88-240 I
WHITE - CITV CL RK
PINK - FINANC COIIRCII
BI.UERy - MAVORT ENT GITY AINT PAUL File NO. � rO1���
� Co nc ' , lution -
� �
Presented By ��`"`�
Referr d To I Committee: Date
Out of ommittee By Date
I
RESOLV D: That Application (I.D. #53 32) for the renewal of a Class A State
Gambling License applied f r by the Shop Pond Gang Inc. , at
1079 Rice Street be and th same is hereby approved.
,
COUNCIL M MBERS Requested by Department of:
Yeas Nays '
Dimond
Lo� In Favor
Goswitz
Rett
s�6e;be _ Against BY
'„�'°� FEB 1 S 1988
Focm Approv d y City Attorn y
Adopted by Cou cil: Date
Certified Passe ncil Secre y By
i
By '
dlpproved by Ma or: D �—��'�1 �E8 1 g 19 p►PProv by Mayor for Submission to Council
By ��.�-� By
PUBLISHED �E�3 ? 7 19 8
G/'� v2��
�,�� a���
J� oa�a: °" �#�� '��E�` Mo.fl0�3�1 ..,
� �� �,����
�� � . _ � - — �,��� —��
NUMBER F _
F� & . . as�so� _; �° — ��, . — : _ _
, � �.,-. . . �.. ..CRYA�TOpt�Y... .. . � _ . . , . , , - �.�-. .� ._ � .
GYant app o� ren�ewal of a Class A Sta Ga�tibiing Lic�ense for S�hoP P�or� C,ang, Znc.
at �079 . _ St�r4aet.
.APP'LI� . I�0►rIFIID .BY LE'rI�32 I�l7.� 2/3 88 THAT � HEARIl�TG nATE WII�. e� 2/I6/88. :
;
REOOI�tOA1fONS:( W a ReJeot(R)) COUNCN. REP�ORT:
auHrr�o. qvw Semnce� ��� �+ ��� : �anE ND.
mwM�a oo�wre� �n szs scrioo�eo�wo �
A sT� ow�n ca�nseaa ns us nour. • r�ro ro oa�rra�s .
— _���o. —��ooEO*
oisrwcr�.
*acvu�urior�:
auvvafrFa w�a�caM+rx �
Council Research Center
� ; FEB Y��
A
�r�wa s�o�. �or►oennrnr tNn+u.wn�.wn.�.wn.re.v�: . ,
�P � . �• �n�de applicaticn for c3f ttyeir State of M.innesata Class A
:Gaed'�1itYg .. ,oa� January 21, 1388. , .
,�►nt� . �a�w.�e..R.e�n.►: .
St�op Pa�rl , Inc. will be granted a State of Mirjnesota, Class A �.ang Lioer�se.
. ,: _
o0N�E011iNCB(1Mrt, air�To wnom?: _ . . _
The City of ' t.Paul (tt�:. locai gv�a�ning ) wi1l rr�t be a�v3ng sai�d appl;icatiori
within tl�e dayys fro�n date of a�p�.i.ca.tion.
� K�w►,a�: . �as ca�s-
� wsr�rrvnsc�rs: _
, �litj.Il@ , $tr8t1Ve'WOx'k. , , .. -
• - ,. .-
LiOA�lilHEi:
. � I C�������
UIVISIO OF LICENSE AND PERMIT ADMINIST I TION DATE °� Ii �D / �- � g
INTERDF. ARTMEI�TTAL REVIEW CHECKLIST � Appn Processed/Received by
Lic Enf Aud
,
Applica t ����.+� a�,�✓� Home Address � CI� �� �.�u-cx�
Rus ine s Name �D ?R ,a�l_�� �� Home Phone t'�' g g�a�Z-�
Busines Address I�, Type of License(s)
I �1 � �
Busines Phone �Q4� -ay Zb 5-�-�c, l.e-a.00 � �a.,-+� ��
Public earing Date z i License I.D. �� � 3�3�
at 9:00 a.m. in the Council C ambers,
3rd flo r City Hall and Courthouse State Tax I.D. �l -�
llate No ice Sent; (V� Dealer 4�
to Appl cant l g ' _
Federal Fixearms 4�
Public earing
DATE INSPECT ON
RE IEW VERFIED (COMP TER) CONII�IENTS
A roved Not roved
Bldg I & D I I
��4
,
,
Health Divn. '
�
x��� ,
Fire D pt. i +' �� �
nr I
Police Dept. � (
���I ��
Licens Divn. � �
f
City A torney �
1
Date Received:
Site Pla j��/4'
To Council Research
Lease or Letter Date
from Lan lord _ � ,D S
_�—
� . .: - . . ��"� �� �
" ' �'°��'q,, haritable Gambling Control Board : � '
` � � `�� 6�'��+?. m N-475 Griggs-Midway Bidg. I For Board Use ONy
� ��0• $21' U�ivers�ty Ave. Paid Amr
. � � t. Paul, MN 55104-3383 � Check No.
