88-1113 N�HITE - C�TY CI.ERK y �
PINK - FINANCE GI;TY OF SAINT PAUL Counci! (yG�`!�
CANARV - DEPART�vIENT Qa
BLUE - MAYOR Flle NO•
� Cou cil Resolution �����
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Presented By
Referred To Committee: Date
Out of Committee By Date
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RESOLVE'D: That ApplicatiQn (I.D. #16866) for a State Class A Gambling License
' applied for by the Guadalupe Mexican Education Society at 1494 N.
' Dale, be and the same is hereby approved/i�wis�l.
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COUNCIL 11�EMBERS ' Requested by Department of:
Yeas I� Nays �
Dimoud
r.o�I' � In Favor
Gosw�tz
Rett�Sc6ei � � __ Against BY
Sonn�u✓' ,
�"`��" ;IUL - 7 1988
Form App oved by City Attorney
Adopted by Cquncil: Date •
Certified a =ed by Council Secretary i BY � G Z� ��
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By�
A►pproved y �lav • Date� _ , � � f.f�7 Approved by Mayor for Submission to Council
B �I i'�" "'-_ ' �.�_ � `_ By
Y
PUBLISHED J U L 16 1988
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c� � o�u+rr�r o�ron wvun pn�ararn
� � �+N+c¢a�uN�ae�e�r awv�s owECron an a.�wc
R �ER Fon — 3 _
: ,_ � � noun� �*�«+ 2 ,Gounci T Research
j �� 1 C47Y ATfORNEV . . . . _
A iicati,on for a Stat �Class A Gambling License.
I
: , . N 'f� a ion Date: 6- 88 Hearin Date:���
c 'U)Pr�(R)1 � t�4NidL REBEANCFI � ''
� Pl�M�6 CML SEHVICE(�1�1 ��' DATE IN� -. DATE QR � . . , � � W�ONE NQ� .
.. � .�ONMO . 130.826 BCFIOq.BOARD . � . .. . . . . . .
. . BTAFF � . . .CHARTEA.WI`MAI8310N� . �i WMPLElE AS IS� � .-��- � * T Ad L�.� .�.. �_��• .
� �DIB'�C'f COUIK:IL •pfPLAWATIq�I: . . . �
- 81�I+ORf6 YNMCFI OOi11CN. -� .� � . � . .. . - . . �- � . . � - . . ..
���N S�' . .i S c��-�.F,c�6 -l�IQ : .
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. w� o�romurrr�wno.wn.�.vM,.a .whr�:
A nes Mei hofer, on beh 1 f of the Gt�iu�pe,:t�ici��i Educat#on Soci ety,
r quests. �ouncal appro �1 of her new application for a����t�te Class A
G . ling License at 1 �_N. Dale St., Proceeds frrom the gambling sessions, -
ich wi11 be held on riday afternoons from 1:00 PM ta 5:00 PM, are
d nated to Our Lady of! Guadalupe Church.
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. ��t �.�r , ,
A 1 fees and applicati,' ns have been submitted. �
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�. wn.�..ne Tn w�a: - � ' _ , . :
I Councii approval i 'given, the Guadalupe Mexican Education Society
_ w ll be able to spons r a weekly gam6ling session at 1494 N. Dale Street.
I approval if not gi ien,, the gambling sessions will not 6e held. ` .
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w�sw�s: — rnos _ cx�e
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wsronr
� �ducation Societ was formerl licens�i at 408 Main St.reet.
