88-237 wHiTe — cirr CLER COI1t1C11 ���
, PINK - FINANCE GITY OF SIAINT PAITL �
CANARV - DEPARTME T
BI.UE - MAVOR File NO.
�Co n il IZesolution �.
Presented By
Referre o Committee: Date
Out of C mmittee By Date
RESOLVE : That Application (I.D. #538�08) for the renewal of a Class A
State Gambling License appl�.ed for by Blessed Sacrament School
Board at 1060 University Av�nue be and the same is hereby
app rove d/�e�.i.e��,. I
COUNCIL MEMB RS Requested by Department of:
Yeas Nays �.•-
Dimond
�� T In Favor
Goswitz 6y
Rettman
scne;ne� Against BY
8s.r�,
iV�st�
Adopted by Council: Date
FE� � � 1�� Form Appro d Ci A or
Certified Pa.se ouncil ret BY
By
Approved by 1�tavor: D te 2_ �,q_�� FEB 19 1988 Approved Mayor or Submission to Council
�
By BY
PUBliSHED ��L .� �� 3� �v��()
«�,,,� , �„�.�„� �,�� C°'��3 7
�atie�t Odalen
, .��EI� S�EET No. 0 00 9 5 6
� oa�r�CT ve�soM oEr�an�wr o�croa wffvan,on�enwn
;rC.'1'1�1$t1t�E _ A8SHiN — awwc�a�woax�rn s�v�ces owECron 3 cm a.�wc
NUMBER FOR —
Ew
�' ROt1TING euooEr ox�c'raR ?�11 ��w.t�,
� Fit�tyce-& . 298-5056 oaoER: — • `�"�
� ��� �
Grant of � of a Class 'A State ],in�g Li�se for the Blessed Sa�a�n�nt
Sc�rx�7. Board t..1060 L�a3.�sity Ave�ue. _
AF�'iSCANP 1�flC7�'� BY L�.'1�'Elt L1ATID 2/3/88 �'H�A�RIl3G I]A7.� WlLL BE 2/].6/88.
w«�c�►� �c�. n�o�r: _ ,
.�� ��� ��w oa�f � �.� ��.
�� ���.� �
�j .sr� : �R.c�iseaH �ns �oa�x+w * a�rv ro ca�rr�r. c�smurai.
— _wn�oo�.�a. _��oe�t�c ba�*
ols'fF1ICt ooUMC�I *ElQ+uranON� _. .. . � - . . � . - .
. . .�BUPrORTa NiMp1�C0UNpL . .. . � � . � � . . � . . . . . � .
Council Research Center
r� A �'EB 10 �
.�,�.�.�.�..� �.,�.,�.;�..�:
Tl�e Blessed t .Sr.�apo�l Board made appl' ' ta.ar� for renewal. of their State a� Min��esafa
�ass•A C�nb Lioense at 3at�uary �0, 1988. �
_.
�+sfwcn�t�e«�.�a, .�>:
T'he Blessed �tpnt School Bo� v,rill be gr ted a State of Minneeota Class A Caantbl3.ng
I�.�.
_ Ctf1Ai0WUCl�nNMR YNNi1. Tp WlnmJ::,. _ . . . ::. :
T3�e City of ' t Paul. (�h�e local gc>vpxnang ) will not be appraving sai�d applica�tioaz
within the 30 from date of applicativri.
K�rm • vxus ooNS ' , ;'
u�src�nn��rs:
_Routine a�na:ria: ti.v�e war'k. . .
_ ;
�: .
�awes:
� . �����37 '�
UIVISION F LICENSE AND PERMIT A.DMINISTRAT�ION DATE ��°�U ��/ a�l—o �
� INT�,RDF.PA TMENTAL REVIEW CHECKLIST �I Appn Proc ssed/Received by
Lic Enf Aud
Applicant � J2cDC�v I Home Address 1 a � c� .M��� ��J
�
Rusiness ame ��j� �x� ��4�e Phone 4 51� ��U3
Business ddress 1 ��� (J��F�Type of License(s)
Business hone � '`+� �'-5 �3 II 1�0�a�J �' sU�.