• ••:.....:�� ' 612) 642-0555 `', Date:
p ' �4 I
s �,�, „ GAMBLING LICENSE RENEWAL APPLICATION
, _
�
, LICENSE NU BER: /EFF.DATE: ` 7 /AMOUNT OF FEE: S1ap��p
� �'w�
1.Applicant-L ai Name of Organization -- 2.Street Address
t�,�:,', ,
r� . SFl� � FNC �P70 �1 laroer►trur �t247
'��� , 3.City, State,Z p 4.County 5.Business Phone
j SE Raul �9M lf3 Raasev 6iZ 48B-e426
6. Name of Chi f Executive.Officer 7.Business•Phone ^ • _
��� Rirharrl 4cor� � (�!a'C 6 -oa.s�". .
L 8. Name of Tre surer or Person Who Accounts for Revenues 9.Business Phone �•
' �'f'�L! �- - y��L fi�k` �l ����t.b�
10. Name of Ga bling Manager 11. Bond Number 12. Business Phone
Aot+ert �{u�t� n ' fi�'ii(16u��:�i���i :�{9���/��'
13. Name of Est lishment Where Gambling Will Take Place 14. County 15. No.of Active Members
iVc�r±h Es�d I�o ^,ua St �dul P,�p�5e 172
' 16. Lessor Name 17. Monthly Regt:
W;r'h �rd i; '"' -=��/^��'G
18. If Bingo will conducted with this license,please specify days an times of Bingo. �
Da Times Days � Times Days Times
.-- � r
/ ,�U' ` G!'.,c`,'A.-/.i:GD! �
19. Has license e er been: ❑ Revoked Date: Suspended Date:• ❑ Denied Date:
20. Have internal controls been submitted previously? [�Yes ❑ No(If"No,"attach copy)
21. Has current 1 ase been filed with the board? ❑ Yes �No(If"No,"attach copy) �
22. Has current s etch been filed with the board? • �3,Yes ❑ No pf"No,"attach copy)
�GAMBLING S TE AUTHORIZATION ~
By my signature elow, local law enforcement officers or agents of the oard are hereby authorized to enter upon the site,at any time, gambting is
being conducted, o observe the gambling and to enforce the law for a y unauthorized game or practice. �
BANK RECOR S AUTHORIZATION
By my signature elow, the Board is hereby authorized to inspect the b�nk records of the General Gambling Bank Account whenever necessary to
fulfill requirement of current gambling rules and law.
OATH
I hereby declare t at:
1. I have read thi application and all information submitted to the Boa�d;
, 2. All information submitted is true, accurate and complete;
3. All other requi d information has been fully disclosed; ,
4. I am the chief xecutive officer of the organization;
5. 1 assume full r sponsibility for the fair and lawful operation of all acti ities to be conducted;
6. I will familiariz myself with the laws of the State of Minnesota respe ting gambling and rules of the board and agree, if licensed,to abide by those
laws and rules, including amendments thereto. ,.
23.Official Legal ame of Organization Signature(Chief Ex cutive Officer) Date Title , �.,
����f f'� � C�A G ; , /'r.;- � .-_�' ':_, � ,:,,
r�: �/ rn/C. �' ;-` ,�.,- .'.,� ' ��,��; ,� ,�.� '-� ��
� ACKNOWLEDGEMENT OF NO ICE BY LOCAL GOVERNING BODY ,'
I hereby acknowl ge receipt of a copy of this application. By acknowle(iging receipt, I admit having been served with notice that this application will
be reviewed by th Charitable Gambling Control Board and if approved y the Board, will become effective 30 days from the date of receipt(noted
: below), unless a r solution of the local governing body is passed which pecifically disallows such activity and a copy of that resolution is received by
"i the Charitable Ga bling Control Board within 30 days of the below not date.