� ey discontinued in � y r
e 6uadalupe N�xican nuary, 1988, urtt}1 ai new location eould be �flurt�d:
�.�aw.�..uES: i
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UIVISION OF LICENSE ANI) PEI�MIT ADMINISTRATION DATE � (/ o�/ � �7 0 �
INTERDFPARTMFNTAL KEVIEW CHECKLIST Appn rocessed/Received by
� Lic Enf Aud
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Applicant �' �i + _� Home Address �SR �j ��f��
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Rusiness Name �. t � 1'1 Home Phone
Lelu c4 SoG t-��
Business Address �t�/� ��a�,L� Type of License(s) S�{(„�(„ ��QSS �
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Businelss Phone �77 (,�.• '1�� m �
Public Hearing Date �� License I.D. 4{ [ �� � �
at 9:00 a.m, in the Counc Chambers,
3rd flloor City Hall and Courthouse State Tax I.D. �t �,�"
llate rTOtice Se Dealer 4� �,1 )�
to App,lican ��� � �
Pederal Firearms 4� � f�"
Public! Nearing
DATE INSPECTION
R VIEW ,VERFIED (COMPUTER) COMMENTS
A roved Not A roved
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B1dg I & D �
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Health Divn. '
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Fire' Dept. j � �
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Poli�ce Dept. �n{'' I
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Lice6nse Divn. 1
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City Attorney j_ �
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Date Received:
Site Pllan r �
To Council Research �P ���
Lease r Letter �j Date
from Landlord � � ' O �
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' � e .- . _�-�./Ir�
�° """'•• -CharitableGambling Control Board FOR BOARD USEONLY
Room N-475 Griggs-Midway Building �.
1821 UniversityAvenue �N�` ,\`.-:..-,--': . .
_ St.Paul. Minnesota 5�51�04=3383 AMT ..
- (6?21642-0555
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'�•• �:ni . . '� . - ..a . .L-'%3iw0�lrLKfC.iicy{.�y K . .... � � '
�DAT�"`.�„�
GAMBLINC LICENSEAPPLICAT10111�
INSTRUCTIONS:, .
A. Typeor print in ink_
B. Take completed application to local.governing body,obtain signature and date on all copies,and leave 1'copy.Applicant keeps t
copy and sends original to the above address with a check.
C. Incomplete applications wiil be retumed.
Type of Application:
�]Class A — Fee S 100.00(Bingo,Raffles,Paddlewhesls,Tipboards,Pull-tabs)
i�Class B— Fee S 50.00(Raffles,Paddlewheels,Tipboards.Pull-tabs) ��+«*•�era�.eo:.
❑Class C— Fee S 50.00(Bingo onty► �'""'°a G1°'n°��°""�+a�°""O�B°"d`
.. .- -. 4Class D- .Fee.S 25,00(Rafflesonly) Y .. � . y ;� ,._ � :.�,.-_ ... ,, , , .
❑Yes�(lNo 1. Is this application fora renewal? If yes,give complete license number 0 - � -�
�Yes�Na 2. If this is not an application for a renewal.has or anization been licensed by the Board before7 If yes,give base�
license number(middle five digits)
YesONo 3. Have Irrternal Controls been submitted previously?Ifi no,please attach copy.
4. Applicant(Official,legal name of organizatioR) 5.. Business Address of Organizatiort .
R e
6. City,State, p 7. County 8.. Business:PhoneNumber.
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9. Type�oforgaFlizationc F�aternal Veterans� jQi Religious.,. ther;nonpro it` _ .. . - -,�� � ,
�_ �'l�;organixatiort�i�arr,••otbe�nonprafit"''orgaoizatio�.`answerqueations:lQthrougfrl3:lfnot;gatoquestiomt4."OthernonprofiY"organizationsY
r .� ''-"mustdxumentitstax-exemptstatus.
�Yes�Na� 10. Isorganizatiort inco rated as a nonprofitorganization?If yea,give numbecassigned to Articlesorpage�and�
' book number: Attach copy of certificate.
�YesONa� 1'T. Are�articles filed.with the ecretary of State7
�lYesONa� 12. A►garticles filed with the County?
�►Yes�N� 13. IsorganizationexemptfromMinnesotaorFederalincometax?Ityes,pleaseattachletterfrortrlRSorDepartmentofi
Revenue�declaring exemption or copy ofi 990`or 990T.
DYes�JNa 14. Has�license ever beert denied,suspended ocrevokedt lfyes,check all thara�y: :
O Denied: ❑Suspended O Revoked Give date:
15. Number of active members 16. Number of years in existence Note: If Iess than fouGyears,attach
evidence ofthree�year�:
: �� � f? � existence:. _
- - 17..�Name ofChief�Executive Officer .�...JC 18. Nari�aoftreasurerowper tsfacother,revenue�- �
� ofth�or anization:. �
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. Title Title '
P �f f' a c C! (?
