88-1552 �
WNI7E - GITV CLERK COIlI1C11 y��
PINK - FINANCE GITY OF SAINT PAUL �,3"3�
CANARV - DEPARTMENT
BLUE - MAYOR FIlC N/. -
Council Resolution
Presented By ''�'��'��'��'�/
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #34408) for renewal of a State
Class B Gambling License by the West Side Youth Hockey
Association at the Brown Derby, 567 Stryker, be and the
same i s hereby �aci/deni ed.
COUNCIL MEMBERS
Yeas Nays Requested by Department of:
Dimond
�� In Favor
Goswitz
Rettman p B
s�ne�be� Against Y
Sonnen .
Wilson
�SEP ,2 2 �988 Form Approved by City Attorney
Adopted by Council: Date _ �
Certified Pa,s Counc�l S ar BY �
gy,
Approved �Navor: Date Approved by Mayor for Submission to Council
By BY
pI1�1.I�HE9 0 C 1 � c� �988
�on , . _ _ oat�e�rtureu or��� .
Mr. J. Carchedi
���� s�w�-r �. o o z 1�1 ^
carr�cr o��ar�Hr o�c,� �roA roA�sr�
Chri sti ne Rozek . "�dN — T
NtMABER FOR. flwwcE a w�[KOa�ear sorv�s oa�cron crtr CaEaK
°�. . ROUTINO �- euooer ar�croA
OplBER° ,lx�'v�rrow�r
� REVISED
Appl`ication for renewal of a State C1ass B Gambiing License.
Notjfiication Date: 9-7-88 Hea in Da e: 9-22-88
71011i:U�DWow(A)or iieled(R)) , COIMIC�L R66EARCM`REPORT: _ _
. . . PLAlMMq Cpiti16810N � CNIL SERVICE OOMk9.9KiP1� DATE IN�- -OATE OUT - ANAIVST . � � � � , � .PFIONE NO. . � � � . .
. . . .. . . . � � . . , t -" .
. � .�01!NWiD COMMS61p!� � .. ISD 826 8CF100180ARD . � � � � . � �
� . - BTAFF � . . GIARTER COMMI88WN . � .COMPlE7E AS IS � AODt IqFO.ADDED* - RET'D TO CAHLA�T . � �. fSt3MBTITUENt � . .
� � � � � � � . � � _ . � _FOR AODi MiFO. . _.FEEOBACK�DO�• ��
D�CT CE1lI1�R- . - . .
- � '�D(PUNAFpN: . . . . . . . .
� .� BUPPORB Nllilpi OOUNCIL OBJECTME7 � , . . . .. . .. . . . � . .��� . � "
� : _ S�p��
: c:i�. � �
..,�,�,�,��„�,,,�.�.,�,,,�.�:
[��tc
. � Mark S. Mules, on behalf of the West Side Youth Hockey Assaciatien, requests
approva7.o�f his app]icati;on for renewal. of a State G1ass B Gambli.�� License.
, , West S.1de Yauth Hockey sponsors a pu1ltab 600th at the Brown Derb�,`
567 Stryker. Proceeds are used to sponsar youth athletic actfvit�es.
�t�,rr te�c.�rn.�:�en�.�e.��: ; . . ., ,
All fees and a�plications h�ve been received. A11 10� contributior�s to the
City Wide Youth Ath�e�ic Fitnd are current. - �
f�1qE01�6 fw�rt.Y�R r+d ro vNwm): • . . . . . - .. ,.: .
If Ctwncil approval is given, t-he West Side Youth Hockey Association wi11
contiaue sponsarship of the pu'i:ltab booth at the Brown Derby. �
., ��.�i++rrn�: . _ �os _ co�s
LEGAL ISSUES: On September 23, 1987, the B"rt�n Derby was fine�t $200.OD b�r t#te
. St, Pau1 City Council for illegal gambling (:cash`pay vffs on video
�ker machines) activities a�t �he Brown Derby, (Viola:t�ons �ok
��a: p ace in pri Y, , an �ppare y were no rQ a e u
. licensed charitable organi�at�on selling pulltabs at t��t locatian).
The State wi11 nat approve this r..enewaT at the Brawn Derby beca�se
of the gambling violations.
�.�►,� .
