88-1671 WHITE - UTV GLERK
PINK - FINANCE COUflCll
GANARV - DEPARTMENT GITY OF SAINT PAUL File NO. ���7
BLUE - MAVOR
un il Resolution �'�'�r'�
Presented By ��
Referre To Committee: Date
Out o �Committee By Date
RESOLVED: That application (ID #22183) for the transfer of a Gambli g
Manager's License currently held by Robert Kusterman DBA
Shop Pond Gang at 1199 Rice Street (E. K. LeMant's) to
Sarah Kusterman DBA Shop Pond Gang at the same address, b
and the same is hereby approved/de�i�r.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
�� [n Favor
Goswitz �
Rettman
�� _ Against By
��
Wilson
Adopted by Council: Date
U�iT 'j � 1�8 Form Ap roved by ity A torney
Certified Pas e n il , cret r By
By
A►pprov by Ylavor. D C �� � � Approved by Mayor for Submission to Council
By
�,g� o c T 2 � �ssa
. . � �-�-��rr 1
DiVISION OF LICENSE AND P�RMIT ADMINISTRATION DATE � .Z� � I / ` �7 ��
" INTERDFPARTMF.NTAL REVIEW CHECKLIST A.pp Pr cesse�/Received by
I Lic Enf Aud
Applicant S�t,ra.h L�us-he►'ma� Home Address � ��.� �- �.yGs�,/91/�1C ��.�'
Rusiness Name ��Q� �nd C�rtnq Home Phone
Business Address �i �q I�,�CL�r Type of License(s) �C{,rl� �l��g /�'fq,r`
Business Phone �'1rQ/1$•�r"'
Public Hearing Date �� la O� License I.D. 4{ �°Z� g�
at 9:00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �� N��i
�
llate Notice Sent; Dealer �f �V t�l
to Applicant �(' '; g�
rederal I'3_rearms �� �
Pub.lic Hearing
DATE INSPECTIUN
REVIEW VERFIED (CQMPUTER) COMMENTS I
A roved Not A roved
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Bldg I & D � I
N� �
Health Divn. � I
' �, �,� '
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Fire Dept. �
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Yolice Dept. I
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License Divn. �
10 ��� !� I
a
City Attorney l0��� „)� �� i
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Date Received:
Site Plan N �� I �(y
To Council P.esearch f� � "
C�
Lease or Letter �I� IDate
from Landlord
I
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". . • . ` City of Saint Paul ', , . . - ..
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_ . Depanment of Finance and Management Services I, . .,�/6 7/
_ License and Permit Division �� �
. • 203 City Hall �i
St. Paut, Mtnnesota 55102•29&5056
�'s: �, APPLICATION FOR UCENSE . . .�,
�.' CASH CHECK CLASS NO. New Renew •. �
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;,, - . _. n , . Date /9�-
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�. Code No. Title of License •- � �0 �
-- - From 19_T¢ 9 � 19�
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• '�"�'�/ � ' . ApplleantlCompany Name I
. . '°° �j � �'10 � � �1 Cc.r-�
100 Buslness Name
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' " ' 8usiness Address Phon�Na
100 -� /�
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100 Mail to Addross Phone No.
100 •
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' Manaper/Owner•Name �— �}(�.
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Alanaper/Gwn�r-HOmaAddnss , PhoneNo.
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4098 Applicatlon Fee • - , .. - , , ,
,: Recelved the Sum of _ 2. 00 c--r � �t(� �/'� ���U O
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- .,_ � ManaqeNOwner-Ciry,Stat�a Dp Coqe :
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'�"Minnesota State Identfficatfon No� � Social Security No �
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.:� VeMcle informatfon: � . ' � . •� .
S�NaI Number , att NumpK I�
Other �_ _ -
THIS IS A RECEIPT FOR APPLICATION i
' THIS IS NOT A LICENSE TO OPERATE Your epplication for license will either be granted or rejected subject to tM prqvisions of the=on(ng
{-c:.�
ordlnancs and comptetlort oi the inapeetions by the Health,Fire.Zonin�andlor License inspectors. �
. ., . . �
.
_
.
,
. �.