�-
24.Ciry/County N e(Local Governing Body) Township: If site is located within a township,please complete items 24
�;J � � and 25: �
4'--
Signature of F�r n Receiving Application: 25.Signature of Person Receiving Application
1 - 1
`
t `�-•� Date Received(this date ins 30 d �period) ��Title: ��?' � 1�.�'�, '' �;��+��°��'z� :��'� ;��`
l.`" � �t;.;�, ,��. � G�,�..c�__ 1 ? s�y�
� '_Name of P.erson D livering Application to Local Goveming Body: Township Name �
CG-00022-01 (5/8 � Wlhite Copy-Board Canary-Applicant Pink-local Goveming Body
� Clty ot Saint Paul ��° ��� t/
: Department of Fina�nce and Management Services � � �13L/
License and Permit Division �
203 City Hali
St. Paul, M nnesota 55102-298•5056
� APPLICA�'ION FOR LICENSE
-; �.CASH CHECK CLASS NO. New Renew
► 0 0 -�- . _ [�] 0
'i . l:. , , Date . Z �g g�
, . �
; '�Code No. Title of License From ` �• 19?��To 19
! �yf,
; ��� �ya � ��sv � �y� s� �
I `:;� . (/' 1 ,00 ��.o� �o.;:1 �.�c r� L,
' c`-�- \� yn �• T j"1(f PS�L• I-vt�,L� ApplieantlCompany Name �l�- -
V
! 100
� �
' " 1!��' �l K� C t� _;�1../,� �-
100 8usineas Name
� ' —
100 �� �C; i.� ( � '� f/�
� Business Address Phone Na
100
100 Mail to Addross Phone No.
� �J1//, r
1�� � � �� � t ^ ✓ ! `�� fY14� /�
� ' MaoapeNOwner•Name r`
100 • `t� �
: �19�f ���Yta ��G �.:� .� 4a !^
, 100 AtanagerlGw�er•Home Address Phone No.
4098 AppliCa fon Fee �
' 2. 50
Received the Sum 100 C � ' ��� ��'; ��'1 r } _- J((��'•
���.'l%'(� ManagerlOwner•Ciry,State&Zip Code
100 Totaf 100
, �.� �� �c✓� `.�G[;I(G�/' .1� /�.c�� �--i/�.!�
, LiC8n3B In5p8CtOr By: �' ` `� S�gnature of Applicant
Bond:
,
Company Name Policy No. Expiration Date
Insurance: '
Company Name Policy No. Expiration Date
Minnesota State I entification No. Social Security No.
�:. : _ . . . .- _
�`�:. Vehicle informatio :
� � Serial Number Plate Number
' t
' Other. �
THIS IS A RECF�IPT FOR APPLlCATION
THIS IS NOT A UCENSE TO OPERATE.Your application br I(cenlse will either be granted or rejected subject to the provisions of the Zoning
ordfnanCe and completion of the inspections by the Health, Fire,Zoning and/or license Inspectors.
t -
4 ��:' ` �
� ..�,, $15.00 CHARGE FOR �1LL RETURNED CHECKS
�{r�. � - ..
_,�� ,
�.�. .
'. , :�_ : , - . :.
.
:... . . . .. , ti .. .
_ , ., . , . .-.;
,
�j /�Cl t I !'l,o�► �s �I-o �b�- Kw s�C.,�4�
. l, T, �n,...�.w �',i 1
�, �'" -�-
��-�.,�- a �6 � crz
. I P,�"-�-�-��� �
. - � City of Slaint Paul
• Deparcment oE Finance �nd Management Services
Division oE License a�d Permit Registration
INFORMATION E UIRED WITH APPLICATION FOR PE IT TO CONDUCT CHAR.ITABLE GAMBLING GAME IN
SAINT PAUL
:.:;;*` ,
�_:::.s,.:,"
�;I.-, Full complete name of rganization which is applying for license
2. Address ere games will be he ����9 /G� s%, ��L.�n/', �.�//'�/
NumI� r Street City Zip
3. Name of manager signing this applicationlwho will conduct, operate and manage
Gamblin Games p (J '' Date of Birth
(a) Len th of time manager as been memb�r of appiicant organization ,�,6 Ef� �
4. Address of Manager �O p L C tJL / � O
- i
Num er �tre�t City Zip
S. Day, dat s, and hours this application isl =or �U —��2� , T ;Gp E'
b. Is the a plicant or organization organizeld under the laws u= the State ot �L*1? r 5
. �
7. Date of 'ncorporation v O
8. Date whe registered with the State o= K:t�nesota !,j'1r (,_
9. How long has organization been in existen�e? o�
10. How long has organization been in esisten�e in St. Pau1? 02
11. What is he purpose of the organ�zation? D s p ' "'� ,��
o � s L _ � o f3 ER
12. Officers of applicant organizat�on
Name i vame , 0 5 p L
��/���/) T /Y�/�
Address � � C v ,��a3 aadrzss �a�0�,LftRP�n�'�EvR �dd7 Sr.,�.u��y���rr
' ,B�nr6d'F f'vl1.-��i'B ..t�'�rl�
Title E DOB I Title �°E,qsvR�,� DOB 7j 6
vame F i �aae p�iL/� �A55ELL/�S
Address �(�'l Address _q9i�u�G�ss s�`'T,�RUL{ Ml��(, ,�'1�U3
Nf�k[Ree ov�vTS
Title C DOB D Ti*ie T�P�sts'u�'ER �OB l � +
.
