89-2139 WHITE - C�TV CLERK
PINK - FINANCE G I TY OF S I NT PAU L Council _�/�
CANARV - DEPARTMENT �
9LUE - MAVOR File NO.�
��o ` cil esolution y3�,
Presented By
Ref red Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #451 6) for a State Class B Gambling
License by Westside Boost r Club, Inc. at Wallace's Westsider,
429 S. Robert Street, be nd the same is hereby approved/
denied.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
'� In Favor
Goswitz
Rettman
��;be� Against BY
Sonnen
Wilson
—aL�-,��Q Form Approved by City Attorney
Adopted by Council: Date ,d.,�— - -
Certified Y� - • d by Cfluncil Secret y BY � 2� �
By ��
r -.
Approve M r. e �`�''�',i� ' Approved by Mayor for Submission to Council
1
_ . — BY
p�� D�C 16 1989
, ���a��
DiVISION OF LICENSE AND P�:RMIT A.DMINISTRA ION DATE � 0 "/ / O � b �
INTERDF.PARTMF.NTAL REVIEW CHECKLIST Appn roc ssed/Receiv d by
Lic Enf Aud
J oe ,�u«
Applicant / �/5"'�� �OOS r' C� Home Address �p J /U. C'pnCo✓� fKC�,Cch�jP�
I �a, S-E• �ac� l S5a7��
Rusiness Name L�. �Q'1G �p� l().�S�Sjder Home Phone
£usiness Address �a� �o. RO .�/`��� Type of License(s) C, �Q,S.S `�--
Business Phone l.�Qvn �'J<<n� (.lC��nS�
Public Hearing Date �a- � �j � License I.D. 4� � S �� ����b
at 9:00 a.m. in the Council C ambers, � J
3rd floor City Hall and Courthouse State Tax I.D. ��
llate l�utice Sent; Dealer 4� � ��
to Applicant �/� n
Federal F3.rearms �� /U/H'
Pub.lic He..iring
DATE INSPECTIU
REVtEW VEKFIED (COMPUT R) COMMENTS
A roved Not A roved
�
Bldg I & D �
IU��'
Health Divn. '
�
( � ,Ci'
�
Fire Dept. � �
' � 1�
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Police Dept.
! <;�ir,� I t0��£� j
� 0/ �� ��5 � /L
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License Divn. '
r� ,yg � oi�
City Attorney �
���,� � O�
Date Received:
Site Plan u�� r�� e
To Council Research �f g ,
Lease or Letter �1/� Date
f rom Landlord ��rr
, ' . City of Saint Paul C��'�I��
� ' Department of Finaac and Management Services
Division of License and Permit Registration
INFORMATION RE IIIRED WITH APPLICATION FOR P T TO CONDIICT PIILLTAB/TIPBOARD SALES IN
SAINT PAUL (Class B Gambling License ia Li or Establishments - New Application)
1. Full and omplete name of orga�ization hich is a lying for licen
^ ' Y
2. Does your organization meet the definit on of a "large" organization as outlined in
the November, 1988 revision of Section 09.21 of the Legislative Code? /,'/r�
Attach to this application pertinent fi ancial and/or organizational information to
support your answer to this question. OTE: Only 5 large organizations will be allow-
ed to open pulltab operations under the revised citq ordinance. If more than 5 organi-
zations apply, qualified applicants wil be selected randomlq bq the City Council.
3. Address where games will be held / .,C.t.•� ` � /
L � �, � i���� � ��
N ber Street City Zip
4. Name of manager sign �g thi applicatio who will conduct, operate and manage
' /. .
