88-303 WHITE - C�TV CLERK
PINK - FINANCE COUACII
CANARV - DEPARTMENT GITY OF SAINT PAUL File NO• � �� �
BI.UE - MAVOR
\ Counci Re lution �,
Presented By /
Referred o Committee: Date
Out of Co mittee By Date
RESOLVE : That Application (I.D. 92050) fox the renewal of a State Class A
Gambling License applie for by Church of the Sacred Heart at
835 E. 5th Street be an the same is hereby approved/a�d.
COUNCIL MEM ERS Requested by Department of:
Yeas Nays
Dimond
L.o� In Favor
Goswitz
Rettman p
sche�be� __ Against BY
Sonnen
Wilson
� — � '� Form Approv d by it At ne
Adopted hy Council: Date 1
Certified Pas e ncil Se ar i , By
By� _ � ,.
t#pprov � avor: Date —
� ' �- � �� Approved!�y ay for S mission to Council
By — BY
Ptl€1�Y�7��D �':: .. ;.. - J C�
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o�,��,m �,�� �ir���1�t �i��T wo. 0 00 9 l4
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�, �,w„�d� �„�,�,��,
Christine �N —�.��� 3�� .
. �o. Huiae�
pouTlNO ` euooET wn� _ 2 �1 Rese�1`�Ch
Fir�at�e & t. 298-545� �R: —
� CRY.ATfORNEV.�. . . .
State of ' C�aritable G�nbling Class �. (Birx�o/Pul.lt�bs) . �
r�r�c�� � s�vr: 2/17/ss n�: 3/�Ss
_ �R w«�tR)) c�a.- nenolrt:
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016TRICT CIXJWCM. � � � •IXPLANATI�1: . . �.
"��'�` Councii Research Center
FEB 2 3 � .
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Marlehe , c�nn beha],f of the Ckurcn of Sacred I�t, r�qu�ests �.1 appra�al. of
their �: l.ieata,on for a State of Qzaritable G�nbl.ing I�,ce�nse (Bingo/
'Pullt:�ab�)` at 5 �ast 5th Street. Their si are oa� T�s2sday ni��s,between the � ; _
� of 7:00 p;m. 10:00� p.m. '
�uatwr,�rno�r tco.ue.�.t�.. �: , : : :
All z�equy.�ed licatio�s and f.ees hav+e .:tt:�. 'T�e px�ooeeds e�f this �ti�i,ty are
all c�orlated to �,Tieart C�urch to be v� religi,aus ar�d ec�Cati�a�l. actiuities. ,
:oorueo��c+�nw.wi+�. ro mw�„�: _ _ .
If C7oiarcil is mt given, th�e o tt�e Sacre�d Heart will no l�gei� be aZlawed
t�o � itable Gat�li:ng (Bi.ngo & ) ixi the ci of Saint Paul.
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T�IVISION 0 LICENSE AND PERMIT ADMINIST TION DATE °���7 �$� / a "��"'g�
INTERDF.PAR FNTAL REVIEW CHECKLIST Appn Processed/Received by
� Lic Enf Aud
Applicant r� Y1 �[ ►' Home Address $ �{0 '� �p`�'�"► S"�"+���-}
Rusiness lv' me 1.,�'�,�1� Q-�"�'�1�t. JRLrt ` Home Phone �7�1 ' 0�1 �`�' �
Business A dress �3$� � S� a�• Type of License(s) S,}�-'�'L C �QSS �
Business P one '')��p — �.� µ� M ...�..I'�VQ'.�T' q�Or f""�
Public Hea ing Date 3,� I S � Licease I.D. 4� q��t��
at 9:00 a. . in the Council Chambers,
3rd floor ity Hall and Courthouse State Tax I.D. �t N �a
llate Notic Sent• ��� 1 Dealer �� {�,J '�
to Applica t � (,�(� ,�/��/gg �
� Federal Firearms � aj�/4
Public Hea ing
DATE IICSPEC ION
REVIE VERFIED (CO TER) CUMMENTS
A roved Not roved
Bldg I & D N �R �
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Health D vn. � '
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Fire Dep . i N �� �
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Police D pt. �tGDr1 (C.ka 3!�n'�
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License ivn. '
a���(�
City Attorney (� �
f
Date Received:
Site Plan �
To Council Research a�'�� ���
L _ e r (1,�_C�.,N,,, Da t e
f�em-tarttl l o d �l�1'1 r0 � .._--�
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; CURRENT INFORMATION : NEW, INFOR�;SATION •
. . . . , , , , .