a-I 1 l�� p� •�
Public He ring Date License I.D. �i 5 3g��
at 9:00 a m. in the Council Chambers, 'I
3rd floor City Hall and Courthouse I State Tax I.D. 41 IU1,�
llate Noti e Sen ; � ��� I Dealer 41 )v�1�"'
to Applic t � � �j�
r�l � �
II Federal Fi.rearms �� 1��
Public He ing �-
DATE IICSPECTIO
REVIE VERFIED (COMPUT�R) COMMENTS
A roved Not A roved
Bldg I & D ( I
1v��- , �
, �,i
Health D vn. '
� �� I �
Fire Dep . ; � I
� � �� I i
Yolice D pt. D �
� ����
I��e
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License D'vn. �
�
City Atto ney � II
I
Date Received:
Site Plan
ITo Council Research
Lease or Le ter I Date
from Landlo d ��.QS I
-T
I
I
. . � v�-�.-�� �3 7 .I
. . ..
� c�1"E�'�:, Ch ritable Gamblin Control Board I
'"-°"`"'":;�'��a 9 For Board Use Only
��`w' - �+�:: R N-475 Griggs-Midway Bldg. I Paid Amt:
��' 18 1 Unive�sity Ave.
' St. Paul, MN 551043383 I Check No.
� . 'x ,�� (61 )642-0555 I Date
� � �` ��`��� H"�s' GAMBLING LICENSE ENEWAL APPLICATION ��f�*���'' r : =�''�'
° �• � ; ... ,
y : �y;� . .'; ,,� ,.:�' . ,.. i .,:. . . .. . .''�+r:: . - .. :. .�::.� < +ca.�;..
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,. .�� UCENSE NUMB R: ;,*,`A�-00��3-Q4I , <s� ,�r,f EFF.DATE. ,''?. � > 03/�4/8T '" b�'F.' 'f AMOUNT OF FEE. .;,�<. lf00.40 '�.. `- �
- 1.Applicant-Leg Name of Organization ;f;� r� , 2.Street Address •� • ���
. , ,
;,. _ . .: �,. ,,�; _ ., � ;:.:
.,. . 'L
��..� .. . _ ..:.' _,. ;�
3.City,State,Zp 4.Counry � 5. Business Phone
St Pa 1 9 - -
6. Name of Chief E ecutive Officer , 7. Business Phone i:� «�..;�,��
Candic! Da�10 73 75. '� ' `;
8. Name of Treasu r or Person Who Accounts for Revenues 9. Business Phone
1 o r o �i 1 7 'i �
10. Name of Gambli g Manager I 11. Bond Number 12. Business Phone
�ar�� Seidl 51�Q7�5 �� � ,1�� _ �- �
13. Name of Establi ment Where Gambling Will Take Place I 14.County 15. No.of Active Membe►s
Miiftar order ?ur�ieHeart 4�Y i�
16. Lessor Name �� 17. Monthly Rent:
_ (�'��r.f a r �„
- ..a :$ �1 # '- l
18: ��ingo will be c nducted with this license, please specify days and tirrpes of Binga
Days Times Days Times Days Times
Manda�t t :30 - 5:30
19. Has license ever een: � Revoked Date: ❑ Su�pended Date: ❑ Denied Date:
20. Have internal con rols been submitted previously? I l�Yes ❑ No(If"No,"attach copy)
21. Has current lease been filed with the board? I � Yes C�No(If"No,"attach copy)
22. Has current sketc been filed with the board? p Yes � No(If"No,"attach copy)
K' GAMBLING SITE�UTHORIZATION � `' a
By my signature belo ,local law enforcement officers or agents of the Boa d are hereby authorized to enter upon the site,at any time,gambling is
being conducted,to serve the gambling and to enforce the law for any u authorized game or practice.
BANK RECORDS UTHORIZATION
By my signature belo ,the Board is hereby authorized to inspect the bank ecords of the General Gambling Bank Account whenever necessary to
fulfill requirements of urrent gambling rules and law.
OA�H
I hereby declare that: I
1. I have read this ap lication and all information submitted to the Board;
2. All information sub itted is true, accurate and complete; I
3. All other required i formation has been fully disclosed;
4. I am the chief exe tive officer of the organization;
5. I assume full res sibility for the fair and lawful operation of all activitie$to be conducted;
6. I will familiarize m elf with the laws of the State of Minnesota respecting gambling and rules of the board and agree, if licensed,to abide by those
laws and rules,inc ding amendments thereto. I
23. Official Legal Na of Organization Signature(Chief Execut ve Officer) �2_D,at Title
BOARD � ,� � S-�?
