88-1773 WMITE - CITV GLERK
PINK - FINANCE GITY OF SAINT PAUL Council J �j
CANARV - DEPARTMENT �'�/ �7, �y
BLUE - MAYOR File NO. � �`�
Council Resolution
�: ���
Presented By
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #20409) for a State Class B Gambling
Cicense at Pub East, 1180 E. 7th Street, be and the same
- � is hereby approved.
COUNCIL MEMBERS
Yeas Nays Requested by Department of:
Dimond
�ng In Favor
Goswitz
Rettman a B
Sc6eibel A gai n s t Y
Sonnen
Wilson
��`;� — J j� Form Appr ved by City Attorney
Adopted by Council: Date - .
Certified Yass b cil Sec tar By �
By�
� �'�:''��� ' E`,� ��$ A roved b Ma or for Submission to Council
t�pprov y Mavor: Date '�`-`�' PP y y
gy By
�R�a�a� ����'�4 1 ', �9GU
� ��`/77
: ���� �,�� , .
. 4�_ ���� ��:� ,�:o 02 s�,
� � Mr. d. C�rc�edi
e�o+tr�cr�sor� _..- ,. � _
o��v�oron . ►Mraa;�i�sra�rn .
, � Christ�ne Rozek �� �.��� �"«n�
: . _ ��. �.ou,x� — �� �Cau�ci l Rese�r
�i r�a�ce. .& mt. .. . 298-5056 °n�'' ,�:��„�
. _ :�,�:
- Application f4r a State B G�pnbling License. -
P�Oti€ication Date: 9_�9 88 �ari Date. 3J88 -
,_ cM a►�el�t�� oourx�►. `: .: ,
� � F!LAM*IB COAM/lRIDN . . �GVN.9EAVICE COIMAI�lION DATE RI - /INAlYBT �. � _ . . � . � Pl10ME NO. - - .
� �OINq OOMIYBBION . . 180 626 9Gl100L-BO�D � . � � . . � � . � � . �
� . . &1'AFF, .. . ..G11AR,TER�.CA�1 COAAPt.ETEA818. AD4LIIiF0.A�6� .� . RE7'D7�O:QpIJ! .. . OONB'Anl@ij-. -. � ..:
� � � � - � - � _� . �`FOR AODLIWF�U�� _,_F�911CIC • _ .
�_ DI6�IMCT f70p1iCL . � . . . ` . ... .
. . *El(PUINATION: � . . . .
..... Bti�P'01118 YMIICM OOUNCIL ObJ�71V€? . � ' ; � . . . �� - . : �. � . . . .. '� ..:� ... : .. . ���,� ,`�. .
...� .. . . . . .
�Nii�lY.NN�!O�ROl11{Mr f�.YMWt.VYIIBII.VMIxB,Whp): �. . .. • '
'Thomas Wukawi�z, on beha1f of }larc�ing`Area Hockey Association; requests>
Council approval af his appli�cation �or � State �I�ss B GambTing Lic��se
at Pub ��st, 118b E. 7th St_r.eet. Proceeds fror� the pulltab sales wi:ll be
used for �routh hockey programs. .
. : :
_ _
«
. �.��: ,:
All fees and :applications have:l�en received. Hard�n a nvn- fat
organizat,�on. _,., _ . ����I �esearch��enter :
.. . _ _ . . . .. . _
: . - . O CT 211988 .
... _ _ . .
_ �l�.x�ran..Aa�wt�,: _ . . .. . , ,.,. ; . . "
- If Counci� a�ro�ai �s- gi�yet�;�-�ardi n��Area Hockey wi 11 be ab�e to se11
pul l tabs.:at Pub East.�
�w�sw►nr�s: �� . :; , rnos: : . .
:: � :
. ,:d
:""�1°'�b East will be the second pulltab 1�cation for Hardirtg t#ockey. Nardi�ng Nc�ckey ; `
- currently has a gar�lin.g location at ..NTin�ef�aha 7'ave.rn, 733 White 6ear Avertae, T - .
- Qrganizati_on �s: current on i ts monthly .report� �n� i0� t�ay�ents. I� hav�.rece�v
:,
`'�°"`�': any i rregul ari ti Es at i nspecti ons. '
� 1'�re has b��t� precedent for .grantit�g a=�nd gambling locat:ion. �ast Twin's Babe t� ;
� . `has previ:ousl y la�een t i censed fvr 2 �t't l taib l ocat:�ons (or[l y 1 of t#��ese l���t�i or�s i� �
operating at the current time).