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� � �urrent �Corpdration Name: ' Neta "Garrporation Name:
.
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, � . . . � . . � , . . . x . ,
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Current DBA: New DBA:
,
Current Of�i¢ers: Insurance:
� Bond:
+
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Workers Compensation:
,
; .
New Officers:
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Stockh'olders:
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:��;�ffi_.. Ch ritable Gambling Control Board
� ���� Rm N-475 Griggs-Midway Bidg. " For eoard Use Only
� '� 18 1 University Ave. Paid Amt:
- _' St. aul, MN 55104-3383 Check No. •
. •:.......:� (61 ) 642-0555 Date:
' GAMBLING LICE SE RENEWAL APPLICATION
IICENSE NUMB R: H-��3+)5-iu'�i /EFF. DAT : ��;ii�5/{ii /AMOUNT OF FEE: �iUU.i'��
1.Applicant-Lega Name of Organization 2. Street Address
r7li,�,�� I:� �-t ; ��� r;�r+RT ;T ?id,� d�+11 � :ixk� �kr•�!ei
3. City, State,Zip 4.County 5. Business Phone
�t �3tll. :�� ��'�h i3;3i5Bk �3;C i(]-�7+1
6. Name of Chief E ecutive Officer 7. Business Phone
�r ?O►1a.�iJ ?1.;,�?c T' _ •
8. Name of Treasu r or Person Who Accounts for Revenues 9. Business Phone •
�, � r,.�.v. Cr F� ' 7 �-'��l=
10. Name of Gambli g Manager 11. Bond Number 12. Business Phone
+rei: �•3ss Ls�+���_'
13. Name of Establi ment Where Gambling Will Take Place 14.County 15. No.of Active Members
�acrAo �e3r*, zc�;�i �i .'aul zaa�ev �o(x1
16. Lessor Name 17. Monthly Rent:
=C
18. If Bingo will be c nducted with this license, please specify days nd times of Bingo.
Days Times Days Times Days Times
T ��, T ...
19. Has license ever een: 0 Revoked Date: ❑ Swspended Date: ❑ Denied Date:
20. Have internal co rols been submitted previously? �Yes ❑ No(If"No"attach copy)
21. Has current lea been filed with the board? ❑ Yes ❑ No(If"No,"attach copy)
22. Has current sket h been filed with the board? f�Yes• ❑ No(If"No,"attach copy) ' _.: .,_, _,,,_,,_,_ _,,.,,.
GAMBLING ITE AUTHORIZATION {
By my signature belo , local law enforcement officers or agents of th Board are hereby authorized to enter upon the site,at any time,gambling is
being conducted,to bserve the gambling and to enforce the law for ny unauthorized game or practice. .�..
BANK REC RDS AUTHORIZATION �
By my signature belo ,the Board is hereby authorized to inspect the bank records of the General Gambling Bank Account whenever necessary to
fulfill requirements of current gambling rules and taw.
OATH
I hereby declare that: , _ , �
1. I have read this a plication and all information submitted to the B rd; , . , „ , . .
2. All information su mitted is true,accurate and complete;
3. All other required formation has been fully disclosed;
4. I am the chief ex utive officer of the organization;
5. !assume full resp nsibility for the fair and lawful operation of all a tiviti�s to be conducted; •
6. I will familiarize m self with the laws of the State of Minnesota res ecting gambling and rules of the board and agree,if licensed,to abide by those
laws and rules, in uding amendments thereto. •
23. Official Legal Na e of Organization Signature(Chiet xecutive Officer) Date Title
i;` � � /�]��?"
