88-1300 LERK
'INANCE GITY OF SAINT PAUL Council . A�/G�
C - DEPARTMENT �/j( /�DD
BLUE - MAVOR � File NO.�.,
Co cil Resolution r��
r
Presented By
Re rred Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D. #36916) for the renewal of a State Class
B Gambling License applied for by Johnson Area Hockey Association
at 955 Seminary Avenue (Minnehaha Lanes) be and the same is hereby
approved,4Ae�ed.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
�--�� [n Favor
Goswitz
� �_ Against BY
��
w'usoo
Au�'j — `t � Form Approved by City Att rne
Adopted by Council: Date - �
Certified Pa s o cil Se r y BY ls �
By
Appro by Mevor: Date -�� Approved by Mayor for Submission to Council
By
P118�ISNED ���G 1 3 19 88
�,� �.��,,,�_ �,�� ' �'�-/3�a
Mr. J. Carchedi GiR�� ���rt No. O�ZQ��
CQNTACr PElIAQM:,` o���Kr ar�c�roa — i�troa tai�ss�r,�u�rr�
t_ `''
Christine Rozek "� — �����„ �,,,�
coerr . ncr r�no. NUMBHR FOR — �
ROU""a �°�� 2 Counci'�.Research
' � � ORDERC� � CI1Y ATI'ORNEY � . - - . . � � - .
CT ECU
Application for Renewal of a State C1ass B Gambling License.
NQti#ication Date: 7-15-88 � Hearing Date: 8-2-88
�INIEIiDA7fON8:(Mlxwe(A)a►ReleCt(R)) COUNCIL RESEARCN REMR'T:
. . PLANNM�(i CO�AI98ION�. � � CNIL SERVICE COMMIS810N � DA7E IN� DATE WT � ANALV3T � -PFIONE NO. � . . , .
. DOIiN�10 COAN�ION� . ISD 628 3Cli00l.BOARD � . . . . .
� STAhF � �_ � . . . CNARTER COMA�N38bN � .. .. -WMPLETE AS IS� -ADD1 INFO.ADDEDt� . �_�ADD'L�IPF"O�� ��_��_� • .
DISTPoC'T OOUNCL � _ . . .
. =DCPLANATION: . . _ . ��J��
... &lPPORTS NM1IICl1 COUNCIL OBJECTNE4 .. � . . . . � . �. . :� - � . . . . .
� � . . �� . �. ���� � � � .. .
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. � . . � � . . . � . .. � .. � ��� �� �
>MTN71N0 PROB�EM,IBSUE.OP�OR7UNf1Y(WFW.Wh�t NTherl.VNNre�WhYI: , . `
Steve Younghans, on behalf of Johnson Area Hockey Association, requests �
�ouncil approval of his application for renewal of a State Elass.� B _
Gambling license at Minnehaha Lanes, 955 Seminary Ave. Proceeds from
pulltab. sales� ar.e used to support youth hockey and other youth atfitetic �
activities. Councit Research Center
�usnwcnro�+tc.�.�.�.�r. , . �
_ Ji�! 2 61�88
All f�es and applications have been submitted. Johnson Area Hockey is current
in Tts i0� contribution to the city-wide youth athletic fund.
�trr�w.wi,«,.aa ro wr,�>: ' _.:
If Council approval is given, Johnson Area Hockey will continue pull�ab
sales at Minnehaha Lanes. If Council approval is not given, pul1tab
sales will discontinue. -
KT�IWA7NES: _ ppp8 WWg _
l�b70RY/PIIECEDENT8:
IEaAL ISSLIES:
. ��`�
DIVISION OF LICENSE AND P�:RMIT ADMINISTRATZON llATE � 00/ � I� U�
' 'INTERDF.PARTMENTAL REVIEW CHECKLIST A.ppn Pr ce sed/Receiv d b
Lic Enf Aud
Applicant V y� Q,�S Home Address � C a-�_
Rusiness Name �o ht1 SOh �'�"C4. �'�O���ome Phone
Business Address Q� SQ/ry�n p�/H Type of License(s) S`�A,� 1..��,$,S
Business Phone 8 '' �Q�'Iq,�/M(� ��GfiMS[.._��GL�/0.(
Public Hearing Date p �, g� License I.D. �F 3 Gq/�o
at 9:00 a.m. in the Council hauibers,
3rd floor City Hall and Courthouse State Tax I.D. �6 ��/q'
llate Nutice Sent • Dealer �� �'�
to Applicant p
_-��� I'ederal I'j.rearms 4� �!
