6�'�
/�� '�7 � ��S'c� �� • L��G 1�� •
Address
who is the C I'Y) L/�uG Ca - of the applicant organization.
Name
19. Will your organization's pulltab operati n be operated/managed solely by members of
your organization? yes no
20. Has your organiaation signed, or does it intend ta 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 �,
Ir answer is yes, give the name and addr ss of the �person and/or company contracted.
Name - Address
:�ame Address
If answer is yes, how will such a consult nt be paid? (percentage, f2at fee, gambling
funds, general funds, etc.) Attach a cop of said contract to this application.
21. Operator of premises where games will be eld:
tiame �l'LxJOL ��71� p�
Business Address 1'��8 �1/4 �7~L � �VC,
Home Address �
� } . . . ��-a�3�'
. 22, a) Does your organization pay or in end to pay accounting fees out of gambling funds?
yes _� no
�
b) If you do pay accounting fees, t whom will such fees be paid?
� Q r
Name M (�.P A . Address �3 pv 1�.tvE.TZ�,`� �NE
�DOB �� Member of rganization? ���
c) How are the accounting .fees cha ged out? (flat fee, hourly, etc.)
'��....A,"� �
d) What do you anticipate will be y ur average monthly deduction for accounting fees?
23. Amount of rent paid by applicant or nization for rent of the hall:
'� 35D °b MO . � ��CaO°� �� �2.
P
24. The proceeds of the games will be di bursed after deducting prize layout costs and
operating expenses for the following purposes and uses:
�G'� 11mE E v P ENT �ov2N�r�+��TS
25. Has the premises where the games are o be held been certified for occupancy by the
City of Saint Paul? ��'
26. Has your organization filed federal f rm 990-T? �� If answer is yes, please attach
a copy with this application. If ans er is no, xplain why:
Any changes desired by the applicant assoc ation may be made only with the consent of the
City Council.
Cp,�n � oVr� �x �0�.
Organization Name
Uate /��-�� -89 By: �AV�� �. �1J��2S��
Manager in charge of game
Organ zatio sident o
. ��9.�7
, Cit ot Saint Paul
' Depariment of F1nan e and Management Services �/�G r�;���� �/
; License a d Permit Division � d'� d
2 City Hall
St. Paul,Min esota 55102-298-5058
. APPLICATI N FOR LICENSE . ,,
CASH CHECK CLASS NO. • Ne R n w . • �-
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i . THIS IS A RECEI T FOR APPLICATION �:��� �
4 :. . THIS IS NOT A LICENSE TO OPERATE Your applicatfoR for licens will either be yranted�or rojected aub�ect ta fhe provialons ot the zoninp:;.,�:
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• UNIFORM CNARITA lE G�1fMBLING FINANCIAL REPORT
' � LAWFUL PURA45E ONTRIBUTIONS - WORKSHEET ✓� �� °� �
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� Line #13 - Total Lawfui Purpose ontributions. S 4 2� 42 (o .5$
List below all checics writt n from qambling fu�ds which are / o?�..��
charitable lawful purpose c ntributions. The total dollar `��
amounts af these checks mus match the amount claimed in
line �13. Use additional s eets as necessary.
' CHECK �V DATE ' PAYEE CHEC K AMOUN PURPOSE
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NOTE: These expendltures r+ill be provi ed to Council Members at your Council hearing.
8e sure that youM financial repo is ca�lete and accurate.
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� UNIFORM CHARITA6l GaMBLING FI►VANCIAL REPORT
' . � LAWFUL PURPOSE CO TRIBUTIONS - WORKSHEET `S�''J '��o� �o
, _ . . . ���i3d�
� Line #13 • Total Lawfui Purpose Co tributions. S
List below all checks written from qambling funds which are
charitable lawful purpose con ributions. The total dollar
amounts of these checks must tch the amount claimed in
line �13. Use additional sh ts as necessary.
' CHECK � OATE � PAYEE CHECK AMOUN PURPOSE
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NOTE: These expenditures will be provi ed to Council Members at your Council hearing.
Be sure that your financiai repo t is complete and accurate.
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' LAWFUL �URPaSE CON IBUTIONS - WORKSHEcT ����
(�'4 ;
Line #13 - Total Lawfui Purpose Con ibutions. S �
List below all checks written m qambling funds which are
charitable lawful purpose cont 'butions. The total dollar
amounts of these checks must mz ch the amount claimed in
line �13. Use additional shee as necessary.