Church of th �acred Heart- ,��;',�/�, -, "�;;��� .; ,�_ pastor
:�t. t 3u ACKNOWLEDGEMENT OF OTICE BY LOCAL GOVERNING BODY
I hereby acknowledge receipt of a copy of this application. By ackno edging receipt, I admit having been served with notice that this application will
be reviewed by the C aritable Gambling Control Board and if approv by the Board,will become effective 30 days from the date of receipt(noted
below), unless a resol tion of the local governing body is passed whic specifically disallows such activiry and a copy of that resolution is received by
the Charitable Gambli g Control Board within 30 days of the below n ed date.
24. City/County Name(Local Governing Body) Township: If site is located within a township,please complete items 24
�_!,�-ta s.' ,,-�,- T"'�.r.�%� and 25:
Signature of ers�on eiving Application: 25. Signature of Person Receiving Application
�
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Titte Date Received(this date begins 30 day perio� Title:
• .. :.:_- . }�-'� ' �
Name of Person Deliv ring Application to Local Governing Body: Township Name
Marlene eqser
: CG-00022-01 (5/8� hite Copy-Board Canary-Applicant Pink-Local Governing Body
� C ty of Saint Paut - ����_a�
' -- • • Department of Fina ce and Management Services
•' � License nd Permit Division � a C S �
2oa c�ty Hau
St. Paul, M nnesota 55102-298-5056
APPLICA lOhl FOR LICENSE
CASH CtiECK CLASS NO. ew fienew
� (� � n _ �� '�/
Date � 19-
Code No. Title of license � ., �X %� � ,�i —�� °� `j
From -'� 19"=To 19"'
aZ _-'!�ry ,Cl,., c, —`. i��Jr•;r `1 -±%,�'� :-.
, � _ 100 (`. i�li n �; --t•�.t `:;� j ��� ; �
r� � - �-�-!::.it; ��; - .). AppllcanUCompany Name � S+�r�
,o'0 8 3� � S
� �
100 euslneaa Name
,
'� .L�i
��Q �i � J:l �_l � , i } ; .� � �J (�7 .
Businesa Addreas Phwn Na
100
100 Mail to Addroaa Phone No.
1�00 �� .r : _ � . `� , _ '
.
ManaqeNOwnsr•Nams ' / -�-
100 � ,�� ;
��,C 4 :� ; ;�••_„ —, _�� �; �r
100 AlanagerlGwnsr•Home Address Rane No.
4098 Applfeation ee p, 50 �
Received the Sum of 100 �,,j• '�'r -�� ;�? ; � ; � r U(.,,n
� U•�� ManageHOwner•Cfty,Slate 3 Zip Code
100 Total 1b0
`•� � � i`"i. :t°.C-Lx�;.� :�,�c,-.,.�;���j
License Inspector �?'� By: �¢�� SignatUre of Applicant
Bond•
Company Name Poiicy No. Expiration Oate
Insurance:
Company Name Policy No. ExpiraUon Date
Minnesota State Identi icatfon No. Social Security No. �
Vehicle Information:
Serial Number late Number
Other.
THIS IS A RECE PT FOR APPUCATION
THIS IS NOT A LIC NSE TO OPERATE.Your application for licen will either be granted or rejected subject to the provisions of the zoning
ordinanCe and com letion of the inspections by the Health, Fire.Zoning and/or License Inspectors.