Public He�.iring
DATE II�SPECTIUN
REVLEW VERFIED (COMPUTER) COMMENTS
A proved Not A roved
�
Bldg I & D �
� �
Health Divn.
, N��4 '
;
Fire Dept. �
; N�A I
Yolice Dept. ! �� J��� '�
1��S I� p--�-_
License Divn. �
� ����� a ��
City Attorney
� /5 c. ,
Date Received:
Site Plan N ��
To Council P.esearch
Lease or Letter ^ ^ Date
f rom Lar.dlord " 1 1 ��
: � � �71-b
: City ot Saini Paul.
' . " • Department o�Financ�artd M�anagemenr Services �����
: - � Licens�an�Permi�Divisiocr
_ _ • :�_::203 Ctty�Halt.�
� SC Paul,.Minnesota 5510Z-298-5056:
� . _ ARPC.tC'A�.TiONY FQF�UCENSE
�-; CASH• • ,CHECK CtASSNO'. Nevw� Renewr . �
Q� Q -u.�-° � , - Q-[�� . � �� ��
- - Date� 19
, Coda�Nc: Titl�ot License� Frortr � t��To t��,
� S-�� C(�ss 3�.� - � t
� ��% � S`tc v�e. �'(ou r� �c r,s
`l �1 �(�Y1 l -e� APPlicanUCompany Name:
10Q. r f� �( �� `
, �n cJ t 1� Yl�D� /`t��!� 7'tv C 1.t
l OQ BuSfness N��
� 1 112 l 1
�oo. �55 � s�� rtih�.. ��u �.
Business Addresa. Phon�N0.
10Q �� �O�"/
100 Mail taAddress Phone No:
,oo� u Q. Li } u r G �i n
ManapedOwner Nam� �
,oa: � �c' `�'� i�l C; !t�-'t�
100�. htanagedGwner--HOmeAddress Pho�sNO�►
4098: ApplicatiomFe� Z.. SQ �� ��I' /+ � ,n �� T��
� Received thcSurtrof. 10Q v� Y � �v
� ��• � ManagedOwner_-Gty.Slated_Zip:Cod�
-. 100j - Totalc_ 10� _ _ -
�T't 1� �
Licensglnspectoc �� Byr 'C Signatureorn �canr
-�
; . �
. Bond- _..
� Compan}r.Namee� Poiiey No:.; Expiretlort08ta+
Insurance-
� •:
Comparry Name�- Policy No_ Expiratiort 0atsi.
MinnesataStateldentificatforrNa: ' SociaCSecurityNo
Vehicle lnformation-
Serial Number- Plate Numbec
Other.
THIS 1�,4r RECEIPTFOR-APPLICATiON=
THISISNOTA LIC�NSETOOPEFIATEYo�xapplicatiorcfonlicense�will eitherbegranied-ocreiecie�subiecttctheprovisionsoEthgzonin�
ordinanc�and:completiorrotthe�inspectians-brthe=Heaith; Fire;.Zeninq and/orLicense:lnspectors_