� �_,ss.�..-.
. . �„�..m►� �„�� GR��fi1=���1' No.O 0 26 0�6 .
` Mr. J. Carcfiedi
�°" �„�� �►��«+��,
,_ , in `R zek ,�ss�ap --�.��� —�«�
� �, NUMBER FOA _ _
ROUTIMG euoGEr oi�croa ' �
' ORDERe `—' —
. . , .. . � �.. �� �.qTY,AT7'OtWEY. �. � . ... . .. . : . - ........ ..
Application for renewal of a State Class 8 6ambiing L�cense.
Notification Date: 9-7-88 Hearing Date:�
��1NS:ck,o►p+e(at a A.lea{R)) oouta�.a��acH t�O�iT:
. PLANMNq COh�AI8610N GVIL SERV�CE COMMISSION WTE M � DATE OIJ� � ANALYST . . � � - � .PF10NE N0. . . �. . -
.. . ZDNIN3 COMM&9qN . 18D 826 BCHOOL BOARD. . , � . . . . . . � . .
. . STAFF• . - � CWIRTER COMM18810N � . .COMPLETE�AS 18� . ��AdDL qVFO.ADOED*. � � -IiE1'i).TOOOttF/�'C . . � .�. G�BTfRIEW[ � � .
. . . � � . _ - � .__FOA AdDL��FO. _F�0@ACI(ADDEb.* .
. D6TFIICT CU!liCll - � � . .
*EXPLANATION: . � . � .
. ...BUPPORi3�YMNCFI CQUNCN.OBJECTIIIE? . . . . - ' . � . , � � � - . . � ��
_ . . . .. . .. . . - _ . .. � . . . . . . � _ �. . . � . . .. . .. �
M11A��MIIOlLEIfr�.OP�01111NfiY(YVhq WI1e1,YYl1l11.Wi1sf@,Why): '�
Mark S. Nh�les, on behalf of the West Side lfouth Hoekey Association, requests
_ , approval of his a�plication for renewal of a State C1ass B Gamb1ing License.
` :West Side Youth;Hockey sponsor.s a pulltab' booth at the Brown Derb�,
567 Stryker. Proceeds are used. to spansor youth athletic activities. .
_ .��o�r�co.�e«�.w.�r.e...�xs�: , _ ;
All fees and applications have been receiued. A11 .10� contributions to the
City Wide Youth Athletic Fund.are currrent. �'r�;
., ,
_ ,
coMnoua�cw°cyawr.vb,er�..�a�o,�a,o�►): .
If Council approval is given, the West Side Youth Hockey AssociatioR wil�
continu� sponsorsfiip of the pu1l�Cab booth at the Brown Derby,
: �u.�r�►� .no�s c�ws
Councit.Research Center
� S P 121988 �
__ �►�:
��8:
, ��-�s.��
DiVISION OF LICENSE AND PERMIT ADMINISTRATION DATE � 3l �l � % U v
INTERDF.PARTMENTAL REVIEW CHECKLIST A.ppn P oc ssed/Received by
Lic Enf Aud
Applicant M�y/� (,(�(Qrj_ Home Address �s� C • zsa.b Q l
Rusiness lvame ��$`'�'SL���(� ���e Phone �� -'oa,� �
Business Address ��7 s�� x��' Type of License(s) �p_n�(,(�Q� '
Business Phone ����ss B 5�'�.� G�rn blin� La ��SeJ
Public Hearing Date � Za � License I.D. 1F '3 �`f��
at 9:00 a.m. in the Council Chau�bers,
3rd floor City Hali and Courthouse State Tax I.D. �t � �/�
llate Nutice Sent; ^ �c/ Dealer 4� � r�'�'
to Applicant �'� b
Pederal F'irearms 4� ��
Public Hearing
DATE IrSPECTIUN
RE`JLEW VERFIED (COMPUTER} CUMMENTS
A proved Not A roved
�
Bldg I & D +
N !
Health Divn.
� �
�u 19'
�
Fire Dept. � �
�
j � � �
I �
Yolice Dept.
9 1 o k..
,
License Divn. '
9 � �' 4!�
City Attorney A ��� � O Y
�1 +`..