$15.00 CHARGE FOR LL RETURNED CHECKS
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' • City f Saint Paul � GF:_���
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: .- � Department oE Fina ce and Management Services
' Division of License and Permit Registration
INFORMATION EQUIRED WITH APPLICATION FOR ERMIT 'LO CONDUCT CHAR.ITABLE GAMBLING GAME I:�
SAINT PAUL
l. Full and complete name of organizatio which is applying for license
Sacred Heart Church
2. Address here games will be held 835 E. Fifth St. Paul 55106
umber Streec City Zip
3. Name of anager signing this applicat on who will conduct, operate and manage
Gambling Games Joe Forliti Date of Birth 8-6-39
(a) Leng h of time manager has been m ber of applicant organization ZO years
4. Address f Manager 1010 Jenks St. Paul 55106
Number Street City Zip
5. Day, dat s, and hours this application is for Every Tuesday, 7-10 Pm excevt during
Holy Week, Christmas and New Year .
6. Is the ap licant or organization organ zed under the laws o: the State or yIId? yes
7. Date of i corporati�n 1881
8. Date when registered with the State of Kirtnesota 1881
9. How long as organization been ia exis ence? 107 years
10. How long as organization been in e:cis ence in St. Pau1? 107 years
11. What is t e purpose of the organizatio ? Provide worshin, Social, Educational and
snir tual guideance.
12. Officers f applicant organization
Name Fr. onald Blaeser O.F.M. Name Jon Auge
Address g Address 8302-68th St.S. , Cottage Grove
Title Past r DOB 7-31-41 TicZe Secretary DOB 5-3-57
Name Joan Rettner Name Earl Chanman
Address 173 N. McKni ht St. Paul :�ddress 180 Maria, St. Paul
Title Tre surer DOB 3-19-46 Title PPC President DOB 9-15-44
13. Give names of officers, or any ot:�er oe sons who paid =or services to tne orgaai�ation.
Name Vame
Address �ddress
'�itle _icie
(Attach separate sn ��� `a: addi=:or.s: ::a�e�. '.
14. Attached hereto is a list of names and addresses of all' members of the organization.. '
15. In whose custody will organization's records be kept?
Name Marleae Keyser Address 7637 216th Avenue N. . E. , Wyoming
inneso a
16. Persons who will be conducting, assisting in conducting, or oper�ting the �ames:
Name Joe Forliti Date of Birth $-6-39
Address 1010 Jenks
Name of Spouse Deanna Forliti Date of Birth 3-25-43
Dates when such person will conduct, assist, or operace Sunervises other team
managers, is at most bingo sessions.
Name Date of Birth
Address
Name of Spouse Date of Birth
Dates when such person wi1l conduct, ass�st, or operate
17. Have you read and do vou tharoughly understand the provisions of all laws, ordinances,
and regulatior,s �over.+.ing che operat:on oi Charitable Gambiing games? yes
18. Attached hereto on t!�e for*. �ur..ished bv the City o� St. Paul is a Financial Report
which itemizes a11 receipcs, e:cpenses, and disbursemeacs o= the applicant organization
as well as ali organizatjons vho nave received funds =or the precedfng calendar year
which has bee� signed, prepa*ed, and verified by Marlene Keyser
�Iame
7637 216th Avenue N. E. , Wyoming, Mn. 55092
�ddress
who is the Business Manager oE the applicant Organization.
vame oc Office
19. Operator of premises where Aames :�il� be heid:
Name Games held at Sacred Heart/St. John School
B�rsiness Address
Home Address
20. An►ount of rent paid by anplicsnc Organi�acion tor reat oi the hall; specify amount
paid per 4-hour se=sion N/A
. � . � - ����-��
. .
21. The pro eeds or the games will be dis ursed after deducting prize layout costs and
operati g expenses for the following urposes and uses:
, Rel ious and Educational
22. Has the premises where the games are o be held been certified for occupancy by the
City oE Saint Paul? es
23. Has your organization tiled tederal f rm 990—T? no If answer fs yes, please attach
a copy th this applicacion. Ir ans er is no, explain why:
We e exempt as none of our work rs receives any compensation for their times
wor d at bingo sessions.
Any changes d sired bv the a�olicanc assoc at:on may be made only with the consent of the
City Council.