.�� , . �g-� �3
• DIVISION OF I.ICENSE AND PERMIT ADMINISTRATION DATE � �/ / �Z ga
INTE,RDF.PARTMENTAL REVIEGi CHECKLIST Appn Proce sed/Received by
Lic Enf Aud
`7'homas u Kw,cur� -l'7�r
Applicant 'f"'� r �ty��N Home Address
J n ��-
Rusiness Name Home Phone
Business Address ����� '�$c Type of License(s) 5`�'�G �f�� $ _
Business Phone �14�M ���nG � t«iM�S'�-�
Public Hearing Date I� j � License I.D. �� �Q ���
at 9:00 a.m. in the Counc 1 hauibers,
3rd floor City Hall and Courthouse State Tax I.D. 4� ��p9 Sg ' ?
llate Nutice Sent; � �� ���� Dealer 41 � I14'
to Applicant
rederal I'irearms �� �,! 14
Public He�.�ring
DATE II�SPECTIUN
REVIEW VEKFIED (COMPUTER) COMMENTS
A roved Not A roved
�
Bldg I & D 1
� � ,
Health Divn.
� � fi '
i
Fire Dept. �
i �I� �
' � � IZ g�
Yolice Dept. .�► � I
�'( �s O�.
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License Divn. ��'���Ji O �
��b
City Attorney � � �
� � ��
Date Received:
Site Plan � I �p � g� � �
To Council P.esearch
Lease or Letter C (y(� at
from Landlord � b O
` �� �� � ��� �7�-�
...��,"�'_u"^oE'Y"lm�4� Charitable Gambling Control Board FOR BOARD USE ONLY
: ' '•.,�� Room N-475 Griggs-Midway P�uilding
, 1821 University Avenue �i���°`
f- St. Paul, Minnesota 55104-3383 AMT
t. � - (6121642-0555
� Q'l�' CHECK#
' DATE
; GAMBLING LICENSE APPLICATION
�
° INSTRUCTIONS:
� A. Type or print in ink.
� B. Take completed application to local governing body,obtain signature and date on all copies,and leave 1 copy.Applicant keeps 1
� copy and sends original to the above address with a check.
C. Incomplete applications will be returned.
`� Type of Application:
❑Class A — Fee S 100.00(Bingo,Raffles,Paddlewheels,Tipboards,Pull-tabs)
�IClass B — Fee S 50.00(Rafftes,Paddlewheels,Tipboards,Pull-tabs) ���h�*svw+���
` ❑Class C — Fee S 50.00(Bingo only) Minoesotsf�arkabl�GambingConholBoa►d
❑Class D — Fee S 25.00(Raffles only)
DYes�1No 1. Is this application for a renewal? If yes,give complete license number � - 0 - 0
❑Yes�No 2. If this is not an application for a renewal,has or anization been licensed by the Board before? If yes,give base
license number(middle five digits) �� � �
�. Y�]Yes�No 3. Have Internal Controls been submitted previously?If no,please attach copy.
4. Applicant(Official,legal name of organization) _ 5. Business/>ddcess of Organization
� JJR , �_ h`� " � - ��N�r ,a�. '/ �� ►: rla �,l 1' ►.�.
6. Ci�S�e,Zip �.. 7..-County 8. Business Phone Number
. I' ✓1-- /Y�h� �.� /� � � !� ,v�s� � k'�/` 1�') �y�
9. Type of organization: OFraternal ❑Veterans ❑Religious �JOther nonprofit"
� •If organization is an"other nonprofiY'organization,answer questions 10 through 13.If not,go to question 14."Other nonprofiY'organizations
must document its tax-exempt status.
�YesONo 10. Is organization incor orated as a nonprofit organization?If yes,give number assigned to Articles or page and
� book number: Attach copy of certificate.
t
8]Yes❑No 11. Are articles filed with the Secretary of State?
�YesONo 12. Are articles filed with the County?
�lYes O No 13. Is organization exempt from Minnesota or Federal income tax?If yes,please attach letter from IRS or Department of
Revenue declaring exemption or copy of 990 or 990T.
�Yes�INo 14. Has license ever been denied,suspended or revokedl If yes,check all that a ly:
O Denied ❑Suspended �Revoked Give date: -
15. Number of active members 16. Number of years in existence Note: If less than four years,attach
/ evidence of three years
�, � ,-� r:;a�S existence.
17. Name of Chief Executive Officer 18. Name of treasurer or person who accounts for other revenues
of the organization.