13. Give name of officers, or any ot::e- perso+�s azo paid ror serrices to �ae organiz2tion.
i,
Name �•i,;� I Vame ��r,Q�
Address ' address
Title I __�.e
(�,tLach SE�'d_dC2 Silz"r -.,- ac::=-=or.�: .._�a�.
,
,
I
I4. Actached hereto is a list of names and addresses of all members of the organization.
I5. In whose custody will organization`s records be kept?
Name L `�/I p Address ra�'JO(l�l, LAR�7�uli', �v�o7,51.'�iv4 ti►�'l•
- �'�/.�
I6. Persons who will be conducting, assisting in conducting, or operating the games:
Name c Date of Birth � 3�
Address � ���
Name of Spouse ������.'fj �v�c�TEd?�� Date of Birth D
Dates when such person wfll conduct, assist, or operace '���s'[)/1� S
�
Name C (f /5 Date of Birth oZ
9ddress _�7�n �O Mb /�yE 7r�A[l4r /�AtiY�/ �S��O 3
Name of Spouse S//al'G'LE Date of Birth
Dates wtten such perser_ �ai1? concuct, ass�st, o; ope.ate ��� S"���/',S
17_ Ha-�e ;rou read ar.d do pou thoroughly understand the orovisions of all laws, ordinances,
and regulatior.s eove�ing the operat:on ct Char�tab'_e Ganb��n� gumes? r
I8. Attached here�o on the �o� fur^�shed by �he Citq o� St. Paul is a Financial Report
whic�: �temizes a?'_ recei�cs, e:tpenses, ar.d d'_sburse�e�cs o� the applicant organization
'�S W2;� 3$ 3�? O.^aP._Zd�:0i1S G[1C :7278 _3�e,'lo� _1I1CS �OI' L.'12 precedi-�g calendar year
�
W�'1�CI: 4dS tiJ2°^ S-<�-'•2:.� r�2C?=°d� dI1Ca :'2���_eCl .7�
� :V' ZII2
la �o �r. ��,=,�T� �ao7 sT,���- ��,�,�, � fl �
� �
cdress '
who is the��,�Go � �GL—�f3 � � Ul�'�� o•` �he applicant Organiaation.
' Vame �� 0��_ce '
19. Operator of premises ahe-e ,2ames :�i1; �e held: �
Name �p/�'fl'T �/1�D ��Q�Dy�MFN'T �L Ll�i
Business Address ��O�9 /\_�C� ',T/r�Lt/_ ��y�y', �f'��� �]
—�r�
Home Address
20. Amount of reat oaid by appl:canc Or3aai�ation for rezt of the ha11; soecify amount
�
paid per 4-hour se�c:or. ���pp
.. I i�_�_��� �
21. The p oceeds o* the gar�es will be dis�ursed after deducting prize layout costs and
ope ing expenses for the rollowing p,urposes and uses: ��
�
, � �
L��wG�1�;
2Z. Has t e premises where the games are tp be held been certified for occupanc}• by the
City f Saint Paul?
23. Ras y ur orgar.ization rile ederal �o m �O`;' �S It answer is yes, please attacn
a cop� wit:� t�,is applicacio . I: answ�r is no, �Yplain why:
Any changes desired b•� tae a�ol�c�nc sssociltion ma� be aade only wich the conser.t oi the
Ci ty Cour.c� .
.
Organ'_za on
�ate Bv: ��
Aiaaage: �n c arge of ga�e
:� :� � � � Z I � �� r - ^ .�. -- i (� cn
'�G � I ^ � 'D O rr
rr r- n rr� ,� I = 11 :7 rr ..
