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88-1174 WHITE - CiTV CLERK COl1�1C11 /f /.)� PINK - FINANCE GITY OF SAINT PAUL X / CANARY - DEPARTMEN7 BLUE - MAVOR File NO. V -�/" Council Resolution Presented By Referred To Committee: Date Out of Committee By Date RESOLVED: That Application (I.D. #19762) for (2) Temporary On Sale Malt Licenses applied for by Palace Booster Club at Palace Playground, 790 Palace, for July 16, 1988, between the hours of 8:00 A.M, and 9:00 P.M. and for July 17, 1988, between the hours of 12:00 Noon and 8:00 P.M,, be and the same is hereby approved. COUNCIL MEMBERS Requested by Department of: Yeas Nays Dimond Long in Favor Goswitz � Rettman B sc6e;b�� _ Against Y �� Wilson �p� JUL 14 J�DO Form Appr v d�by City ttor Adopted hy Council: Date ' /� � Certified Pas e b il Sec y t By gy. � Approve Mavor: Date � Approved by Mayor for Submission to Council By PUBUSNED J U L 2 3 1988_ ! �� //�� V' t . CITY OF ST. PAUL, MINNESOTA • APPLICATION FOR TEMPORARY ON-SALE MALT BEVERAGE LICENSE NOTE: This application must be filled out and signed at the time of your interview with the License Investigator, 30 da s rp ior to the date of the event. 1. Name of organization �� /�CE �dD��/2 ��L�,U 2. Address of organizatioa �8r`� �/A�'�= /��J,E , 3. Type of organization - check one which is applicable. � CHARITABLE ( ) RELIGIOUS ( ) VETERANS ( ) 4. List all officers and directors. President �iC !Jj/�,L�I � ' �lqL��,� G'/�U �/i�vrlt� ZZ�� CJ�/g NAME ADDRESS PHONE N0. Vice President �/ir� /�n��/� �U�' ,��q,U 2 Z C�'-�l�c�� NAME ADDRESS PHONE N0. SecretarY �,f�� d �/� �2. '�`a�'+ .�%9�� Z� �`y�� NAME ADDRESS PHONE N� Treasurer LI.Lf�--L�.��-! /7`��'�/� � U (/�C'e.0`t3 /�v.S. Z.Z� U�f�� NAME ADDRESS PHONE N0. Others NAME ADDRESS PHONE N0. NAME ADDRESS PHONE N0. 5. Location of premises for which application is made �i�¢C',� �II�V�;/ZpvvcJ� � St. Paul, I�T S��/� Z (Zip Code) 6. Date(s) and hours during which the non-intoxicating malt liquor will be sold J�ly �G S��, 8 Aw� � � pn� ✓k1ti�� .°o� P�l. .- � . P nn , �(,, 7. For what will profits be used? ��? �/V� ]I'/��' , � �,pD/ �/� ' How will profits be disbursed (or spent)? ��'/U/ �t� ,f� ��PO/'�� . 8. Upon completion of events you will be required to submit a financial statement showing expenses for event and use made of profits. . 4. Attach to this application a letter of consent from the owner and/or a person with lawful responsibility for the premises for which this license is being requested. (OVER) 10. Every applicant for a temporary On Sale Malt Beverage License shall file with• his application therefore, a bond with a valid Power of Attorney attached, in the sum • of Two Thousand Dollars ($2,000.00) . The surety on such bond shall be a surety company licensed to do business in the State of Minnesota, and the bond shall be approved as to form and execution by the Corporation Counsel. Said bond shall be conditioned as follows: a.) That the licensee will pay to the municipality, when due, all taxes, license fees, penalties and other charges as provided by law. b.) That the licensee will obey the law relating to such licensed business, and that in the event of any violation of the provisions of such law, the licensee will pay all fines, penalties and other charges as provided by law. - c. ) That the licensee will pay, to the extent of the principal amount of such bond, any damages for death or injury caused by or resulting from the violation of any provisions of law relating to the business for which such licensee has been granted a license, and conditioned that such recovery may be had from the surety on the bond. The amount recoverable shall be measured by the actual damages, provided, however, that in no case shall such surety be liable for any amount in excess of the amount of the bond. STATE OF MINNESOTA ) ) ss COUNTY OF RAMSEY ) � ,�I�YLt, 1�• �Y�uL �, being first duly sworn, deposes and says that he has read the foregoing application and knows the contents thereof, and that the same is true to the best of his knowledge, information and beli . � , � /•� . � Subcribed and swor to before me this ��. day of 191�� ' - ' � �cais�nraa�. s�+v,��r�� NOTARY PUBU�—?vttk':E:S:iTA � No ary Public, -�ounty, Minnesota , _. - eaKO�;,C�ut.,'r � , �tAY r�Q7yidA u;{P{RES..