. �
. �` �� $15.00 CHARGE FOR ALL RETORNEII� CHECKS
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' �icy oc Sair.t Pau1 /��_
` . . , � Deparcment o� cinance and Management Services `�/`''d� !3 ad
� � ' Division of License and Permit Regiscracion
INFORMATTON REQUIRED WITH APPLZCATION r"OR ?E�MIT TO CONDUCT CHARITABLE G?u'�tBLi�G G� I�
SaI'N'� PAUL
1. Full and complece name of organization which is applying for license `• ° VZSotr�
Q.tres.� �" o c���.�,� � � SS C�C.. �
2. Address where games wi11 be held i dV Ve- � 5���
Yumber Streec Cicy Zip
3. Name vf manager signing this applicatfon vho will conduct, operace and manage
Gambling Games p �„ �r�v� Dace of Birth �� �,�`�� 5(�
(a) Length of time manager has bean member o= applicanc organizacion �1 v 2G1�_
�—
4. Address of Manager � � c � � . GZc.� � b
Yumber Screec C�c� ip
5. Day, dates, and hours thfs applicacicn fs cor � G�0.�/� 4� LU�Q-� 5"' �
6. Is the applicant or organizacion organized under che Iaws o: t;�e State o= 'Q(? v'�s
T—
7. Date of incorporaci�n f ��
8. Date when registered with the Stace of Kircnesoca � 7 3
9. How long has organiaation been ia esiscence? � ��/�2G1{/' �
10. How long has organization been ia existeace ia Sc. Paul'. ��\/'1LC.�f/'S .
11. Whac is the purpose of the organization? �6 v
O O cSLr �l G (��l��tFe
I2. Officers of applicant organizacion
Name 6.V'O � 0` Yame �Y`1�� �����
Address � L, � � �-.�-� � Address ( �"'( � � CJ�!/�j�
Title �Y�,���-� DOB °E 2 �JG Tit?e `'��t/�0�� �OB '� �
�ame v_,�7► �p d� �C� !/\Vld 1/' `(ame �
Address ���� :�ddress � ��w
Title lJ . � DOB � l iitla �(���tZl� �oB 0 �
13. Give names oi ofricers, or any ot^er ?ersans :rao ?aid �or serr:ces co �ze o:gar.:=st'_cr..
tiame Vame
Address address
Title --='-e
(�i[[ach separace 9I12C' -.^.' acc==:or.�_ -��as• �
. � �-=����
14. �c��ached hereco :s a iisc o� names and addresses oi all �emoers o� _�e :;5ar.:za__;- .
�
15. In vhose custody viil organiaation's records �e kepc?
' �ame a�/' �.� �ddress ( �� � �'f' �(ti
16. Persone vho vill be conducciag, assiscing in conducting, or operacing che games:
;r'ame C�`v;� �Q�1/`�- � Date oc Bfrch � � �l
Address l� `'�! �-.�, N
'lame oi Spouse ' "�"^'� Dace oE Birth "-�
Dates when such perscn wfll conducc . assist. or oparace �JC3��/'toC�;-� I� � o.1�t`�s
O�VL V'���..` '�` ��e._ l�tJ�2 Q.�C
Yam� j� �..� w i �-. Dace of Bi=th f U l I �(��
�._rt.�.�,
�lddre ss ��� �c7-��'(,� U��_
Nama oF Spousa `�`-- Dace of Birth ��
�^
Dacea vhen such persan �il'_ can�ucc, aas=st. or operace
17. Have you read aad do ;rou ct:craughly unde:scand che provisions of aLl 1avs, ordinances,
and regulacfor.s go�re_^..=.^.g c�s cperac:an oc Clu::tab=e GambLiag g.:mes? -�'
18. �►ttached hereco oz c`�e Eo:=►� ;ur=shed 5v che Ciz•� c: Sc. Paul is a Financia? Reperc
vhicZ ::emizes aL: recai�cs. ex�easea� ar.d d=scurssmeacs ei che applicanc organi2acion
as we:= as a:: o;gan:zac_ons Jaa zav� :ece�'1@¢ _''1lid5 :o c�e orecedi:g ca_andar year
� /�ahica �as besz s:3^.e�, tre�ared, aad va==::ed Sy C�UI� ��'�. -
` �(ame
�� � �1 � �� �
�adre9$
vho is che Pt/'2-�r'j l�O��.V��- a c the aoplfcanc Or3anizac'_or..
Yam� �t Of-=ce
19. Operacor of premises vhere �amas :ri�= �e `�e?a:
�
Naa�e �,� �G.�G� ' Q-V\�5
B�csiness Address �_�� ���� ,�o.✓y'
Home Address
20. amount oE renc ?aid by app�:caac Or3ani:.acion car ceZt oc che hall; speci�y amounc
pald per G-hour s��a:on � ,� '. �U
. � . � �����
� ' , 21. The proceeds ot che games will be disbursed after deducting prize layouc costs and
� operating expenses for the tollowing purposes and uses:
• � ' ' G\ V� oG � ` "t-G ✓�
�
O 1�1/� ✓2 � C��
22. Has che pre�ises where che games are to be held been certfffed for occupanc� by �he
City oc Sainc Paut? � -�.—�
—r
23. Has your orgar.izat=on :i1ed cederal Eor� 990—T? � Iz ansver is yes, please atcach
a copy wic:� chis applicacion. I: answar is no , explain why:
Any changes desi:ed :� cze apo�=canc �sscciatfon ma� be aade only wich che conse.^.t of che
City Council.