Date Received:
Site Plan O 3t g� �/
To Council P.esearch Z.. �O
Lease or Letter � � ��� Dat
from Landlord
� _ ;, :
. <� .. �. �� .::i •.:.ry:". �VY
' � .��Jt'J�'""d�.
- ••� Charitable Gambling Control Board
' � �.`�� Rm N-475 Griggs-Midway Bldg. For Bo�d Use Ony
1821 University Ave. P��
-� St. Paul, MN 55104-3383 Check No.
+. ..:'� (612) 642-0555 Date:
GAMBLING LICENSE RENEWAL APPLICATION
LICENSE NUMBER: � 1�?{�,?.»�) I EFF. DATE: ,� ;nt r i !AMOUNT OF FEE: ;�) ��,
1.Applicant-Legal Name of Organization 2.Street Add�ess
HCt�tEY aS�C;ATIOV �c3" 3IU� Yi�ir�+ 3�1 "c ?oa��
3.City, State,Zip ' 4.County 5. Business Phone
St �aa I. �i ��.,107 ?a+nsev 5 i� r.�7-15I 0
6. Name of Chief Executive Officer 7.Business Phone
s_ee ;or�tovd -
8. Name of Treasurer or Person Who Accounts for Revenues 9.Business Phone
��o�r.-1 Th . -s-l�'rl� _ 6►� 2`I^� �._.�./y
10. Name of Gambling Manager l�' 11. Bond Number 12.Busi►�ess Phone 'Z`�3�f(qZ
�n»--�aabew` A�� '3• ,v`v.�e.`-� +e�:lr.�+t, '� 1 -v�'i t,.l "� ;
13. Name of Establishment Where Gambling Will Take Place 14.Counry 15.No.of Active Members
��wn i�ee��v �� ��ul �31T:3P_V 7�}
16. Lessor Name 17.MoMhly Rent:
Aichard �'n�nas 4�GJ
18. If Bingo will be conducted with this license,please specify days and times of Bingo.
Days Times Days Times Days Times
19. Has license ever been: ❑ Revoked Date: ��' ❑ Suspended Date: ��' 0 Denied Date: ✓��
20. Have internal controls been submitted previously? O Yes �No(If"No,"attach copy)
21. Has current lease been filed with the board? O Yes �No(If"No,"attach copy)
22. Has current sketch been filed with.the board? �`. „; ❑ Yes �'No pf°No,"attach copy}. . __ ,. .� ._._,,.. _.�:. .-_.. ___.:.
r,..-�•,: ,�. . _ ...__ ., _ ..
GAMB�ING SITE AUTHORIZATION • �
` By my signature below, Iceal law enforcement offlcers or agents of the Board are hereby authorized to enter upon the site,at any time,gambling is
being conducted,to observe the gambling and to enforce the law for any unauthorized game or practice.
BANK RECORDS AUTHORIZATION
By my signature below,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 law.
OATH
I hereby declare that:
1. I have read this application and all information submitted to the Board;
2. All information submitted is true,accurate and complete; .
` 3. All other required information has been fully disclosed;
4. I am the chief executive officer of the organization;
5. I assume full responsibiliry for the fair and lawful operation of all activities to be conducted;
6. I will familiarize myself with the Iaws of the State of Minnesota respecting gambling and rules of the board and agree,if licensed,to abide by those
Iaws and rules, including amendments thereto.
`. 23.Official Legal Name of Organization Signature(Chief Executive cer� Date Title
w�s-� S►�/� �N�� ua�� � �,�r,�� ��. � �_� y_,s; �-? 'H�
�s���.
ACKNOWLEDGEMENT OF NOTICE BY COCAI.GOVERNING BODY '` �•
I hereby acknowledge receipt of a copy of this application. By acknowledging receipt,I admit having been served with notice that this application will
be reviewsd by the Charitable Gambling Control Board and if approved by the Board,will become effective 30 days from the date of receipt(noted
below), unless a resolution of the local goveming body is passed which specifically disallows such activity and a copy of that resolution is received by
the Charitable Gambling Control Board within 30 days of the below noted date.