� CHECK # DATE PAYEE CHECK AMOUN PURPOSE
1. l Z`J�7 Il��p$ ��MS��( Co_ 3`L4�j o`� �C�G �►"�b-
2. �Z �g ►�1�j�a ►�o,�►���+�w �oGk �., ZS_�' z�,� �►..,�
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Svg. TOTAL CHECIC UNT $ 5�9D 5 �
NOTE: These expenditures will be provi d to Council Members at your Council hearing.
Be sure that your financial repo is complete and accurate.
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� . UNIFflRM CHARITABI G�IMBIING FI�ANCIAI REPORT S� �,.¢ o� �
' LAWFUL PURPOSE CO IBUTIONS - WORKSHEET
. . . ������
Line .'#13 - Tatal lawfui Purpose Co ributions. S
List below all checks written from gamblinq funds which are
charitable lawful purpose con ributions. The total dollar
amounts of these checics must tch tl� amount claimed in
line �13. Use additional sh ts as necessary.
' CNECK �Y DATE � PAYEE CNECK AMOUN PURPOSE
__
1. /.2G 7 �•� 1�yp NiasT1;Z/� � Nac. c 2 3`. on . f�- �ce E�F Tu�,►�mcw�
t � � �
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J
3. .�,7Q ,� � ►� jgY p� ��� � �_ � -
ti `��,.� o:.�� 11 $" v-S•�u�r�'� �<>�.r�c�trv�
4. ���3 �a � �% �$� �Ca.r� �cw 1����'�a�� Nc�� !�p � °= ''' � t
t e ta r�3�f'a1 r 4�7'J QY►ti S �" S(�G t f•T f
5. tl?� ia � �8 D
� � �V 14rv►4��r � ��Cc ��.'�,� _'." L�� �.c. Fcc s
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6. ., � S� 9 ,
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7. �,� . � 3l$� r�d A�,� s f1� ��� r r _ .
y �� '.;.' -r `' �
8 ��� � ( � J D�(A 4 '1�`- ;+! �r. 711 L` .
• l� 7
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9. ;�. . � � f �, ' �
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��
S 4 b TO?AL CHEC K UNT S ��� � �
NOTE: These expenditures r+ill be provi ed to Council Members at your Council hear�ng.
Be sure that you.* financial repo t is co�lete and accurate.
_ . • � �
- — . r • • ,� • T .� � � i
•
� r � .; � ! � j � w ! Q y
� r � • � Q '� �
i � • A ` � + � e � y
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s ♦ � 2 `� ,�. �. � s � S�
w � • •• � � w s � � Z � � s
� � � M A • / � • � � r 1�
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w j � � . � � : � � �
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� UNIFORM CHARITA6 E GAMBLING FINANCIAI REPORT
' � � LA�1fUl PURPOSE C NTRIBUTIONS - WORKSHEET S,y � �g a,c �
. . . �a���'
�
Line #13 - Total Lawful Purpose C tributions. S
list below all checks writte from qambling funds which are
charitable lawful purpose con ributions. The totai dollar
amounts of these checks must tch the amount claimed in
line �13. Use additional she ts as necessary.
' CHECK +� OATE � PAYEE CHECK AMOUN PURPOSE
-
1. )a 5� 1l �(189 y��'D►s�. ✓�I�/ /�5 °= �i�.�s�� a w c e �c rn .
2. /3� v �l �1��9 l�cn�sev� Co�� � a 3'��� °-= .�cE' 7,m �- .
3. �3a / � � a /� �^� J �
� �/ 1 Q 1 g l J I �U t'��. ���=1� �/ (= �v� G�, t/ '� L�1`J r�i r ��4�'`� .
a. �3a� �� � G y�� � � .
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s. 13a3 ���91g9 �y���. Eti-�, ySr= o
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6. � /� �5��°1 Lac��e Sc��s����f /�x� So�' �°- �rns - -}� w �,� 5'.
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�. (�US �/Zsf 8S �IqJN, l'irtil�i �tc.lt �� !�G d ' ' ��vSura� C �
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8. �,�:1� ,/`,� $q ��,i;�y ,�' S.� , �� , 3�.. _ o c� /O � � �
.. 6 ,i, a f-e
9 � �
.
10.
lI.
12. �
13. �
- S.�6 T07AL CHECK UNT S .3
NOTE: These expenditures will be provid d to Council Members at your Council hearing.
Be sure that your financial repor is complete and accurate.
.