F3LESSED SAC AMEN'" SChoo 1 �Q. ;1�Q ±� �'' :.�[7,���L':.i �ha i r
ACKNOWLEDGEMENT OF NOTIC BY LOCAL GOVEHNING BODY
I hereby acknowledge eceipt of a copy of this application. By acknowledgin� receipt, I admit having been served with notice that this application will
be reviewed by the C ritable Gambling Control Board and if approved by tt�e Board,will become effective 30 days from the date of receipt(not�d � � .
below), unless a resol tion of the local governing body is passed which ificatly disallows such activiry and a copy of that resolution is received b� °
the Charitable Gambli g Control Board within 30 days of the below noted d e.
2 .City/County Na e L al Goveming Body) wnship: If site is located within a townsF�jp,please complete items 24� � `
.�ar ,
� . a d 25: ,. ,-
.:,= ,�, : _
. , _, ,y ,,�,:
��� Signature of rsort, e�wng Appl�cation ��. .� S�gnature of Perso�eceiwng Applicatwn���,�N F`:� ' �
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�tl � e Received.(this date � i 30 day perio�� �7. tle."� .;:� ;�"����"`•�•'����y�
� �� r o ..._ .s�-• 1 Z F� " c�' " . �'
Name�qf�Person Deli� ing Applicatio�ctD Local_Governing Body: Tpwnship Name
��� '.C-GL -'f� _s c��=C/ �� -' `!.C.�� I
, � .
CG-00022-04�(5/8� White opy-Board Canary-Applicant Pink-Local Governing Body
, Cityl of Saint Paul -/ ✓
. • '_ Department of Financ�e and Management Services / 2 Q ��(
License a�d Permit Division � -.> D �
2 3 City Hali
St. Paul, Min esota 55102•298-5056 O,__- G�_��'�
APPLICATI N fOR LICENSE G� °
`�CASH CNECK CLASS NO. N Renew
�*.ao � � �. � , . o _ .
" . Date � -aU �g SZ"�
":-f'. ' _ . ' . . ' .
��.
-�:
•ist...
;,;` Code No. Title of Llcense From � '� 1 �s�'� To 1 ' zU is 4=�
'1 . 1 1� .�.�\
� V �� r� /� � � n 1 n�L - -T C � I �JV { 1 c -
- 100 ��S G�',.i �,C ��_rn � ,1'1. �C_�'.,-,�1 �-:c. ��
.
ApplieanUCompany Name .
"' II 1� _
��� -� �
j 100 Business Name
�:'-1�^ '
�o0 1 C",(_•, 1 t �^_� �: ,� �_�,-. r 't���, ;� ``-'
Business Address Phone No.
I 100 'J.� ! —
^--� %^� lc <' -1!< U,Q_;
� � —! i �n � � � ; �., �_( l�....� �..�
i 100 Mail to Address Phons No.
II100 ✓+r.;�, �'f � �. •.
�r :i.� ; r�_ '^. •. �.1 Y . .
ManapeHOwner•Name 5�,� `
. O ..
�V �•1/1 V�.�^�'�W ' I Y, . ._„ ;..� '�: 1^r .: �
J100 AlanagerlGwner•Home Addresa Phone No.
4098 Applicatfo Fee 2.� 50
Recaived the Sum of 100
�-�• � � I�
--1.•�....?_ n_:.__.;•. t �� --_.\ �, ManagedOwner-City,Slate&Zip Code
-- —----_ 1100
�j;, := . � �
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1�'� � ��^ � I �^ /�/',�!�G�'� �f�c?:. .c_:�'! ,_�!_..�.:=-�—�'�
License Inspector l By: ��� �' � � ) Signature O(Applicant
. '
Bond:
Company Name I Policy No. Expiration Date
Insurance: �
��T Company Name Policy No. Expiration Oate
",�- Minnesota State Ident fication No. ! Social Security No.