�o�n c�5��. G�.r��c-���
Organ�zaclon �
Date � � �� By:
'.�Iaaager n cha ge r game
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City of Saint Paul ��i���
, Department of Fiasnce and Management Serv3ces
f
� � . Division of Licensa and Permit Admin3�tration
ITNIFORH CBARITABLE GAlIDLING FIIiANCIAL REPaRS
� Date
1. Aams of Organization i � �Q
2. Addraae vhere Charitable Gambling is condnetad � \.��.� ��-� L
3. Report for period covsring 19�through �(,��.� 19��
4. Total numbar of daya played ��j
� S. Grosa receipcs for abova period ; � , �_��
i6. Groae prize payoats for abwe paziod (include cash ehort) S '��,���-L�P"��o�J
7. Net receipts - line S miaus line 6 � 1���;�
8. Expensea incurred ia conducting and operating ga�e:
A. Groae wages Qaid. Attach vorker list with
namea. address and groes vagns. ; ���'U �
C- '
B. Kent for�� weeka � �c�Of?,. (�[�
C. Licease fee j ���i (�
D. Insurance �
E. Hond S ��� � QO
F. Dinhonored checks not recovered ;
-- �
C. Accounting Eapenae ;
H. Employara F.I.C.A. ; � cY ��
I. Pulltab Taz Paid to DeQartment of Revem�s ; , L�� ' � � ' 4 I�
, -. � -,
J. Kinn. O.C. Tax S
_ •,
K. Federal Exci�se Taa � Stamp ; _
.
L. Statn Gambling Taa ; '�—
M. Miscallan�oua Expenaas. Idaatify the asount
and co whom paid.
� �.�.�,y.� P�.,�T��� : I L1. ��a,�
2.���i+�z� lllorthuJes�``.• �A`�,.o`�c�
3.�'��.� Y�.��G.w.�t.N : �t 14 ,�1�l
4.,c�K ���1 �� ; a`�• °� �'
9. Total Espenaes ?QTAL ;
�a �s8 � �
10. N�t. Income - line 7 minus line 9 ; � �V_q�V��.L_1
� G
il. Checkbook balaace begianing of period ; � 01 IJ
12. Total of line 10 and 11 j -'���`_"f"'�'�?
13. Total eontributiona fron liae 17 S L7�O_ �CLL •�7
14. Checkbook balance end of reQorting period - � •�, ,8 3
line 12 leas line 13 S �
15. SQecif usa made of amount on line 13: �
�c. hc.c�cGzec/ cfi�Cc��1..J �,J� � -
�2�.r'�c� �21 r nG 7E-�� � � q�'3.� Q.Q�d,U �l�
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• � � Addreea �`�� � �T�{�- S i addrans
Daca Rec`d Date Rae'd
P� � �� Purpose
Slgnacure Signacure
o[ Etecipi ��af Recipieat
.(„)()
Amounc Amounc
Name ,y�e
Addrena r�c�m �03 � �1� Address
Dace Rec'd DsCS Rec'd
Purpase ��vt�,7i'� ��U��i�� Purpora
Slgnacure Slgnacire
of Recipienc of Rscipien[
Amounc��� Amount
Name Name
Address Addresa
Dace Rec'd Date Rec'd
Purpcaa Purpoae
Slgnacur� Slgnature
o[ Reeipient of RecipienC
Amount Amount
Nama Name
Addresa Addrees •
Dace Rec'd Date Rec'd
' ?urposa Pvrposs
Signacure Signacure
aE Recipienc of Recipient
Amoune Amceine
17. Tocal Disbursamcncs ��_ (_p(n� •��
'T—°
'LHIS eZEPOR? HUST HE FILL�•I:1 COI�LETELY TO QUALIFY APPLICATION FOR CHARITABLE Cdt�IDLINC
LICENSE. ,
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