(D fD � � ; � I ;A r.' !D 7 1� . 3 f'7 .
_ n _ •� . ;7 '7 _ � JC I r` (D
- � . � ... i �t,
-' rT r- O
�- 3 J C �, ..,r, :O � r�r r t9 F+ �-�n r-n
� � ., y I :p �r- � `! y
, �� Q '� r7 ^ 3� F�
r, � ,� I �-i y � r r. 'D Uf
^ J %9 r�r � 9 7
� � '9 i �� � r � , � r' rl � f0 !A
� � �i � n :a c I_ ^ : � a
� rt
iL I n � '� u
... � _ � �
� � � l y
f9 .. '< I �
ro T �� f� �r � .�.�v
O f+ r ` ^ ^.I O r.• �7
I--' ''t �— �� � ..� y
F'- fD ;� I � � -*� CA I U1
f9 �D 1 � r � � � � i
C� r� � f � I � J I S � (rt rt �Si
h+� r'M "'� +i i f7 � �T ;.i ip R I �
� ; i _ � I ,0 _ rt r' ? IJ ..
E
�, , �, ! _ I I � A - ^ �
A r � I - � �� ' ,� R T r'r � A ( . .
`I �� �
I � I y I � �, ( A E �'S ^t '9 � fA
IT �7 C :o .-+ I
— —� i i �
, 7
.
I
� . . . ' �� ��� J
C.Cy �f Sainc Paul
, Deparc�enc of Finance and 4anagemenc Ser✓ices
Division oE Licens� and Petmit Administration
UNIFORN CHARITABLE GAMBLING FIHANCIAL REPORT
.i5"��� .. I V'I���
, . .. . ' �SC!
� 1. Nams of Organizacion m� �;/� C7 /rG' C,
2. Addresa vhece Charicable Gambling is Conducted �Q'19�GE�`� S'���v[� t//!/�; �1.► /�7
...�__._r - �
�. Report Eor period covering � 19�7 through �ECEMI�EIp .3/�1?�
—�- r
4. Total number of daya played
. S. Cross receipc� Eor above pariod = �''���� 9� ��
6. Croea prize payoucs Eor above perloJ S /7� 'T rjt-1, f 3
f
7. Nec recelpcs - li�e 5 minus line 6 , f �� ��_���
. Expenses incurred in cooducting aod o ecacing gama:
A. Croas vages paid. Accach vorker �19t with
namen, address aod groas vages. ; 0�J Q• �a
B. Renc for � ; G��j�p
O ueek9
C. License fee : �_
D. Insurance j ...�
E. Bood i .B—
F. Disho�ored checks noc recovered ; `i�'�'J��O
G. Employer� F.I.C.A. s �
H. Sales Tax S 3���v
Z—
I. Ninn. U.C. Tax s .�.—
J. Federal U.C. Tax s ..�—
K. Niscellaneous Expensee. Idsncify the amount
and Co ahom paid.
Bi��c E�e�P,
1./N(Knl.!r P.9oKRD Ca� Pr:L�ffF i • '/�
CQc/�� !�'RCfF�S:S
2. O!'F'�-G F�%FKSE$ — i ' I O�r I 9
3. ;
4. ;
9. Tocal Expenses I TOTAL S ��Q��Q•oZS
t
L0. Nec Ineooe - line 7 minus line 9 i ���7.�. .30
11. Checkbook balance beginning of period , f / /�� E 9j�
12. Tocal oE lins 10 and il S �! �j �9•O�_
1J to�a1 eontribuctons from line r6 s �� �6L�?yZ
14. Checkbook balanee end of reporting per od - �r
. Llne 12 less 11ne !3 � f ��J� �3
LS Speeif uae msde oE amount o� line � ,:
- , � � •