Business on� u r Business Phone Numbe��
( / 1 �J'.? ?� ( 1 ! ' �7`:� �
19. Nameof establishmentwhere g�inbling will b� 20.. Street address inot P.O.Box Number)
conducted '
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21. City,State;Zip 22.. County w e gambling premises is located) �
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CG-0001-02(8/88) WhiteCopy-Board Canary-Ap�' ant Pink-1ocalGovemi�gBodY
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. , ' City of Saint Paul ��`�Y�
� Dep�,artment of Fnance and Manageme�t Services �/,...����3
Lice�se and Permit Divisiorr l./�
. _ 203 City Halt�
, SL Paul, Minnesota 55102-298-5056
� '� APPLICATION FOR LICENSE
CASH C1-IECK CLASS NO. ' New Renew
Q Q �+' ' Q Q �p ��
' Date `.� �(� �g c�. .
Code No. Title of License ' Cp ' ;� �`� (g � f� /„ �c�
From 19'=To � 19�
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J�4�LA-T:.. l_ I/;�;. �' � � � l.'1 .
. �� 1�./ t C�G /u ��,� � ' �;i �f[t��
�; r.,�(, �—.J r U G 7, �Z ApplfcanUComp�ame .-- �
' 100 LUic�-t,,:n _Ocir'F �
'�, j �lG y! ,�..,;� ± ;�1 c
100 euaineas Name
.. . ;,,� –f/ J
. � -i' i 1 ��i (
100 � • ! " f • ,
' Buainess Addross Phone Na
100
, 100 Meil to Addreas P�e Na•
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1� �'�•� ,) l�c ��- . . ;i'w' � . � -
MsnapeNOfwner•Name
100 � ,
j '� -- � , (:r': . >1 f � L
J J
100 AtanapsHGwner•Home Atldresa Phon�No.
4098 APPlicatlon Fee .
2. � �,,, — -•; ; ,..1 - — `/
Recefved tha Sum of 100� �r; ! • ' �' �•- '' � � ' ��C
�;; ��:�•Ui..! ManaqedOwoer•City,Slate 6 Ztp Code
100 Tota1 100
�icense�nspector `—� ey: r �� ��` ,.�� . Signature of Applieant
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Bond• I�
Company Nam Policy No. �O��tion Oate
Insurance~ .
Company Nam Policy No. Expiratto�Ost�•
Minnesota State Identification No. ' Social Security No
Vehicte Informatfon: Plata Number
Serial Nu ber
Other. '
�THIS IS A RECEIPT FOR APPLlCAT10N
THIS IS NOT A LICENSE TO OPERATE Yourt application (or license will either be granted or rejected subject to the provisions of the zoning
ordinanCe and completlon of the inspection4 by the Health, Fire, Zoning and/or License Inspecto�s.
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��Y�' $15.00 CHARGE FOR ALL RETURNED CHECKS
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�ow �.•�
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14. AcLached hereco is a lisc of names and addresses oi all members of the organization.
15. In w ose custody vill orgaaization's records be kepc?
Name � ' L. �e Address /�j.�5 � /"�,�7Yl�r'A �
16. Perspns who w111 be conducting� assisting in conducting, or operacing che games:
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Name' ��q�,��S �/ /�� ��%,P Date of Birth � �lJ
Address � � S /1 �„� "b��� �- �-�-
Name of Spouse Date of BizLh --
t r . ,
Dates vhen such person will conducc. assist, or operate �'� S �- ;' � � .�/ ��y
Name - - Dace of Bi:th �' �, =�
� t.��l C C/
Addrless �,�� ��i� /L� 4iiY`-' 1�7T �C) �
Nazae' ot Spouse Date of Birth
Date c:hen suca person will concuct, ass:st, or ope:ate
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17. Have '' ��ou read a^.d da ��ou choraugnly understand che orovisions of a�l laas, ordinances,
, and regulatior.s �ave�i^.g, cae operat_Dn ot Cha��tab?e Gaabiing games? ��_
18. Attached hereto oa che fo�:� °ur..ished b;� c!:e Cit� o� St. ?aul is a Financial Report
whic:� i:e�izes al'_ rece=�cs, ex�e:�ses, a,d d!s�ursemezcs o� che applicanc organizacion
• as we?1 as a�: o:gar.iza:=ons :rho iave �ece:�ed 'uads �or tae orecedizg calendar year
whfc:� ;�as beea s:3^.ed, prle�3red, and re:_:_ed Sy
' `ame �:
=� � � ' ,� '"�- /dG
� — .