: � "` l .� 1 �'� � ��. O h
F.
i. Title Title%
—�
. ^ �
�� L l --"� -
. Business Phone Number Business Phone Number
± ��! � `� ► �3 � �=19�� � ► � � � � > qL
19. Name of establishment where gambling will be 20. Street address(not P.O.Box Number)
� c.o�nducted ,_..., ,- j �� ---""'
r
,, , i= ;:1� � ; X ,•� �.. '� 1�
21. City,Stste,2ip 22. County(where gambling premises is located)
� ! �a, � ,,,�. ;.; � � ;= ±�C � n <; - .��
CG-0001-0218/861 White Copy-Board Canary-Applicant ` � Pink-Local Governing Body
. . , $�- !-7�_3
Gambling License Application Page 2
•Type o#Application: O Class A I�lass B �Class C ❑Class D
QYes�No 23. Is gambling premises located w�thin city limitsl
❑Yes�No 24. Are all gambling activities conducted at the premises listed in#19 of this application? If not, complete a separate
application fo�each premises(except raffles)as a separate license is required for each premises.
❑Yes No 25. Does organization own the gambling p�emises?If no,attach copy of the lease with terms of at least one year.
❑Yes EINo 26. Does the organization lease the entire premises?If no,attach a sketch of 27. Amount of Monthly Rent
the premises indicating what portion is being leased.A lease and sketch � �Q I�C,�
is not required for Class D applications. �
❑Yes F3No 28. Do you plan on conducting bingo with this license?If yes,give days and times of bingo occasions:
Days Timss
• ❑Yes ONo 29. Has the S 10,000 fidelity bond required by Minnesota Statutes 349.20 been obtained?Attach copy of bond.
30�Insurance Company Name 31. Bo�d Number _
C ,�1. / = "� i �; � �- % J , � F-� C
32., Lessor Name 33. Address �' ,i -�"'' 34.�Ci2Y,\State),Zip � _
'�'�� t' � � %�_ � '��;� i` , � ��1 ��� f /'f UL r� � l/`,�'�
y�,5. Gambling Manager Name 36. Address 37,�C�ty,State,Zip __
�� .: w � , — � ,– �- -.rv �/y!J J�i �a vl. v � ..�•5 1
38. Gambling Manager Business Phone 39. Date gambling manager becam
( �, � � � '� !' � C� member of organization:
GAMBLING SITE AUTHORIZATION
By my signature below,local law enforcement officers 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 aIl 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 office�of the organization;
5. I assume full responsibility for the fair and lawful operation of all activities to be conducted;
6. I will familiarize myself with the laws of the State of Minnesota respecting gambling and rules of the Board and agree,
if licensed,to abide b those laws and rules, includin amendments thereto. /
40. Official,Legal Name of Organization ^ 41. S' u�e(must be�signed by Ct�ief Executive Office�)
\�
��� �1. �r< `�l _ �t.���. ' . �� X r. % �� .. � �
,-- le of Signer�_� y' i , Datg� �– �,1+ � / _
.t..: � .�=--� \`. ,v/a r- ,v ✓
' ACKNOWIEDGEMENT OF NOTICE BY LOCAL GOVERNING BODY
I hereby acknowledge�eceipt of a copy of this application. By acknowledging receipt, I admit having been served with
notice that this application will be reviewed by the Charitable Gambling Control Board and if approved by the board, wilf
become effective 30 days from the date of receipt(noted below►,unless a resolution of the local governing body is passed
which specifically disallows such activity and a copy of that resolution is received by the Charitable Gambling Control
Board within 30 da s of the below noted date.
42. Name of City or County(Local Governing Body) If site is located within a township,item 43 must be completed,in
_ addition to the county signature.
. . : ._ __ __i
Signature of person receiving application 43. Name of Township
X
Title Date received(30 day period Signature of person receiving application
begins from this datel :
.� -- � X
`44.J Name of Fersort delivering application to Local�Goveming Body Title
-a- ,a'�-� L' �`-��--
CG-0001-02 18/86) White Copy-Board Canary-Applicant Pink-local Governing Body
L�.�- . . . . r .__..dU�v�J
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- License a�d Pennit Division �� ����-3
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�.'M(nnesota State Identificatton No� � �� ,• � , � �'� � _ ,
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� �s ,a� THIS IS NOT A UCENSE TO OPERATE Your appitcation for Itcense wii{sither be granted oc re�ected subject to the provislona ot the zoMeq `=
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� , , , Deparcmen[ oE Finance and Managemen[ Services
� � ' Division of License and F'ermit Registracion
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INFORMATION REQUIRED WITH APPLICATION rOR PERMIT TO CONDUCT CHARITABLE GaMBLiVG G�ME' I*1