cor+ri.i:rr Till� ItCVrRSL Sic;E
' • \
,.,. ., ::u:ser..e^CS _:om a:oun[ ia _=ae l2:
,_ . �' '
/-� //- � � � � _,�- - C�
% � �ame /,Z�t,�-r�.c�C�l��--(�u.c.'.c-�ur�c�L✓ \�i/ Namnc".�-bi:�l(cu{c.�.c�-w<l��`f : !"/' `t
�f�; / , �
Address��°�.Gy�(o� o�,�����v�u�c Addrssa v
Dace Re''d / Data Rae'd Q.!-�8��
Purpoae Gt Purpoa �� .L[[/�-e�
Signacure Signac e
of Recipianc of Recipienc
�
ounc �Q�OTl. Amount .J'� .OD,
C�) Name �! �/ Yma � Ll.�t.eCu'/'�wcc+�'1 ����
/ � ,, n / y
Address� .f .`L .�� Addreas �� //q'rl�,
Dats fiac'd �/ /� � Dace Rec'd �-rl/L��Q'j
' � • � �.*�c�.�y�.�w<,,.v,�'�s�-�
Purpose �fd/ Purpoee �'�E-��`�
Signacurq�� �j Signacure�° � , ,� �,,
of Recipl�ant of Recipienc �.�,1�0 �
. AmounC1 � �p�/,f,Q/'1 , Amount
CC� Name�� f +.�i �}c.�c�/��j J Name /��0'G�IL�,CNCV�-i.�/✓'
' j r
Addresg ��?i l,�a+�-.�!�t��.�skv. Addresa ���lC.".C�+�C��.�i�'T"�/�w
� �!/�( `37
Dace Rec'd %a./-t-Cµ� Date Rec'd
,/ ,, n /�_
Purposs a,�'�s�/1�'�f4 �'c�,,� . Purpoee� � !� �� lTJ�4�"- ���,,vJ¢��
Signacure '' � Signatufe �-7 �" - y��,�
of Aeeipienc of Reeipienc ���
Amounc �J/1.�1L=� ; Amount � /,��(�jc i
CD� Name�—�G ,�—G��.yr�������e� � Name I y I�'``� / '�
l+/1 _ .-� � _,p._ � � �'�g n U� ! �o
Addr�sa �-�i �Z,iGeI� ,A�v �/ Address �p� ��. •���
, . � '
Date Rec'd dj�� � Date Rec`d ��(L}-�y�c.[�S� �
�) q ' �7� � , , � 1 �
� ��� �� �e�J N ��' � � / ,_,,�/�,y�
' Purpose C�`.wcf.-�G�/1.'1.a.-�3:_ ^ � Purpose ,��:.l.�h-�LCX�E�+4.1.(..�':.i.cU:�����' �'"`'"�"
Signacure ! Signature / �j / ✓'�
of Recipient of Recipient °
Amou�C�/J����, Amcunt ��`�`� /�%:
17. 'focal Disbursemencs
:HIS eiEPORT HUST BE FILLED• IN COI�LE'LELY TO QVALIFY APPLICAT20N FOR CHARITABLE CAMHLING . •
LICENSE.
t
Q � �-1 A tA tA A �-1
,` 7 �O n S O y ►` � .�w m C > Oa 7 ..
� • tp O n Z �-�1 �
O Z -9 7 O �n
D �J n rw H Rf A K •n �-1 [n r+ .�
� I n � ,,,� � r y �o ^ •! � a �-1 y
� �s O '*f �i
3 C n O � 2 �e O � o a -n = O >
�] n w A .. � �-i
> � � � m � � m ^ g � = m �' � rn m cc*i
a �e z � •e s �a e 9 � � 7-i � �
.°,' m �v a I � a a a� A R > x -a dT
R 0,
� � � � � 7 n .�w 3 m � +�i O
m ^ .�w a n ...... n re ....... ao a
� .� y � n v a � n S� s�
n '�e �e r, w o x n a n m � +t
n o m v • n �e m cf
� � n o � a O � a •�w' t=�n $ +f
� � ' W � �
a m m d I d r z
m � 3 �z
c n ar .�
n
� �.� ;� � o m O 'o cAn '.�.