$15.00 CHARGE FOR ALL RETURNED CHECKS �
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- �Qo�e� �us-�� II
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.. �. Sa.�� c�.��Y�s s ��
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�G�'�-�� 9--°Z?��y�i .�� �
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. .� ` City or Saint Paul I /�'`��G��
. - Depar[ment oE Finance and Management Services v�
Division of License and Permit Registration
INFORMATION RE UIRED WITH APPLICATION rOR PERMIT TO CONDUCT CHAR.ITABLE GaMBLI*iG GAME IN
SAINT PAUL
/-
1. Full and/complete of o nization which is applying for license �
�,`
�
�G��� ,
2. Address whete games will be hel �G .5T dL I .
Yum er Streec C�y r Zip �
3. Name of manager sig g this applic tion v�io will conduct, aperace and ma�age
Gambling Games Gz��J Date of Birth G 6
(a) Length of tfine maaager has bean membe� of applicant organization
4. Address of Manager / � � �f/D�
Number /, Scree[ Cicy Zip
V� �
5. Day, dates, and hours this applicacion is for / o �1/ .7� , ;oo��.
6. Is the applicant or organization ganized under the laws o: the State oi �Il`i? ��.5
7. Date of incorporation V/1�� D !`
8. Date when registered with the State of Minnesoca l�N�E �D, f��7
9. How long has organfzatioa beea in e:ciscaace?
_.
10. How long has organization been ia exiscence in St. Paui /
11. What is the purpose of the or anization? � �
� �, �'r"' �
ri
12. f icers of applica ganiza[fon '
Name ' (p, �� Ya�e r'
/f, i
Address O � . dc�C/ Address � v�o
/ ,�fNroo'� a!l Q � �f u�, M�(.
Title � /F�-�� DOB b � T;tZe � v _ DOB O
Name Vame G P��'.�LL v5
Address /?�/�� ,•/ ' ' ��� �ddress C�I�6f.SS • �dG/�?�!
� EHE A�a vN'T9
Title DOB 0 / Tit�e j�j {�vR�� DOB � .3.�
�
13. Give names of of icers, or any ot^e: gersor.s �rno �a_^: �or s�rr_ces to _�e �:3ari_at:on.
Name Vame
Address address
. Title __�:a
�
�nCLdC:': S2'aZ:3 C2 S:.c"_ '_ � 3i:�_'_..:'.3_ -•..—=.. •
.
€
anization• ,
a lisc of names and addresses oi all members of the org _ .
14. Attached hereco is �
will organization's records be kept� , �A f ��
15. In whose custody U ��3
s�.OG� Address 7d $r � ' ►
N�e L. � erating the games:
in conducting, or op
�-; ass isting `
16. Persons w ' vill be cond cting, Date of Birth
a�,y� �. 7.. � f,rlOb''
Name �. s �
��5' .�SSAMCr(� �p0
Address Date of Birth �
E vs
Name of Spouse � or operate
erson will conducc, assisc,
Dates When such p M, � ;� . /v(,
�� S, y��EE .�o0
Date of Bi*tih
N ame
Address Date of Birth
Naae o* Spouse
Dates w�en sucz oerson
.,�ii1 concuct, ass=st. °r °Pe=ate
�o �Tau �ha��uQnly understand che provisions of all laws,
ordinances,
17. Have ;�ou raa� a�d , �
t:or.s =ove=:�f•^•� ��e operat'_on ci Cha:itab?e GambiinS €ames.
and regula � g�, paul is a Financial ReP°rt
.� 1 , � c?�e C�t•I o� _ �Re aoolicant organizatior
-o oa che fo^.' tur.^.��hed '�: � T o�
Attached here_ a::d d-sbu_semenL� oCe�_�g �aiendar year
18. �i! rece:?cs. e:{?enses, .� °_uzds ior cae or-
whica ?�-�izes ;�ave =ac�=1ed
. zS we1� as ai= orgar.:zat'_ons :rna .
whica `�as beel s_3^•e`�� L:e?ared, and
vz.;i_ed Sy �;ame
� ;�cczess �
oL �:�e applicant Qrganization
who is che vame oL Qi=-== �0/�/�
rz�ises «ner_ zames
�:1: �e �eld: �IYLE
lg, Operato: of P-
..� � r5 ,�.ri/
Name
�.ddress / ��� s� sT�v`� M�'
B�ss ine s s �E�S, �r- �- ST-- A d�, N( • �����
���r � soecii;� amounc
Home Address fe�� �: �re ha_1;
� j -snc Or3St1i:3C'_on �or
20. �tmount of rer.c paid by a?o-_`' ♦ �
�q� � ,00
paid per 4-hour se�;=Jn
,� . � , �.�_,� 7�
. 2I. The proceeds oi tne ga�aes will be disbursed after deducting prize layou�t costs and
operacing expenses fo the iollowing purposes and u es:
��'' � .