Y I
�, Vehicle information: I Plate Number
Serial Number
,
`;�Other
{ THIS IS A RECEIPT�FOR APPLICATION
; THIS IS NOT A I.IC NSE TO OPERATE.Your application for license w�ll either be granted or rejected subject to the provisions of the zoning
� ordinance and co pletion of the inspections by the Health, Fire,Zon'ng and/or License Inspectors.
�
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� � $15.00 CHARGE FOR ALL�iRETURNED CHECKS
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, ' �( City o* S��air,t Pau1
� �/� � '� Department of Finance land Management Services
/ J Division of License a�nd Perr.iit Registration
_ ,
INFORMATION E UIRED WITH APPLICATION FOR PE IT TO CONDUCT CHA.R.ITABLE GAMBLING GAME I:V
SAINT PAUL
1. Full an complete name of organization w�fch is applying for license
G rl7 E,�/� G r��
2. Address here games will be held ��'��6 �iVi�1E.,A.s��/ Adr . �5�• .41i ��/dy
�um�er Streec City Zip
3. Name of anager signing this application �iwho will conduct, operate and manage
Gambling Games ��,,e,/ `�Fi�� li � Date of Birth ,T' �4' �`�
(a) Leng h of time manager has been membe� o= applicant organization , /��
4. Address f Manager . �/./ V ,�,i . �I - . / � ' , �_j{/
Number � S ree[ Citq �ip� �,�
5. Day, dat s, and hours this applicatien is li for /�l�,���;� . /•�,jo - a.��r �,�-:,1G•-��
_
6. Is the ap licant or organization organize� under the I.aws o= t:�e State or !�IId? ���_�
��----�—
7. Date of i corporati�n �
8. Date when registered with the �State oi �iir�nesoca
9. How long as organization been in eYistencie? ,�� �/E�� <
10. How long as organization been in esistenc�e in St. Paul? � ,=/�y c
11. What is t e purpose of the organizatfon? ��i4,r'�;.;��� �- �'�,�-��`�„ i=�;a�,��i�,,,�
'�,e% ff��� f��
12. Officers f applicant organization
Name ,v. _% j 1 �.� Vame .�./'/i'�C- f,�>j-% C__a'�.�rzs.�_t
Address ' y c'�,/ �i� .�c dili Address �� ��q¢',sj,� �+�� ��-
,
Title� ��. ,�.�<c,.� DOB J-�.✓- -J�� Tit1e �.S�=G��z�i�.r'{L DOB G - 7_ �-�i:�
/ ,
Name ...,. , � - Vame �;`G� ,f�,�c iJc ti c,=
Address � - �� : :�ddress �C� �Qj;/ �`-.�.�
Title /c '- . DOB S/�.�/ Tit12'T"✓CAS�„ed-,� � DOB .�%y-y�
.
13. Give names of officers, or any other person$ who paid Eor services to the organization.
Name ' � �ame
Address Address
Title __c?e
(Attach separate s�Zee� _.. add�t_or.s_ ::�_as. '.
i
14. Attached hereto :s a list of names and addresses of a11 nembers of che organization .�
15. In whose custody wili organization`s records be kept?
Name Ja�/GC 9f��.=/J.��v�f Address /�sa A�,,=,, �UC
16. Persons who will be conducting, assisting in conducting, or operating the games:
Name ___�!%�.��/ ��ial� Date of Birth
�`�d -s%_
Address _l�� � Gig/u/� �- �� j�,�1,��
Name of Spouse ,_/ �, /� � � �/�� Date oE Birth /- ,.��f�a
Dates when such person will conduct, assist, or operate 1��jf.-,� ,����=��i4,�,/
Name ��� - �,��� ` Date of Birth �-�-����
Address _ /�,r� IJOc 1 � ���v�
Name ot Spouse 4J, /%� �-/�,�Z� � Date of Birth
Dates wnen suc?� person wi1l con�uct, ass�st. or ope-ate ���T,�, � �ss,s,,�o/
17. Have you read and do ;rou tharoughly understand the provisions of aIl laws, ordinances,
and regulations Qo�rerr:ing che operat:en o= Cha.-itable Gambi�n� g�mes? �'J
18. Attached hereto oa t:�e forT fur^ished bv the Citq o� St. Paul is a Financial Report
whic?� «emizes al'_ rece±?cs, e_rpenses, ar.d disoursemencs of the anplicant organization
as we�� as a:� or�ar.=za�'_ons anc ;zave .ece:�red =unds ior t:�e preced�zg calendar year
which ;�as been s:�zed, pr_pared, and �:e�i=ied '�y _�'��,�,, : �����
�iame
/��/ l� C�7��U.�.v �U�
:�adress
who is che �,.� of the applicant Organization.