C Q � r. . . E £ >
�, � E •- �''�7' �a �a � �
•+ \. �I n. � !�, a a
�•�� po m �=� c. a
e GI �
� '�'
� �v
.� �♦
. . - � ��-����
;: Dt:Surser.:e:�ts ::om a�:ounc in 1:ne 12:
r 1 Name ,�' �i�tiz.A%��l�t-i.(.�'c�'%'� �Name � `7 z � C O 1\
/ Address�03q� " �s�ul'/ Addresa � ���
Date Rec`d ��'�$' Date Ree' 3 �/�
Purpose Purpasa�` .�cs��l-/� " '""�_�0
Slgnacui� � Sigaacure �`
of Recipianc oE Recipieat
Am uec ��Q,OOa Amoune 3�.3 00 •
� Nama . � , Nams
Addresa CJ'� , � Q�y-� dt,ccE'/ Address
Dac• Rec' Q �- Date Rec'd
1 � �s"��
Purpos ' �1.ss �[tpo,e
Stgnacura � Signacure �
of ReclpisaE a/-t..-r,c.v-c:s.K� � � oE Racipient
• / Amounc � �30,0� . Amount
C ) Name Name
Address�U��^ ����G��l:1rr�'-�i�i.� Addresa
Dace Kee'd �/-r /g� Date Rec'd
,
Purpoae� , . d1�' �IJ�t.C-� Purpose
Signacur� - � ' SSgnature
oE Recipi t of Recipient
Amount ��04.00. '' Amount
� �r �-� '
Nams Name
Addrasa� . � su , Address •
, �
Date Ree'd 7 3/ g'� Date Rec'd
i,vA►vcD��Lr�-�,� Pi�T���s oF
PurposeS%'fO��c.ID C'�/f�n ivN'S f/PTF Purpose.
Signacure M�1„r,gE,f',S OF'!ltS�f3r')i.L-,S'� , �}!L 5lgnature
of Reeipienc 9'-G'ilp�'S r'�/�ANl+S'T.� of Recipient
, �
Amount ,p� � Amcunt
17. ?otal Dlsbursemencs , �i
TH S �2EPORT MUST BE FILLED•IN COMPLETELY TO QUALIFY APPLICATION FOR CHARITABLE GAHBLING . .
Li ENSE.
..._.__�---� �
� -t � ►1 t� �n qf t cr -t n u� v+ z -t
�` `'-' S � n S O �-! � � ,�.� � C > Oo 7 �-=i
f.. .w n C >
� n o •ye � I � o .�e � i -�i •+
,.. I n � n o v�
3 � ° o � S � o �e m o � i oa
n �e n r� rr � r+ n i+ .+ j -1
m r G'o � 2 O h rS'� W � Z t+1 C
t t+ m N t+f H B `! m tn �N c*1
r+� �ef V1 W
- S A 2 7 K yc ~ w 'O m � ^'C O :+1 'J
a z n m m �-t r e 9 � -1 :+�
e e °o n n � m M � n R �> m -1 dz
rp � � e o ►► o e � O c�
re n O 3 � n ^� 3 m +1 O
n� p, iO v v v . (0 v v v p0 �
7 N J is 7 a 7 n � 3 �
. A A � ^ W rw 9 't - wC n � r1 � A
- L N n� 0� O n O O m Z �
` .n � u � � n� . . a �w a . � � � .
r I s r z
a m � n n en�
' v� n a� '_` � � c°� �f
`�C 7r 7 `� O O Rl nr
O S r+ � �, ' �
g r•• r .
� R O n �
�o a o n. n.
A I a, ��� n. a
� a
�1}
I
� � �����
" � I�: J`.:�urser..encs ::or� a:oun� in 1:ae 12: I
� �
C� Name// �-uCL/ ��G..'-'�-c�i}�/ I \��^7 Nam��vLLG-t��-it.l'�lri�-y�,��t:�:.G+'�.v%J.Yi.•:
Address �(� J f ' �+2 Addresa .d�'tt'�'I-�°�-I-�i
Dace Ree`d Dace Rec'd !��!�-a'"'� ��
� �
Purpose Purpose �.E�l
Signacu - " Signacure
of Reeip enc of Recipienc
Amount O Amount �t�'�00,
I� �
C Name � C�y/ Nama ,
,
Add ess� Addrass �u'� � �
, � � � `
Dac• Rsc d � , Date Rec d � 7
Purpose 'TN/1�Purposa I � ^ � �� t ��,
Slgnacure / Signacure U�
of Recipienc of Recipient
• Amounc � 8. Amount G •�(7,
� Name .�G�' �-0� � �� Name �A�Ci ' /.���t�-o-dGC.//��
Addre�s l.GI't- / Address �Li�
Dace Rec'd ?j/d'�}-C.�,c� . ,, Date Rec'd ���-fi6�0�
Purpose P.1dQ.� � Purpose +�h �Ll�/��r'��
Signacure Signacure
of Recipient , � ' oE Reeipienc
Amount ��i, Amount . ,QO.
CName����:C��� ' 1 ame 1 �GI�C�Y
`
Addresa � �.' Addresa -
Date Ree'd 9 '���� Date Ree'd f Y//6���
��. .�,� ,� - • - � ;; � l ;
' Purpose i�4Ki *-� urpoae ��C,�t.�,✓
Signacure ,;�cc4,C��-a^/ Signature '
of Recipient of Reeipient
Amount .,y pd.Gt) . �mcunt ��Qr d� .