O
� � � ��,�o
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' _ �.r �- G�
2Z. �s t premises where the gam s ar co b held been certified for occu ancy by the
City oE Sainc Paul?
23. has your orgar.:zac?on �iled ced a•_ zora 990-T' Ii answe* fs yesl, please attacn
a copy wich tRis applicac:on. Ic answar is no, . lain why:
Any changes desired b•. c�e a�plicaac �ssociac�on ma� be �ade only wich t:;e cbnser.t o� the
City Council.
Orga:�:zac:,on
Date g '' �� �� By:
Maaage: in charge af game
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STATE OF MINNESOTA
DEPARTMENT OF REVENUE
T0: BOB RUSTERMAN. Metro 3 9-13-88
FR: RON OLSON. DIRECTOR
N E A
SOB: CHARITABLE GAMBLING MANAGER
Thank you for your notice indicating that you will resign s the
gambling manager with a charitable gambling organization. ', Based
on our discussion and your assurance that you will not be '
involved in any way, it is acceptable if your wife takes over
the duties that you held with the organization.
Any work , either official of unofficial, with the organization
in connection with the duties of the gambling manager must be
avoided. In addition, if the situation changes and you become
involved in any way, you should seek a further opinion from our
office.
Thank you for your cooperation in this matter. !
-- I
I
AN E�UAL OPPORTUNITY EMPLOYER
_ a►�wru�. ,M�e co�wsll� _ ��"���
Mr. ,�. �arc►��di G���1�1 �H� � �o:f�0218
�,�,��, ��,, _,���,
�— � :
Ehris�ine Rozek - . :�R.� �8���, 3 �
,.. , Rounr,c — .wo�r o� _ , � � •
Fi rM�tt� &. t. 298-� � C ,:. :: oRO�: -:.«��►„�, ,
\ -. _
Application for transfew of a Gambling Ma�ager's License. `
Notificat�on Dat�: 10-3-88 Nearing �flate:_ 10-18-88
' ; t�ow�.ca a�cR►� , c�x��s��ro�r:
xa►�o oow�eean o�vi�s�,ac�c�re�orr u��w o��our �rsr �or�ra:
. zorMrb oo� �o azs ecMOO�egu�n _ _
... gfAFF � CENNTbt-f�0AM11B910q� �� . COMPIETEJl8�18��� ' � � � . ADDLMIFC ADDED*' � �_ORA dL-MNrd �- _fE1DYAC�Q�• .
. OISTRICT COIA�ICN. � . . . -- � . . _ . . . ..
� i EXPW�►JATIOH: .. . .. � . . . .. �� . .
.:81J�P�IIT6�YNIIG1001MdL OB,IECTIVE7 � . . . . . . .._.
lrIMiM9'IMIO�kB1.IMt1E.t1�/OR'1lM'/TY M�.VMrt.WIMIIr YYMitn.ikhY):
Sarah 1Custerman DBA The Shop Pond �ang� at 1199 Ri ce St. requests Co 'nci l ap�roval
of her�applicat�on fvr the transfer, of a Gambling Manager's License r�m . vi.
�. Robe�t Kusterman DBA Shop Pcind Gang at the same :address (E.K. LeMant s).
: nc�r.tsoare.�wwn.�w,�.�ao..��: . . . _
All fees and applicat�ions have been submitted. Cou�ci� Resear h Center .
, : .
_ _ O CT � 1 88 -
_ oo�wea�uwca:tr,�.r,wa.�:.�,a 7o w�i: ._ , . . _ : : -
If approval is given, Sarah Kusterman will become the gambling manage for _
Shop Pqnd Gang's pulltab sales at E. K. Le�lant's.
��e.u►t+,�s: . . �os . c�a
�11sT�1Wlr!!lIOC�DENis:
Robert Kusterman is employed by the Mfnnesota Department'of Revenye. ' Charitable
gambling at the State 1_evel has been taken _over by� the Departr�ent. of eve.�ue. :; D�te
ta a `pos5i bl e otenti al confl i ct of i nterest, Mr: Kusterman w.a 11 � . b�e to �o�rti nue -
�+�� as ga �ng mar�ager. ee attac e e ter. r. sterman has agree�i at al l �
gambling manager duties will 'indeed be in the hanc#s of Sarah Kusternia , h�s wife.