�' Yame o= Of�:ce .
19. Operator oi premises where �zames u�1� be held:
Name _ ,�.F�.a.�,� .t/i�r c�i�1�=.l�� �
B�siness Address /�j� ���-G/fwe�� �Oc
Home Address �i y'i,/�C���� ie�
20. Amount oE rent paid by anpl:csnc Or3ani:.ation tor reat of che hall; specify amount
paid per 4-hour se�sion �/ �� °"'D
- . . . ���3�
J
.
21 . The pr ceeds o� tne games will be disb rsed after deducting prize lavout costs and
� operat ng e:cpenses for the iollowing p rposes and uses:
� � f � .v ./fC � /G� 4� r.S'Scr
G _ /�'1 ..UG L � /� I •v�/� ,Lt� G — u cc
� 6s ,I a /�C ;,�
22. Has th premises where the games are tolbe held been certified for occupancy by the
City of Saint Paul? �� �
23. Has you orgar.ization riled zederal for� 990-T? � If answer is yes, please attach
a copy ith this application. I: answe� is no, esplain why:
� d�/� � `� c ; � �, �, -.
Any changes esired by the applicant �ssociacll{on may be made only wich the consent of the
City C�uncfl
� -
�,c�-t�
Organizacion
Date ' ��Y� gy;
aaager in charge o game
�
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Address /,F�:.Z, ��,,,; � A'� Address
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Dace Rec'd - GI. rlrG) Dace Rec'd s�.s/ cTf/�
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Purpose��,� Ft�ud. � /Pt 1 � Purpose .
Signacure ,O�,P�S/r Sy�s,/y -r-a �.+✓ Signacure
of Recipieac� � )-�� ,i^ of Recipient
AmounC �,• Amount � �'
aTOa � �,�a
Name �lJ �4�d<.�'s o �o .q.�re Namn
Address QQ�, �rd� S",�,T ���Sr Address
Date Rec'd -��G I Date Rec'd �� ��
Purpose Purpose
Signature Signature
of Rscipienc I oE Reclpient
.�
Amount tJ , Amount �
.,��,ra� 3�rea-'
Name Name
Address Addreas
� ` ��L j
Dace Rec d Date Rec'd C �J/�
-, ,�,y
Purpoae
Signacure j Put'Pose
Signature
of Recipienc of Recipient
�I
Amoun[ _ �c.�-3'"d• I Amount `�`2D . � �s�l'1. �
Name
Name .
Addresa Addreas •
Date Rec'd �y�j II Date Rec'd f�
� Purpoae Purpose ��
Signacure Signature
of Recipienc of Iiecipient
Amoun[ �'� ."e I Amcunt �fl�"a � •+r
17. Total D19bursements ���r
- �y ��
THI REPORT MlST BE FILLED•IN COl�LETELY TO �QUALIFY APPLICA?ION FOR CHARITABLE CANHLING �D�
LIC SE.
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. Daparc:nenc of Finance and Manage�+en� ce-••'c=s
Division oE License and Per�±t Administracton
I.T1IFdRH CHARITABLE GANBLINC FINANCIAL REPOR'C
. � Date //� ��
1. Name of Organizacion ���`�5'gd Syl�a�,,,`� � G`1a�,� �Q��q,e�
�.
2. Addrees vhere Charitable Gambling is conducted �/a GJ ��ldr�. �f�, � •
3. Report Eor period covering �- .S 19�7 through - ig�
4. Tocal number oE days played ��
5. Croas receipta for abave period ; �f�/�'��
.4
6. Cross priza payoucs Eor above period
; ��3i�
7. Nea reuipts - Line 5 minus line 6 S �'St,/!�J
8. Expenses Lncurred in conducting a�d operating gawe:
A. Gross vages paid. Atcach vorker liat with
names, address and groas uages. ; _T� ���
B. Rent for �eeks ��Q� Q,���,V,y�,d ; �.
,. .�
C. Llcense fee $ _
D. Insurance ; 1� �
E. Bond ; 9�
E. Dishonored checka noc recovered 7r�4/�-�b � '�
�'�,�•n�lV-3O
C. Employers F.I.C.A. �i<,f'EjA'd"'.ZO � �,��,
C��t,t- G.►.�•,,�.-��
H. �a�R Tax iu c/u s ES 1,�rc• '81 S _ l d � �
I. Hinn. U.C. Tax �
J. Federal U.C. Tax ;
K. Miseellaneous EYpenses. Idantify the a�unt
and Co vhom pald.