17. Tocal Disbursemencs �
TH S etEPORT MIST HE FILLED•IN COMPLE'fELY TO QUALIFY APPLICATION FOR CHARITABLE C.IHHLINC . •
Li ENSE.
-i c -� c� m �n � ... cr .i n u� m a -1
S �O e S O �I �o n S O ^! r► rn =
�-n fe C > Oo 7 M
m I o � z � � o z -t � o �n
., �„ .� rn •e .� a m � a
'��. � A o •e n o .e a �-I �
f�
� 3 � � o � 3 �e O �c n o � 2 � �
1"1 `i n r+ 'r n n t� r. � -1
� a r w � z o � � w � z e+� c
F+ W f/f t�l �1 H `t tl1 N l+f f+7
o. �e 2 0 � o n w .�e m � -rne O � >
� a n m w rl m m C 3 � -1 � az
n m 'O B I n m a S n n > 3 ^I
� 8 n o 3 7 n � 3 t o °�n O
r.� p, e0 v v v (0 v v v QO 7i
'7 L 7 • �O C C. � n - 2 7
� ti � �C r+ N X n m 'r a� n �C rn
7 n o C � T � t^o � C � 7C �-n!
� b tp n� 0� O �'1 O O m =
� n a u� K n O �w u $ �
O 7 OO t�
a m m r m � z
m n 3 � I �, � tz
a n � �` � � c�
`C Tr 7 N
O O :�1 ^+
' p t n C E • a
E r r "' ►' . � �
` r �o o � �
�e a o a a
w m � n �
h � G a a. a.
�;
�� . �
� � �� 1�1���� ✓
: .�._. o�„ C1TY OF SAINT PAUL
'� '�' DEPART ENT OF FINANCE AND MANAGEMENT SERVICES
• •�
� ��� �� DIVISION OF LICENSE AND PERMIT ADMINISTRATION
�'� ,��� Room 203, City Hall
Saint Paul.Minnesota 55102
George Lati '
MaYa --
2/2/88
To: Virginia Baisley
From: Chri sti ne Rozek C�'� '
Re: Record Check
In connection with an applicatio for a State Class A Gambling License by
The Shop Pond Gang, Inc, at 1079 Rice Street, a record check is requested on
the following people:
Richard E. Koran Philip J. Kostolnik
1039 Como Place 1270 W. Larpenteur #207
St. Paul St. Paul
Birthdate: 6/28/38 Birthdate: 3/16/10
Richard Anderson Philip Cassellius
914 Parkview � 991 Burgess
St. Paul St. Paul
Birthdate: 9/10/41 r Birthdate: 1/2/35
obert Kusterman ' Jack Curtis
94 Como Place 776 Como Ave.
t. Paul i, St. Paul
irthdate: 12/28/38 � Birthdate: 11/9/29
r
copy of the application is att ched.
i
. R/ca r �
. ������
: ,�,_•o;� CITY OF SAINT PAUL
�;'' ';�d DEPARTfv�ENT OF FINANCE AND MANAGEMENT SERVICES
�� 11�11�p :�
oen. ,. DIVISION OF LICENSE AND PERMIT ADMINISTRATiON
,.�. Room 203, City HaU
Saint Paul,Minnesota 55102
George Latimer
r�yor :
February 3, 1988
Robert Kusterman DBA Shop Pond IGang
994 Como Place
St. Paul, MN 55103
Dear Mr. Kusterman: �
Your application for a State Ch ritable Gambling License has been
received in this office.
A hearing on your application fpr Class A Gambling ID 4�(s) 53032 will be
held before the St. Paul City C uncil on February 16, 1988 at 9:00 A.M. ,
Third Floor of the City and Cou ty Court House. This date may be
changed without the License & P rmit Dinision's consent aad/or
knowledge. Therefore, it is suggested that you call the City Clerk's
Office at 298-4231 to, confirm t is hearing date.
You are hereby notified that yo r attendance is required at this
meeting. Failure to appear may, result in denial of your application.
Verv• ruly your,�,�,,
. . �/r.,' ��. '� � ��.
. _ �- "" , _ .
��J�i . ^ ,^ ��Yr�� ��
., :�,
J _e$� F� Carchedi
_�icense Inspector •
JFC/lk tj
, . J
i