- Sacred Heart Church
Organization
Date By: �
Manager in charge of game
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, Name Sacred Heart St. Joh C ns. Scl9ame
Addreas 835 E. Sth Street Address
Date Rec'd 10-30—$7 Data Rec'd
Purpose Reli ious & Educati nal Purpose
Signacure � -Si'gnacure
of Recipient ; ' J-o.�G,a,� of Recipienc
Amounc $123.5
Amount
Name Sacred Heart Church Na�e
Address 84� E. 6th Street Address
nace Rec'd 12-2—$7 Date Rec'd
Purpose Reli ious & Educati nal Purpoea
Signacun Signacur•
of Reclpiant�, of Recipient
nmounc $2�500. 0
Amou�c
Name S3Cr2 Name
Addresa 840 E. 6th Addresa
Dace Kec'd 6-3—$7 Date Rec'd
Purpoaa Reli i.ous � Purpoae
Signaeur� Signature
of Recipient f'� of Reeipient
Amount $700.00 Amount
Name
Name
Addr�ss
Addresa •
Date Rec'd Date Rec'd
� Purpoae Purpoae
Sigaature Signature
of Reeipienc of Recipiertt
Aaount Ameant
17. Total Disbursemants C A S --'�/�, (093. s3
THIS REPORT MJST BE FILLED•IN COl�LETELY QUALIFY APPLICATION FOR CNARITABLE CA?�LINE
LIC SE.
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N TO a a � y
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�=�Y oE Saint Paul ' �
Department oE Finance and Managsment Se-.�;ces '
• Dlvision oE Ltcense and Permit Administ;acion
� UNIFORM CHARITABLE CAMHLINC FINANCIAL REPORY
nace 12-31-87
1. Name of Organization Sacred Heart Church
2. Addreas vhere Charicable Gambling is conducted 835 E. 5th Street St. Paul� 55106
3. Report for period covering 1-1-8� 19 through 12-31-87 (g
4. Total number of days played 4 9
5. Croas receipta for above period ; 5$,044.$5
6. Crosa prize payoucs for above period ; 5 3,942.��
7. Nec r�caipts - line 5 winus line 6 ; 4�jQ2.$5
8. Expenses incurred in conducting and operating game:
A. Ccoss wag�s p�id. Attaeh vorker list vith
namea, address and groaa aages. �
8. Renc for veeka �
i.. Licenae fee S
D. Insuranee ;
E. Bond ;
F. Dishonared checks not reeovered ; 135.00
C. Employers F.I.C.A. ;
e. salas Tax to Charitable Gambling Control Bd ; � ,9�t _nn
I. Hinn. U.C. Tax $
J. Federal U.C. Tax ;
K. Hiscellaneous E�cpenaes. Idsatify the amount
and to vhom paid.
t. Service Charges ; 3_20
2• Minn. Tipboard i R9_ 7
3. Deposit Slips S 7.66
4. ; .