S�►INT PAUL
and complece name of orRanizacion whfch is applying for license
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�}� • ^ � �
2. Address where games will be held � � � � /
�umber Screec Cicy Zip
3. Name of manager signing this applicatfon vho will conduct, operace and maaage
Gambling Games � }-�E.;,,�r�� 1�) U�1�v�1 i l� Date of Birth � " �— �/
(a) Length of time manag�r has been member oi applicanc organization / 9�(��
�'f) .-�n
4. Address of Manager � �� l • ei�l V�/V� -�/. I ri��- I�h�hl �5 _� I/Q
Number creec tCi�q Zfp
,s�:��
5. Day, dates, and hours this applicacion is ior 7�—//1y��T�_ = _ ►"�t, 7^I �.
/
6. Is the applicant or organization organized under the Iaws as che Scate o= LII�i? ,�1�_
7. Date of incorporation J C/� �
8. Date when registered with the State of Minnesota 1� r�
9. How long has organization been fa exis tence? .�n�l �/a I-Z�
10. How long has organizacion been in exiscence ia St. Pau1? �t�jaf��
� �
11. What is the purpose of the organization? � r c�. —�
I2. Officers of applicant organizacion
Name v�e
Address Address
Title DOB Tic?e DOB
Name Yame
Address �ddres�
Title DOB Ticle Da8
13. Give names of officers� cr any oc!�er ?ersans. ano �a�d �or serr:ces co :ae o:3ar.:=ac:cr..
`ame Vame
Addreas �►ddress
Ticle --�'-e
(Atcach separace sha�' '^: ac�=::Or3_ �3�ds. '
- � � ��/77�
14. Attached hereto is a list of names and addresses of all members of the organizarion
15. In whose custody will organization's records be kept?
Name �r: n� _��...�.t�`� Address 1� 7.i����1����� N j11 �I-�
16. Persons who will be conducting, assisting in conducting, or operating the games:
Name ��� �7� {�� Date of Birth fa,/�.�Q
Address
Name of Spouse Date of Birth
Dates when such person wfll conduct, assist, or operate
Name Date of Birth
Address
Name of Spouse Date of Birth
Dates when such person wi1l concuct, ass:st, or operate
11. Have you read and do pou thoroughly unde:stand the provisions of alI laws, ordinances,
and regulations governing the operat:on ot Char�tabie Gambling gamas? Y�S
18. Attached hereto on the form fur^ished by the City o: St. Paul is a Financial Report
which :temizes aI1 rece±pcs, espenses, and d±sbursemencs of the applicant organization
as well as ali ozganizat:ons who have :ece:ved funds =or the oreceding calendar year
which has been signed, Frepared, and ve:i�ied by �,�„" �Cj�y�'
�
�iame
lf�, ��s' � � � i��=� � r i��, � �
Address
whc is the V /�- of the applicant Organizacion.
vame oi Office
19. Operator of premises where Aames wil+ be held:
Name � ���� .�������
B�rsiness Address � �,� \��/-y( 1 1�; 7, ,:, �� �.y f�
is�.c1 .
Home Address a �� �{ r' �
r- �1 %v/���il S' / c �.-� I� �
� -
20. Amount of rent paid by applicsnc Or3ani�acion ror re:tc oi the ha11; specffy amount
n
paid per 4-hour se�sion `�a0��e P� fa 1v��-!�, I ��
. � � . ��/77�
' 21. The ptoceeds oL the games will be disbursed afcer deducting prize layouc costs and
operating expenses for the tollowing purpases and uses:
�
� v
22. Has che pre�ises where che games arz co be held been certified for occupancy by the
City of Sainc Paul? V� �
�
23. Has your orgar.izacion riled cederal forsi 990—T?�y'�C If answer is yes, please atcach
a copy wic:� chis applicacion. IF answar is no, Explain why:
Any changes desired b� tne apol:canc associac'on ma� be made only wich the consent of the
City Council. �
,, � ,
Organ�zacion
:�
Date ���,�c��--� By:`��
:-tan in charge of e �
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MIM7ESOTA SAi IDLRTZgIG?IOII NUlIDQ
i Yursuanc to iiv� of Mianesoca. 1984. Cdapter 502, Artiel� 8. S�etion 2 (270.72) (Zax Clear-
` ' aner. Iasuaoes of Gicm��s), licensias authorities as� reqQired to provid� to the Minnnoea
Cooisrioeer of R�venu� th� ltim�e�ota bwinsq ta tdmtifiucioe mob�r and th� �oeial
•�eurity msb�s of sach lleena� applieanc.