1. sF� f��i4G%i�rcNt j ��/�f
2. �
3. ;
4. ;
9. 'fotal Expensea TOTAL ; ���/�,�
10. Net Income - line 7 minus line 9 � ; � � �
11. Checkboak balance beginning of period = ���
12. 'Iocal of line 10 and 11 s ��`�-,./ y
13. Tota2 coatributions from lina L7 �,VG/y�ES aFG-��` ! ��1�_
14. Checkbook balanee end of reporting period -
line 12 less line 13 = '�3,y�L�i�1�
15. Speeify use made of amounc on line 13:
�a ,AS 4, c� .,v / _�4�.�.,�L �� /��«a .S.f� .
�l��i� f�f�w,� .¢�t/ �'77 .��dtie c —7��' �.e'is�l ..S�sl�y/.
/
COMPI.li1'(: TII� itEVERSE SIt:E
. . ��-a3� �
, ' _..�,�'"�;� I GTY OF SAINT PAUL
- ' �' DEPARTMENT OF FINANCE AND MANAGEMENT SERVICES
304 �t
�+ IIII,IIUI ..
,+ "' �� � �� DIVISION OF LICENSE AND PERMIT ADMINISTRATION
`• ,... w Room 203, City Hall
Saint Paul,Minnesota 55102
George Latimer
rNayor
2 /88
To: Virginia Baisley
. F m: Christine Rozek�
R : Record Check
In connection with an application or a State Class A gambling license
b Blessed Sacrament School at 106� University, a record check is requested
on the following people: I
Ca dy J. Damlo . Michael Conners
17 9 Stillwater 24 Battle Crk.Ct.
St. Paul St. Paul
Birthdate: 9/11/45 Birthdate: 6/23/52
Ge rge Shire I Joyce Klevence
19 0 E. Orange 1800 Ames Avenue
S . Paul St. Paul
Bi thdate: 9/17/51 t Birthdate: 8/19/40
y Jo ce Herzo
12 6 Galvin Avenue 1050 View Lane
We t St. Paul St. Paul
Bi thdate: 3/30/45 Birthdate: 4/5/34
. �
A opy of the application is attacfhed. ,
CR car
At achment '
' � . � � ���3�
- ,9��"�:'� C1TY OF SAINT PAUL
_ .
:;`' ^^ ';�:, DEPARTMIENT OF �INANCE AND �ti1ANAGF,titENT SERYlCcS
'uu.um .�
��,: 11O �� ° �� I DIVISION OF LICENSE AND PERMIT ADMINfSTRATION
� �••• Room 203, Ciry Hall
Saint Paui,Min�esota 55102
George Latimer
Mayw - I
February 3, I988 I
Mary Seidl
1266 Galvin
est St. Paul, MN 55118
ear Ms. Siedl: !
our application for a State Cha�itable Gambling License has been
eceived in this office. �
hearing on your application for� Class A Gambling ID 4�(s) 53808 will be
eld before the St. Paul City Co�ncil on February 16, 1988 at 9:00 A.M. ,
ird Floor of the City and Count�y Court House. This date may be
hanged without the License & Pex�it Division's consent and/or
owledge. Therefore, it is sugg sted that you call the City Clerk's
ffice at 298-4231 to conf irm thi� hearing date.
ou are hereby notified that yourjattendance is required at this
eeting. Failure to appear may r�sult in denial of your application.
ery truly yours,
.--..
j � � ;'� .:'� �-:.�`'� '`'� /;+.
, - -�
r.;����.L;;��-��� �. ,.. �;-�. ..�.
� . �:,:.� `�- i
J eph F. Carchedi
L cense Inspector I
�s
J C/lk !
,�
-
.
I