. _♦ _ � s � = � � i 3 s w ��
� � � • � � � • ; sy
• : ,� . ` ( � ; � � • •,i
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s '� w w � f � =s
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w 1 • � �
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� UNIFORM CHARIT 8lE G�IMBLING FIYANCIAL REPORT S� � �a� �
' • IAWFUI PURPOSE CONTRIBUTIONS - WORKSHEET
` . . . . �c�y:�>��'
4
Line .'#13 • Total Lawful Purpose Contributions. S �
list below all checks r+rit en from gamblinq funds which are
charitable lawful purpose ontributions. The total dollar
amounts of these checks mu t match the amount claimed in
line �13. Use additional heets as necessary.
' CNECK �I DATE � PAYEE CHECK AMOUN PURPOSE
__
1. 13C� a� ��89 s��Eit �ol�.s � c.Ee`� � �.5 � �-S��.i,-`�' Tu�uarnc,�►�"
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2. ��: i �l 10189 �Am s�}f ��� '�' � .�3`1�" oa ,�'C� �rM �
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"� 8 " °° /3
3• � ' .r�/ �1 W � �tl i r!.r.:'Ct `� � N � a �I g �� � �7 ft u��' � �7 tJ/�1 S
. . ✓ p ,�� �
4• '�P -f o� i ;o1$� Lo�c►vZ D�.s o. I ct ,,�i0 -� i�iT:�s Nnc�G� lUurw .
1
5. � 3 0� 1 q� / � f�7 L 10 5 � � � j�A nu t�,r�'1 ��� C f t`� S�
r
6. 13a � �/�fs4 �,�s1� � � G-= l�,���`�,
�r �� . .� � 5"
7. !v .Z � '�l� ��89 r��lNJN. ��7%:::;''i �. ,'%C;�L� �..Z � J� � � i : , �` �La '�-
� � � '
8. �3a 8 a;� 71�� C',f ��' sT. � li � 3�� °= �o / r-e�
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9. �3y�o ,3/�l s9 S-re�chc� � c, , � ,
, �
1 �o`C_ c� ���,-n c�v
10. � " '1 t �1{�/ g g �;'�.' r'`S .��4 � � � / / /� �,
d J f7oCCC' �- �a , / /J'!C�✓�
11. ; 3¢' y/-� :�89 ��r'),:.�✓, �1 m�-Te� �E� � r`� //r�/
`� -?S�1_ aU �f��r4 �t i"OR h`G�C C'�41
,, , J ��rnp
12. ���;�,�„ �-1� ii�t� V'`��r u �j�' S�`. �ti,� � ���-�' � �' � � J
� v � r. �
13. � i:
��{ o TOTAL CHECK Al�UNT E /��^ �°
NOTE: These expenditures r+ill be prov ded to Council Members at your Council hearing.
8e sure that your financial rep rt is complete and accurate.
- « — • ' » = ��_
�� i i � � � � w �+�
�i s w + � � .�r �
� � .� ! � n � � Q • ..
_ I . .. w � • + • � • � �
� ; 3 i i � .=i i .ri 3 i � = o s
_ • • s ,. ,• � s � s a
w �+ � � � � w s � � t � a� s
� r s e . — • : � •
� � y i � • �
' � � a '� � � � ~ + �Y
y� s � � • • t � w i �
�� i � � I w > s � � > >A
� • � � i a w • ...r.r �i ' s
. r� ' � � ` �r �r • w 1 i � � � � �
. i � • '� A � � � '� w � 7��
'�� 7
q i � ! � i � i � ��
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� � I � �� I � � � �
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1 a I � a I
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1
• _ � Cit oE Stint Paul Page l /
. Department of Fi anee and Mana�sm�nc Services �/��/
Divlsioa ot Lice sa aad Permie Administzation ��— �
l��
UNIP'ORii CliARITA3 E CAMDLINC FINANCIAL REIOR?
Dste 1��f��'8
i. Na� of Oc`anisation l.�D M /-�2CA T G L�� SSO C-
2. Addses• vhsrs Chasitabl� Ca�blin� s eoodueted f�B� �/� . �AI�oE��CV�
, r� 19�q
�. R�port for p�siod coveria{ " g � 19;_�thsou=h i -r ��
4. Total auab�r of days play�d '!`..
S. Gso�� r�eeipu for abov� p�riod i 3%�� 7� - � 2--
6. Gsoss prise payouts fos abov� pssi (iaeluda eas6 shore) ; 3 j 8 8 � � • �J'��
__.
_ __.. _ _--�j�
7. Net r�c�ipcs - lin� S dnu• lia� 6 = S��2 �S" �O `.'�'
8. Expsn��� ineurred�in coaduaela� a op�ratin� �os: 8 �/ � , /� PULl+7���
A. Ctos� va�es paid. Attaed vosk r lise rith 9� �� , p(� �p G ES
nam�s� addr��sas. �ro�a vafss. nusb�r of hours �
worked� and aaouat paid p�r ho t.