:�ccress
who :�s che ./yf /�-/y,t} � G �Q a c .�e applicanc Organizarion.
' • Vsme ot Oi__ce �
19. Oper tor oi pre�ises :+RCTO_ ;;ames :ri�_ �e he:a:
Name � `
(' '� sf+�L r�./'-Cr��G+�i
- B�si ess Add�=ess f i�r � � ,��� .�1.—
' "� '� �
Home ,Address .��y 7 ��_,� /��,'a�._ ��1- `�^ �./ , : ��-.-
20. amounc of rent paia Sy a� �`_�anc 0:3an:�ac:on :or -e^c o: =he na11; speci�y amounc
�._cii
paid per 4-hour se-s:on / ��
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� • City of Saint Paul �����`Ja
. � Deparcment of Finaace and Managemenc Services
Division of License and Permit Registration
INFORMATION REQUIRED WITH APPLICATION FOR PERMIT TO CONDUCT CHAR.ITABLE GaMBLING G�UiE IN
SAINT PAUL
1. Full and complete name of orRanization which is applying for license
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2. Address where games will be held �� �J�/V, j��,(r �t �T ��� I � .�� c�_,
Number Screec Cicy Zip
3. Name of manager signing this applicarion who will conduct, operace and manage
Gambling Games �gy�e , ��� //7 c� ��R Date of Birth j � � u
(a) Length of time manager has been me�ber of app].icanc organizacion /7-_�1 R,$
T
4. Address of Manager /� 3� �!7,���P�P � )t�A4 � ��; e�
Number Screec Cic� Zip
5. Day, dates, and hours this applicacion is cor �g► n n �f ,��i �$.,� �� ��,'9 !.c� n��5:i�t
� .
6. Is the applicant or organization organized under the iaws o? c;�e State oi ;QI? �Jf=S
�.,�_
7. Date of incorporaCi�n �a �//��r��
8. Date when registezed with the Scate of Kir.nesaca ��-J�3
9. How long has organization beea ia esiscance? ��� i�G'.�-P, S�
_.
10. How long has organization beez in exfstence in St. Paui? ;� .l f=/,(�S'
J ��
11. What is the purpose of the organ!zatioa? _��j�i5.� //�t i�� � �/ 1 c rt <:.- fi u a ��__�
i
�1i'�v Sc��,�., /
12. Officers of applicant organization
Name hl N/1���'� /�/G�f7 c��C 2 Ya:ae ��c.c. M E H �L S l�.,z..` .
Address �'S�,S' ( Z�� /l� ,C�'C� �? - �7 Address /�J ��� ��� �,�� ���r�5.3�/y
"T"
Title ��/�,q�;c� � DOB ��� � ii�?e �� ��/ �OB �'� �,75�
Name ��jc:.f/�/ �/} A� /1 �c Vame
Address ��C' i ��� /./ i1� C iL? � 3ddress
Title ��?/�S��,Fe R DOB �5,�• / � T.'�tle DOB
13. Give names of officers� or any ot�ez �erscr.s ano ?a=i �or s2^:'ces to =�e or3ani=atfon.
Vame 'lame
Address add:e=s
Ticle --='-2
(.�ttach sepa:atz sae�- -. _ .;c===-�..__ ^��a_.
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�21. The ',proceeds ot che gac�es will be disbursed af[er deduSting prize layou[ costs and
ope�aciag expenses for che following purposes and uses:
, _ 1
,
O o
��i^��(.zi /� f�c R �— d Ci � u i2 _ J�i /� iVJ,�7 •�CJ/r7 o D �L
�Z. Has the premises vhere che games ara co be held been certified for occupanc� by the
City of Sainc Paul? � �
23. Fias your orgar.:zacion ci ed cedera'_ �ora 990-T'. �� Ir ansver is ves, please atcacn
a copy �►ic;� ti;:s applica �on. I: ansc:ar is no, e:cplain ahy:
_��/7 /1-�,? � �'%- �,� � 4�f iv / Z l�- �� o iv
Any chang�es desirec b� cze a�pl'_caac �ssociac'_on ma� �e �ade onl�� vich c::e conser.t o: the
City Coun�il.