�h. ,. iSQ'1 � My commission expires , ` �.�.•..�v�'��v�.•vvv�niw•�.,�+n.Mwr.+�nrr City of Saint Paul ��/�� Department of Finance and Management Services C � ^ � License and Permit Division � 203 City Hali . St. Paul, Minnesota 55102• 29&SOS6 APPLICATION FOR LICENSE CASH CNECK CLASS NO. New Renew a �, !,� Q Q _ . Oate � i�"� �-'� 19 .� _ Code No. Titie of License � f � � ��a r ,' ;,y ;� 19 From � `^ `" �a�!'�, . / _�- ' � � " =) �' � �`J' --� T "`i' >^'�,._, ,^J ,J _� . ! , 100 �!;j � �A< ::� �'?�:_ ,rY 'r �^�[�r� �i�� .y ApplicanUCompany Name 100 ' � ✓'i ( �; r ,� f/I ,., , !.. 100 Busfness Name j ' 100 BUSinesS AGdtes3 PhOne No. 100 100 Mail to Addreas Phone No. 100 j'` ' ` j.., �` ,''I 1 ( i' ManaQeNOwner•Name ^ - _ 100 , 1 J` � ' , /� =�%' �� .�- " _ �.: �..�( r : �-� �, " ;.�; 100 AlanagerlGwner-Home Addross Phone No. d098 APPlicatfon Fee 2. 50 �. � c ,�-, i .� Received the Sum of 100 C � ` �i f � i f� �"� r'1 � � ,� . ; ;� ManagerlOwner•Clty,Slate 3 Zip Code 100 Total 100 \ 1 (� �?U`u7/'<., "�, �C ' �l�L/\./ �icense Inspector � '! By: � �r Signature ol Applica�t �- � , eo�d• ��..i ;l ; t-f�r.` T—�� ' � i�S c! ir �- � :� % "' ��:L c:. .,, .:: �';:::- Company Name Policy No.• Expiration Oate Insurance: Company Name Policy No. Expiration Date Minnesota Siate Identification No. Social Security No Vehicie�nformation: Serial Number Plate Number Other. THIS IS A RECElPT FOR APPLICATION THIS IS NOT A LICENSE TO OPEAATE.Your application for license will e+ther be granted or rejecfed subject to the provisions of the zoning ordlnanca and completion of the inspections by the Health, Fire, Zoning and/or Licanse Inspectors.. ��Z vui"` C� � $15.00 CHARGE FOR ALL RETURNED CHECKS G, . i •. � � �.. ` ... ;t • -r...: _.i u �C�`2�"r`"`-'� � _.-I� . I '.J _ j „� , � �/��/ �,� � ��/yf �� f ��/ � � � � t.� o ��,� /��4�'/� � , � � l� .�� c�ra� � ��-. , � � ��- , /,�or��Y �v i l ° 0 � , � �w ` �cQ. � \ (� J (�2c�c.�� 'Q y�-�v.� cQ c�.)�,z� . � � � c�� ,,� Q- u � ,p Y`��u`,� � V�v��`� �t�� GL�.�', _ �� V � . :1 0 T I C E �� Pursuant to Laws of :Zi.anesota, 1984, Chapter 502, article 8, Section 2 (270.72) � (Tax Clearance; Lssuance of Licenses) , licensing authorities are required to provide to the Kinnesota Com�i.ssioner of Renenue the �iianesota busiaess tas identification number and the social security number of each iicansa applicant. Uader the Kinaesota Goverament Data Practices Act and the Federal P:ivacy :�ct of 1974, we are required to advi.se you of the following regarding the use of this i.nf ormation: 1. This information may be used to deny the issuance or renewal of your license in the event you owe �Iinnesota sales, employer`s withholding or motor- veh:cle excise taxes; 2. Upon receiving this information, che licensing authority �aill su�ply �t only to the �Ii.nnesota Department of Revenue. However, under the Federal r.xchange of Information �,greement the Department of Revenue may suppiy this intormation to the Interaal Revenue Service; 3. FAILI3RE TO SUPPLY THIS INFORMATION WILL JEOPARDIZE OR DEI�Y THE PROCESSI:tG OF YOUR LICENSE ISSIIANCc OR RENEWAL APPLIC�TION. Please supply the following information and return along with your ap�ropriate fee to City o= St. Paul License Division, 203 City Iiall, St. Paul, iII�1 �5102. � �pplicant`s Last Name First Name Middle Initial ( i • / / / � ' ��L/�/�Z �/ L'.