B. Rent for J2 weeka TE� R�G. f 33�5�0• � �
C. License f�s. : '� l. 9 . �J � '
D. Insura�es ; � �� . O�
E. Bond = �
00
T. Dishoeasad eheeks not recw►ar � 5(�Z,V 6CE CH a2G.9 ; �S� •
G. Aceountin` Expta�a = �
H. Evploy�ri F.I.C.A. _ �
I. Yulltab tu Paid to D�parn�a ot R�vanu� i �^��• ��
J. liinn. U.C. tax = �
. �. iedasal Lxcisa ?ax i Sta�p = �
L. Stat• Ca�blin` Taa = ` �-��
M. 141�csllaa�ou• Exp�ass�. Id�n it� th� a�ouat .
aod to rho� paid.
• 1• Puu. Toe�. �,o�ot� s 4/�.�� . �� �c�t�e.
2. �Q��p►���T : 3 ¢� .�8 �EAN �/�Al2 �KNOx `um6E2
. 3. CNEC,K.S. s Z2-50
�. � s
9. Total �easss loT�►L ; 33 7 27•SS
�o. H.� ��a.. - �sa. � .��. �ia 9 . s _y3�/!. O �
11. Chsekbook balanee be�inalnt ai p• iod i 2� o �2.J�3_
12. 'fotal of lin� 10 and 11 = �� ��3 " �O
" 13. ?otal eontribution� (fros actuh� vorlcih�at) _ ¢2 4'2� ' � �
16. Checkbook balaaes aad of rsportin pasiod - = Z 5 7 3 rf • � �J'�
lins 1Z l�i� lina 13 K 2D '✓-��7.95
K
� - sTp ,- /l�a�►y $oo°O ��
To L, 25� .95 .
- - ��✓i3�
DEPARTMENT/OFFlCEIOOUNqL ' DATE INI'MTED
Fi nance/�i cense GREEN SHEET No. 5 4 5 3
INfTIALI D/1TE INITIAUDATE
COMTACT PER80N 8 PHONE DEPARTMENi DIF�CTOR �(:RY COUNdL
Christine Rozek-298-5056 �� GTYATTORNEY �CITYCLERK
MUST BE ON COUNqL AOENDA BY(DAT� AOU71N0 BUDOEf DIRECTOR �FlN.d MOT.SERVICES DIR.
MAYOR(OR A8S18TAN1] ���
TOTAL N OF SIGNATURE PAQES (CLIP ALL LO ATIONS FOR SIQNATUR�
ACTION REQUESTED:
Approval of an application for re wal of a State lass 6 a bling License.
��� ��'
Notification Date: //-3—£�y Hearin Date: 'i'�"'� —$
REOOMMENDA710N8:Approve(A)or Rsjsct(R) COUNCIL ITTEFJRESEARCH REPORT OPTIONAL
_PUWNINO COMMI8810N _qVll�RVICE COMMISSION A�� PHONE NO.
_qB COMMITTEE _
OOAAMENTS:
_STAFF _
_DIS7AICf COURT _
SUPPORTS WHICN COUNpL OBJECTIVE9
INITIATINO PROBLEM,188UE,OPFORTUNITY(Who.Whet,Whsn,NIMre.Why):
David L. Anderson on behalf of Co Area Youth Hockey Association requests
City Council approval of their ap lication for renewal of a State Class B
Gambling License at Ted's Rec, 10 W. Larperrteur. Proceeds from the
pulltab sales are used to promote outh hockey in the Como area. All fees
and applications have been submit d.
ADVANTAOES IF APPROVED:
If Council approval is given, Com Area Youth Hockey Association will continue
to operate a pulltab booth at Ted's Rec.
DISADVANTAOEB IF APPROVED:
R�CEt���
N0�,�1�
���� c��
DISADVANTAQES IF NOT APPROVED:
L�:�=�►�.�a kesearch Genter
P�OV 3 1989
TOTAL AMOUNT OF TRANSACTION : COST/REVENUE SUDQETED(CIRCLE ON� YES NO
FUNDING SOURCE ACTIVITY NUMBER
FINANqAL INFORMATION:(EXPWf�
��