� �'" v/i e���,�/l�kn� � �i��-�:�•.����
• Orga:�_za��on
i
t7ate � /�c� Bv:
� Maaage� in cha ge or game
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' ' ' � � C1Cy of Saint Paul �� J�/�
Dsparcm nt of finanea and yanageaenc Secvicss ��
Divisio� aE License and ?ermit Adminiscration
_ UI'�IFORT4ICHARITABLE CANBLINC FINANCIAL REYORT
I
' Dsce
l. Name of O�ganizacion ��� � /1- �i. i.1i b �_�I�I� v�[��+nr L r�Wn ir l �i(/G .
W d� 1�
2. I Address vhere Chsritable Gaabling ts coaducted _�C,3' /�//i i N S'1— �T �/1 rt. �
J. I Report Eor period eoverins . / /� l9� through �9�
� �
4. To[sl number oE daYs played s/ �� /_��c � fu.l�/ '�
5. Crosa receipcs Eor abave psriod S / �(.� (, �1�f' . !1'G
6. I, Cross prize payoucs for abov� parioJ ; � y 7�J� • �U
�
7. Nec r�ceipts - llne 5 mtnus llne b f �f�,, /0 =.L �G
8. Expenaea tneu�reJ !n condl�cting aod opecacing gaA�:
A. Ccosa vages psid. Actach vo�ker list vith
namee, aJdress and grpaa wg�a. S 5� C o . c� ::
8. Rent for .�/ v�eksi f � %�iD G'c%
c. E.�.s�..,-fR E x e i S ° TA� s / 7%.3 7 v
D. Insurance i %O G o .`
E. 9�ed t�'J� � �R i iv�y �T'i+-�c i �-f �f q• .;L Z
Y
F. Dishonor�d cheeka �oc' recovered i �S G • A 4'
C. F�aployen F.I.C.A. S �/0 n . 'r�L'
I N. S+i�� Tax S7'/{ t � S '�, �7�• C v
I. Hinn. U.C. Tsx i ��• D c'
'� I J. Federsl U.C. 'fax S �
I K. Hiscellaneow Expsnses. Idsacify cha amounc
' and Co vhom paid. �
�•/lec�f �.�P� St.t� b�����s �90 � o�
2.����;�s -� E�.�.'„ pM��✓+ : /,��.�5�
3. i�y ilTn r�s !I s l S�� c� �
` ; :
9. Tocal Expensss i TOTAL f �� (���- /• ��e
L0. Nec Incooe - 11ne T minuellline 9 f _�, S-�' i �
!1. Checkbook Salante begLnnlhg of period S � .sG'v2 . 7�/
l2. tocsl oE line 10 and ll f � C`�� � O J . 5 �
13. ''I tota: concribuctons .rom llne l7 : �� ��o� • �iC
I
14. Checkbook balaoce enA of reporting period - �
llne 12 lesa Ilne l� s (.�. ��� • � �
15. Sp�cify use made of amounC on lloe L):
_ nl�1 r; .r �-� e�,��- P .(�, S' , ,' c{ <' �
I
COHPtJi1'E Tlll: (IEVERSE Si(IE
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� vUAD!�LL'PE .�iE�.IC�iJ EDUCATICiV' SCCI:.TY INC.
� � 'I �RCSS V�AGES �:1I� ;�C:t 1�87
Agne� NIeihofer 1535 C:�amber St St Paul ;5106 � g80.00
Caro1 3ushinski 2091 Scenic tlace St �aul 55119 y� 840.00
Ca,rol �iaselman 4�� t�Iacwlester :�ve St Paul 5�108 � 940.00
Rae i:,as�a 1830 E. �loyt �ve. St :a.ul F5119 �102�.00
Sett� Dam�.to 501 Beaumor.t St St Paul 55101 ' � 920.00
Mar�aret Koer_ig 9Q1 r�. Cottage St St �aul 55106 ;� g00e00
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