�ji�,�,l� �.�/ C'!l/�E i Applicant's Address City, State, Zip Code Phone Vo. ' ��G �//�-n�F�' � �I''J��i� �'J�i� �/v Z Z Z��l�I Applicant's Social Security Vo. Position (Officsr, Pa=taer, ete.) � �7� _ GZ _ z�,� Z .-,�>Fs . ' Business Vame `�/?�/'�' `�C� �,�2 �./.,.� � Z 9� -��'7 Business Add=ess City, State, Zip Code Phone No. i 7�/�'' �� .E � *iinnesota Tax Identification Vumber: i � � I ! (If a Kinnesota Tax Identification v�er is not required for the I i business being operated, indicate chat by placing aa X in the box.) • I Kinnesota Ta.� Identificat=on vumbers (Sales & Use '"a� Vumber) aay be obcai�ed from the State of �linnesota - Business Records Department - Room G90 Centennial 3uilding - 6�S Cedar St:eet. (2 blocks soutaeast of the State Capitol) Phone: 296-2863 �""--� /�J� -=�`� � �i d�z�� ( "/`� �� Signature Date . � � � ��i�� . :TOT I CE Pursuant to the �iiaaesota State Legislature by Chapter 332, Section 47, Laws of 1987, every state and local licensing agency is required to withhald. the issuance or re- newal of• a. license or permit to operate a business ia �iinnesota unt�1 the applicant preseats acceptable evidence of compliance wi.th the workers-` compensation insurance coverage requiremeats of Section 176.181, Subdivision 2. This information is required 'oy law, and. Iicenses and permits to operate a business may not be issued or renewed if it is not provided and/or is talsely reported. Furthermore, if the information is not provided and/or is falsely reported, it may result in a �1,000.00 penaltp assessed against the applicant by the Commissioner oi the Department of Labor and Industry payable to the Special. Compensation Fund. Upon request, licensing authorities are required to furnish workers ' compensation insurance coverage iniormation to the Department of Labor and Industry to check =or compliance with �iinnesota Statute Section 176.181, Subdivision 2. �,ny questions regarding workers` compensation should be directed to the �iinnesota Department of Labor and Industry - Special Fund Section - 297-4777. FAII.URE TO SUPPLY REQUESTED IYFORMATION WILL DELAY THE PROCESSING OF YOIIR LICENSE OR PERMIT ISSUANCE OR RENEWAL :4PPLIC?�TION. Please supply the fol.lowing information and retura this form with other �apers if applicable, and your appropriate fee to: Citv of Saint Paul License and Permit Division, Roo� 203 City Ha1.1, Saint Pau1, �IN 55102. � Insurance Company Name (NOT the insurance agent) Policy Number or Self-Insurance Permit Number Dates of Coverage effective expiration OR I a� not required to have workers` compensation Iiability coverage because: ( ) I have no employees covered by the 1aw. f , ., � ( �) Other (Specifq) �'�:'/Gll7��- /<-�`� %�7�; I HAVE READ AND UNDERSTAND �IY' RIGHTS P.ND OBLIGATIONS WITH REGARD TO BUSINESS LICENSES, PERMITS, �ND' WORKERS' COP�'ENSATION COVERAGE, ?.ND I CERTIFY THAT TEE LNFOR.'�IATION PROVIDED IS TRITE �W CORRECT. Business Name , �/��,� �� G�-(�? Address ��i1 �� /'Cl/ i�� -�� street city state zip code , �--� �� %�°� � �-/�'-�� , ,,- ��i-,�-/ �.� si:gnature date � l'� �-//7� ��'��,,` C1TY OF SAINT PAUL �;~ '�',' DEPARTMENT OF COMMUNITY SERVICES '' "�� '� DIVISION OF PARKS AND RECREATION �: ,.Q� °'n ,�� 300 City Hall Annex, 25 West fourth Street St. Paul, Minnesota 55102 GEORGE LATIMER 612-292-7400 MAYOR Joseph Carchedi , License Inspector City of Saint Paul 209 City Hall St. Paul , Minnesota 55102 Dear Mr. Carchedi : The Division of Parks and Recreation authorizes the Palace Booster Club name of group or organization to use the facilities at Palace Recreation Center name o par on �uly 16 and 17 , 1988 at 8 a.m. - 8 p.m. date time The above mentioned party may sell beer if they are able to obtain proper license through your office. APPROVED: , Divi ion of Parks a d Recreation Date June 29, 1988 :mf � �O