Gambling Games ` � :, � Date of Birth �- �3 ""���
(a) Length of time manager has been memb �r of applicant organization
� � � � J� 'r�"i Xe %' �/�; � � � �
5. Address of Manager � � � � k1 � � , : '
Number treet City �% Zip
6. Daq, dates, and hours this application i for � - y � � _ G!1
7. Is the applicant or organization organiz d under the laws of the State of MN?�
8. Date of incorporation �' - `� � ' 7 �
9. Date when registered with the State of M nnesota � � � �j�- � �
10. How long has organization been in eaiste e? � � �' �J
11. How long has organization been in esiste e in St. P ul? ' Y �Q �
12. What is the purpose of the organi atio ? , �
iv�,i ✓� / i
!,
�� '
13. Officers of app icant organization:
Name � i Name
i
Address � Address a`( � � , � ��
Title DOB �^ � � - �� � Title DOB p- f - 1v G
Name � � 1, Name ' f� , v�,
�b� �/ � ,
Address Address 5�� �!j �� 1
� - ,/.��.--(%cF. _
1 //�
��� Title ` n 7 DOB . I t, - / Title �C � Dpg a',� �'�
S�S'�75
� , -� � � ��-���-9
14. Give names of officers, or any other pe sons who paid for services to the
organization. ��B?-�� -
.�-----
Name Name
Address Address
. Title Title
(Attach separate sh et for additional names.)
15. Attached hereto is a list of names and a dresses of all members of the niz ti
16. In whose custody will organization`s rec rds be kept? � � "
(��-� - �j lG
/. `/S�/ 1`�'� �,-'C �'
Name .G'�-L'L�� � a /J/Z�/� Address ,,,� ' i ' � •'` t�
i
17. List all persons with the authority to s gn checks for dis � rsal of gambling roceeds:
) � �.
Name � �� Name ,G� l��'l�n�'�-L ry�
Address ��Q�� .,���2'�rl�'''�. `G,�C. Address `�� � Y , �'1 ��Z�:U''t
Member of Member of
DOB �^/g- L( (v Organization? �-�!J_ DOB �—( - � G' Organization? Y,�7
7 /
Name Name
Address Address
Member of Member of
DOB Organization? DOB Organization?
18. Have you read and do you thoroughly under tand the provisions of all laws, ordinances,
and regulations governing the operation o Charitable Gambling games? ,�
19. Will your organization's pulltab o ratio be operated/managed solely by members of
your organization? yes no
. 20. Has your organization signed, or does it ntend to sign, a consulting agreement or a
managerial agreement with any person or c any to as ist your organizatioR�ith the
pulltab sales and/or recording keeping? yes no ��
If answer is yes, give the n�e and addre s of the person and/or company contracted.
Name Address
. Name Address
If answer is yes, how will such a consult nt be paid? (percentage, flat fee, gambling
fuads, general fuads, etc.) Attach a cop of said contract to this application.
� � � ���
21. Operator of pzemises where games 11 be ld:
Name �� , �
�n //�
Business Address �'� ,�- ,�� . � � 1J c�,,.y " �' ,� ' J f C�
Home Address �I: d L, � v ` — c
. + ' 1 , • ' ' l�
� �i���9
22. a) Does your organizatioa pay or inte d to paq accounting fees out of gambling funds?
• yes x no
b) If you do pay accounting fees, to hom will such fees be paid? ,
, / , �
Name '�..,L-s� t� Address �5�� � �� ` . �/ //��L��
DOB t�_� `�- ��� Member of Or nization? 7- 7 � �'/�5�/���
c) How are the accounting fees charge out? (flat fee, hourly, etc.)
1Z�
d) What do you anticipate will be �ou average monthly deduction for accounting fees?
� �0• � � '•Z ��.�-�-f,.e�
23. Amouat of rent paid by applicant organ zation for rent of the hall:
L��,d ,� /
�
24. The proceeds of the games will be disb rsed after deducting prize layout costs and
operating expenses,for the f llowing p rpo�es and uses: r � _
1 /� f/;
� ��/
" ±� .� � '� "-/�� i �.G
�r � � y
25. Has the premises where the games are to be held been certified for occupancy by the
City of Saint Paul?
26. Has your organization filed federal fo 990-T?� If answer is yes, please attach
a copy with this a ic ion. If answe is no, explain why:
+�i�►.. � zl,rr�`/ .
Any changes desired by the applicant associa ion may be made only with the consent of the
Citq Council. -
�
� �
Organization Name
Date �; �v' - � B � � �;/�,'`�`"
/ � � �� y= �
Manager in charge of game
�
anization Pre den or CEO
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, , y�S/qd
, City of 'aint Paul
Department of Finance nd ManagemeM Services ��� a'�q
; ' License and ermit Division ""'
203 ity Ha11
St.Paut, Minnes ta 55102•298-5056
' � APPLICATIO FOR UCENSE .