9. Tocal Expensea 100.43roT�t. ; 2,176.43
10. Net Income - line 7 minus line 9 ; 1,926.42
11. Cheekbook bslaace beginning of period f 15,188.68
12. Total of lin� 10 and 11 S 7.7,115. 1�
13. Total contributions froa line 17 S 16,693.53
14. Checkbook balance end of reporting period -
line 12 less line 13 ; 421.57
15. Specify uae made of anount on line 13:
COMPi,ii1'li TIIH ItEV[RSE Si()E -
� � _ (d�- ��-�3a3
, f
• . . . -.,_.sz-a-_s .-.- a:__.._ _.. ^e :::
' ,,a„� Sacred YIeart Churc caame Sacred Heart/St. John Cons. School
Address Addzess 835 E. Fifth Street
Dace Rec'd 1-21-87 Dace Rec'd 6-10-87
Purpose Reli ious an al Purpose Reli ,ious & Educational '
Signacure �:gnacure ..,� �;� "
of Reeipien of Aecipieat �5��, /7a.(�U�u.J. f"''u'`�`'
' �mo�nc $50 .00 �mount $5,670.00
Name Sacred Heart Churc Name Sacred Heart Church
. Addrees 840 E. 6th Stree �aerass 840 E. 6th Street
Daca Rsc'd 2-26-8 Dace Rec'd 6-24-87
e�rpose Reli ious & uc ti nal purpo.e Reli ious & Eci ational
Signature Signature �
of Reclplen of Recipie
nmoun� $1, 00.00 �,uounc $1,200.00
Name Sacred Heart Churc Name Sacred Heart Church
Addrea• 840 E. 6th Stree Address 840 E. 6th Street
Dace Ree'd 4-29-87 Date Rec'd 8-28—$7
. purposa Reli ious & Edu tional Purpo�e Reli ious & Educ ional
Signacur• Signacure �
oE Raeipient of R�eipienc
�awunc $1, 00.00 I►mounc �1.500.00
Name Sacred Heart Churc Nase Sacred Heart Church
�adr.ss 840 E. 6th Stre t eddreas 840•E. 6th Street
Dace R�c'd 6-1-87 Date Ret'd 10-6-87
' PurFote Reli ' us & u at onal eur9oee Reli io � �n�l
Signacure Signacur�
of Recipien of Reeipien �
,�sounc $l, 00.00 �mcunc $1,500.00
17. Total Disburses�nts This P e $14,070.00
THIS AEPORT M15T HE FILLED•Ili C ETB.Y 'f0 QUALIlY APYLICA?ION FOR CRARITADLL CA?mLINC
LICElISt. •
� • �� + - ������
.�,,.�, C1TY OF SAINT PAUL
'•� = DEPART ENT OF FINANCE AND MANAGEMENT SERViCES
� uti w,�
ry,
B� DIVISION OF LICENSE AND PERMIT ADMINISTRATION
���� Room 203, City Ha
Saint Paul,Minnesota 55102
Geotge Latimer
Mayor
Z/17/88
T0: Virginia Baisley
From: Christine RozekC�
Re: Record Check
In connection with an app ication for a State Class A Gambling License
at 835 East 5th Street, a record check is requested on the following:
Joe Forliti Donald Blaeser
1010 Jenks 840 E. 6th Street
St. Paul St. Paul
Birthdate: 8/6/39 Birthdate: 7/31/41 �
Joanne Rettner Jon Auge
173 N. McKnight 8302 68th Street So.
St. Paul Cottage Grove
Birthdate: 3/19/46 Birthdate: 5/3/57
Earl Cha�nan
180 Maria
St. Paul
Birthdate: 9/15/44
A copy of the application is attached. A March 1, 1988 hearing date
has been set for this mat er. Please respond prior to that date.
CR/car
. = C�� �-�
'a�';~,� CITY OF SAINT PAUL
�`•` '�� D E P A R T E N T O F F I N A N C E A ND MANAGEMENT SERVICES
g "��� ,,v� DIVISION OF LlCENSE AND PERMIT ADMINISTRATION
'� Room 203, City Hali
I��� Saint Paul,Minnesota 55102
George Latimer
Mayor
ebruary I8, 1988
rlen Keyser (Church of the cred Heart)
40 E. 6th Street
t. Paul, MN 55106
ear Ms. Keyser:
our application for a State aritable Gambling License has been
eceived in this office.
hearing on your application for Class A Gambling ZD 4i(s) 92050 will be
eld before the St. Paul Citq Council on March 1, 1988 at 9:00 A.M. ,
ird Floor of the City and C untq Court flouse. This date may be
changed without the License & Permit Division's consent and/or
owledge. Therefore, it is uggested that you call the City CZerk�s
ffice at 298-4231 to confirm this heariag date.
ou are hereby notified that our attendance is required at this
eeting. Failure to appear y result in denial of your application.
Ver� truly youy�, .
r� � � � '1 _.,,�' ,f �
t�^ . . J y�'. . .�..,.
, ;�.:�
s� . r, � .
3�bseph F. Carchedi
License Inspector
JFC/Ik