24.City/County Name�Local Governing Body) Township:If site is located within a township,please complete items 24
r ' Y ! , �:;r t',_!..�.�.� " ' and 25:
Signature of�ersa'n Receiving Application: 25.Signature of Person Receiving Application
�_ � - ' . r !�-�;�
...-1'- i�'4r' ���..�, �
` Title ` Date Received(this date begins 30,day period) Title:
f ._ ... , �; ! ij '
Name of Person Delivering Application to Local Governing Body: Township Name
CG-00022-01 (5/8� White Copy-Board Canary-Applicant Pink-Local Governing Body
, ,� . —_ , � T „��
' _. , � City of Saint Paul �: y.. ' ,:, �._t. . Y,, ;,-
; , � Department'of Finance and Management Services �
�- . .�:,,� r -.License and Permit Division ' : �����i��'`-
�+ ' ^, -�: ... . 203 ctry Han . ` .�`.
�}� F, �r �� p� T.p�.Pa(��.Minnesote 55102-298-5056 .-.'tS v.r, . � . -
� _.. ' .. � '� :.-�' ' :_ .� APPLICATION FOR LICENSE . � � � " �
.. _� . ,_
�y,i CASFI �CFIECIC ::CLASS NO ?� ����',#''�,.=,..r�:• N�AI .ABf1QW y�s:-H, �,,.4�'.�.,�►�.- ;.: _� M- s; :% .r�•-,
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f Code No. � 7itle of f.icense <. � - `
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�. • 100 Busfn�ss Name .
, .. ' . •. 100 �lJ � -� 1 Y� �Q r" .
. 8usin�ss Addnss Phon�Na
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100 Mail to Address Phone No.
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v.� 100 .. AlsnsperlGwn�r-Hom�Addresa . Phont No.
4098 APPlication Fee - - � 2. � -� ' �: � < pa��
Recelved the Sum of . 1�( 100 , .. , , � �`� -•S J �Q�
, °° � - ' '? � —T I �S� �, ManaqedOwnar Citp Stats 3 Zip Cod� -� .
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`s LICB�SB I�Sp@CtO� �� . '.-8y' ��"�' a ,± . . ' � .•Siynature of Applieant . � _
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�-° " • - Company Name � - • . : ., _ - ; -_ poliq No. ,_. . , F.spintion Oate --
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� Insurance: ' �
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�': Minnesota State Identification No. � ,- �� ' � ��� .•��. , rt S . . . _ -
. Social Security No
= Vehicle Information: . • �. . .._ . � � ,�`, . . _ • - . -
Saial NumbK . at� umb�r
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. :.:THIS IS A RECEIPT FOR APPLICATION . � , •
�'� ' � THIS IS NOT A UCENSE TO OPERATE Your appiicatlon for Iicense wili either be granted or re�ected subjsct to the proviaions ot the zonin�� ',
ordinance and completion o(ths inapsctions by the Health,Fire,ZoninQ and/or Licena�Inspectors. . - . -
,
' . . _ _
. � .. . ,x . _.. , _ . � • x
� $15.00 CHARGE FOR ALL RETURNED CHECKS
.
�/���Q1�`�
� ' Cicy oc Sainc Paul
, ', ' , Deparcmenc o[ Finance and Managecent Services ����j�.