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( . 4098 Application Fee 2• � �� ._ ^^ n �����_
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� Bond•
Company Name Poliey No. Expiration Dats
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�- �Minnesota State Ide�tificatfon No. • Social Security Na '
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� Vehicle Information:
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� THIS IS A RECEIPT OR APPLICATION - .. '�
� THIS IS NOT A LICENSE TO OPERATE.Youc application for pce�ae wil either be granted or rejected wbiect to tbs p�oviabns of the zoMng ' � .
ordinance and completion of the inspsctions b�r�the Nealth,Fire.Zoni y and/w Lic�nss Inspectors.. �< <
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� � � � � - � .�: $15.00. CHARG�� FOR`ALt ETURNED.�CHECKS _ _ . ' ' . ��
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TO BE CO PLETED BY •
� � ORGANIZATION PRESIDEN AND GAMBLING MANAGER
I understand and will uphold Saint ul Ordinance 409, Sections 409.21
and 409.22 relating to pulltabs and ipboards in bars.
Further, I understand that my jarba must meet city standards; that 10�
of the net profit from pulltab sales must be returned to the City-Wide
Youth Fund on a monthly basis; that onthly financial statements must be
filed with the City; and that 51% of net proceeds must remain in St. Paul
or be used to support St. Paul resid nts.
1 �
X ^ � � � _
Sign ture - Manager
�
ignature - Organ'z tion resident �
� � , .
�
�
rganization ame
. � ' �
Gamb ing ocation
. v - -
Date
Please retain the attac ed ordinance for your records.
9
DEPARTMENT/OFFICFJOOUNpI' ` DATE INITtATED
Fi nance/�i cense GREEN SHEET No. 5 4 5 4
IN�TIAU DATE INITWJDATE
CONTACT PERSON R PHONE ARTMENT DIqECTOR GTV OOUNpL
Chri sti ne Rozek-298-5056 �� � �,�,� �j c,TV c��c
MUST BE ON COUNqL AOENDA BY(DAT� ROUTINO � DOET DIRECTOR �FlN.8 MOT.BERVI�B DIR.
12-5-89 � YOR(OR A8813TAN7'1 ��i] R
TOTAL�M OF 81GNATURE PAGES (CLIP ALL LOCATI NS FOR SIGNATUR�
RCTION REOUE87ED:
Approval of an application for.a Sta e Class B Gambling License.
Notification Date: 11-14-89 Hearing Date: 12-5-89
F�OOMMENDAT10N8:Approw W a Rs�ect(I� COUNqL COMM REPORT OPTIONAL
_PLANNINO COMMIS810N _CML BERVICE COMMISSION ANALYST PHONE NO.
_GB COMMITTEE _
_BTAFF _ OOMMEWTS:
_DISTRICT COURT _
SUPPORTS WHICN COUNqL 08JECTIVE?
INITIATINO PROBLEM,18SUE.OPPOR7UNITY(Who.Whet,Whsn,Whsro,Why):
Steven E. Frias on beha1f of Westside Booster Club, Inc. requests City
Council approval of their application for a State Class B Gambling License
at Wallace's Westsider, 429 S. Robert St. Proceeds from the pulltab sales
will be used to provide equipment and uniforms for westside youth. All
fees and applications have been submi ted.
ADVANTA(iE81F APPROVED:
If Council approval is given, Westsid Booster Club, Inc. will operate
a pulltab booth at Wallace's Westside at 429 S. Robert Street.
°�"°"""R"°ES'F�P'�°: RECEfVED
' N�201�
C1TY CtERK
DIBADVANTAOE3 IF NOT APPROVED:
TOTAL AMOUNT OF TAAN8ACTION : C T/REVENUE BUDOETED(qRCLE ON� YES NO
FUNDINd SOURCE A IVITY NUM�R
FlNANqAL INFORMATION:(EXPWI� _/
Cl w