Division of License and Permit Reg±stration
INcORriATION REOUIRED WITH APPLICATION FOR PERMIT TO CQNDUCT CHARITABLE GA.'15LI�G GAME' I�
S�INT PAUL
1. Full and complete name of organization which is applying for license
!.l,e � �l' c � n
2. Address where games will be held �(o� �Q���c �'�.,�� �n S��b�
Number Screec City� _�� Zip
3. Name of manager signing this application who will conduct, operate and manage
Gambling Games �p�� � , ��,� Date of Birth �' Z�" ��l
(a) Length of time manager has been member oi appl;canc organizacion r
4. Address of Manager �� � • �`�-X c�'� �.�-� + `��` ���� !
Numoer Streec Cicy Zip
5. Day, dates, and hours this applicacion is for �.� ` ���� ^ .��,,�`, �l ��l $ /
—�-
6. Is the applicant or organization organized under the laws o: the State oi �i? j/�
�—
7. Date of incorporati�n �0� . �,� 1�1� �
8. Date when registered with the State of !Sinnescta ��� �
9. How long has organization beea ia e:cistence? �� v�f 5
10. How long has organization been in existeace ia St. Paui? '� �Q,.A��.S
11. What is the purpose of the orgaaization? �.t, '�„�����.5 �o�-k``�,
12. Officers of applicant organizacion
Name ,�,e e c�ovjs�r/4 ^iame ,
Address 3i/ ,�, ��p��.¢, Address Z9 ����� �
Title � DOB /D 31-f�� TiC?e �04�Uer DOE � �• ZZ.•� 1
Name ___l70 r1 �Q v , Name l:c r, ��� �.l,i�,y►v L�
Address L-S Z- V`� V.3� on�� �ddress �5 �, �,� ,�q
Title Ul�C. ���e � DOB "� ' S� Title � e. �tr DOB ` �' g ' � 1
13. Give names of officers, or any ot?�er perscns ano paid Lor services to �ae or3ani�at'cn.
Name Vame
Address address
Title __�le
(ACtach separace snz�� =�: ac�=_:or.s_ -a�as. '
. �,
�,c�-�.5",5'�-
` 21. The proceeds oi the games will be disbursed after deduccing prize layouc costs and
. ' � operating expenses for the folloWing purposes and uses:
� _ —L'i��c�.0� �� i�.+��a� . l�C'-��.�.. ��L�c..�� UO�.t�
�c�K�� 2..�'c����v.��1 i ,
22. Has the premises where the games ara co be held been certified for occupanc� by the
City oE Sainc Paul? � �
23. Has your orgar.ization riled iederal form 990-T?� �" �f ansWer is yes� please atcach
a copy vich this applicacion. If answer is no, explain why:
Any changes desired bv the apol:canc associac=on ma� be made only vich the consent of the
City Cc�uncil.
���— �_ ' `- c�<<��.. ����Q�.
_ i
Organiza ion
Date � ��'� �� BY� 0.�- � �� n
�taaagzr in charge oi game
c a _ � � cn _ � n .. — c� cn
61 W t0 `�C O C :1 � !0 O R
n n fp rr S � :0 R R � _
f0 A •t f7 �f �
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r� 3 d C `�C �0 rr tr tf r r*
n :e m s o. ca .- — �e =
� 3 r- r
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S f0 + 3 r► "i f9 y
- n x a � a a _ C = � R
R � � �
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� n = \`R � � � � n I � I'r
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' � � ���.,�-�.
� � � CITY OF ST. PAiIL
Department of Finance and Managesent Services
Division of License and Per�it Adainistration
UNIFORM CHARTTABLE GAMBLING FINANCIAL REPORT
D�ate: 23 Aug. 88
1. Na�e of Organization: West Side Y011th Hockey Association
2. Address where charitable gambling is conducted: 567 Stryker Ave.
St. Paul, Mn. 55107
3. Report for period covering: Sept. 1987 thru June 1988
4. Total number of days played: 304 days
S. Gross receipts for above period � �g��� �
6. Gross prize payouts for above period � y �Z.3r�
7. Net receipts - line 5 minus line 6 $ 3Qig 5 g
8. Expenses incurred in conducting and operating game:
A. Gross wages paid. Attach worker list vith
names, address and gross wages. $ �3��
B. Rent for �� weeks $ y�k�Z- �V
C. License fee � SO. oa
D. Insurance �
E. Bond �
F. Dishonored checks not recovered $ �g S
G. F�ployers F.I.C.A. $
H. Sales tax �
I. Minn. U.C. Tax � �`qro`�o
J. Federal U.C. Tax � `�2. t�
R. Miscellaneous expenses. Identify the amount
and to whom paid.
1. Cost of games $ 2-���•��
2. Cost of Equipment $ Z�Z Zy
3. Bank fees $ 3`� gZ
4. Working Money � �3�U —
5. Funds to be deposited � �`'��8�
9. Total eapenses Z'OT� ���5� 34
10. Net Income - li.ne 7 minus line 9 � t 51 S$ `�
11. Checkbook balance beginning of period ��3'��S
12. Total of line 10 and 11 � � � y� S �-�
2.�
13. Total contributions from line 17 � �11�5 —
14. Checkbook balance end of reporting period - s�
line 12 less line 13 � 2��
15. Specify use made of amount on line 13:
� 1 Soc�o+ � sr � • � 1 q 3SZ� � � �..�� ��S �
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