Ond�r eh� !limesota Cowres�at D�ta Praetie�� Aet a� the l�d�ral Privaer Aet oi 1976. w
u� rpuirad to advis� �en o1 eh� tollovin` repsdia� tM np oi this ta[onntionz
1) Shir lafoe�atioe ea� b� a�ed eo d�n� t6� is�ne� os r�u�ai of �eur lie�os� !a clu
rreut �oa wn Mlnnpota �aJ.��. nplo��z's rith6oldlas or �ocor �ehicl� �zeiu ta�cai
2) Upoo r�eeiviag ehl� inionation. th� licw�ini authorit� rill tappl� it osl� to eh�
Mioa�sota Depaetsaae oE R�v�nue. Fiova�as. aad�r t6� l�d�ral 6uhanp of Infonatioa
Agr��aent eh� D�pastant of R�v�� sa� sup�l� tAi� intoe�tiou Co tha IaNrnal Athnas
Setroiee;
3) FAILUBE TO SOPPLZ THIS IlilORMA'fION WLLL J!A?AlDIZE OR DII,Ai S9L YEOCESSIIIG Of LOIR
LICENSE ISSOANCE OR RQfEWAL APPLIGTIOIf.
Mlnaesota i�c Indeatificatlon Nu�b�rs (Sales 6 Uw i�x It�sbes) � b� obtaim� tro� ehe
Stst� o! Nime�ota - Bnain��� R�cotd� Depsrsa�ns - Rooa C90 Get�esial DuildlaZ - 6S8 Cadar
Sts��t. (uro blocb �wth�ue of eh� Stat� Ca�itolT ��: 296-2863
Applivat� La�e Ifau lint I1u� Niddls Initial
r
1!V iu,l�q� t l �. %'/,�c��A C
' Applieants Addr��� C t�. S4te. Zip • P6on� No.
�� 9�' 1 n ;,.� wja�/ �a� �a .� �
Appliesats Soc a S�carity No. Po�ition Offic e. arta�r, ete.
. .A`Zr �A� . �C1`�N f� l�.r ,���/ Ia.S 5 f•.c ;7�'j t O �r
Buslnea• Nas�
��7:S�t.4 ���� /����on! �� ���� .�)l► �
'Bu�ia�s� Addru• Cie�. Stat�. iip Cod� Phon� Eio.
ltiane�ota T�c Id�ntificatioa nu�b�rt
(If a Mlnnesota Tas Ld�atifieatioa Nu�ar L aot rpuir�d fos eh� �
buiiw�� b�ia` operaesd, Sudicu� that b� pluin� aa Z is eh� b�,) �
,►w�e�+►,►�n�r,►,t,e���wrww�,►,►wm�a s�e�a,�s���w�
HORT.EtS' COlRQISA1TOfl
Purtuaut co th� Mlnnesota Seat� Legislatut� b� CL�pt�r 332. Saetioa 47. Law of 19e7. e��r�•
stat• and loul lis�nsia� assacr U zequir�d cs rlthlwld eh� is�waee or r�n�wl o! a
lic�n�� or p�rsit to op�sata a bwln��s in Mlaw�ota until eM applitaat ps�smts aceapt-
abl� �rideoe� of co�pllaac� vieh th� vosk�rs' ea��wation insuraec� cwnra;� tpais�aanb
ot S�eeion 176.181. Subdivision 2.
'lhi� intoc�ation is rynis�d br l�v, md liem� aed p�e�it� eo op�rat� a bwia��� yr mt
b� l��u�d oe r�nw�A it it is not prmrid�d �od/or i� tal��lr r�oert�d. �urcA�ner�. it c6�
, inLoesatioa !• noe ptwld�d and/oe fsl��ly r�poKad. Lt y� nwit la a 1t.000.00 p�n�lq
�����ssd apiast th� applleaee b� tA� Co�lssioa�r ot tha D�pastMat ot Labor and Indwtrp
pa�abl� to tla Sp�eial Co�pansation Fund.
Upoa rpu��t. lleea�ias wehoritie• ar� r�aaind to furni�6 vorfurs' eo�p�naacioa ln�uraaea
emr�rap iufoetietoo to eh� D�paceseat of Labor aed 2odwtz� to chaek fer eo�pliano� vit4
Mimu�ota Statuc� S�etion 176.181. Subdiviatas 2.
ll�r qn��ciow re;ardia� wrk�rs' eospesuacion siwrld b� dimud to eh� Niimewta Depaswne
of Labor mA Indwtr� - Sp�eial llmd Saatlon - 2l7-i777.
In�araac• Co�p��r Nar
(NOi ch� lowcanc� apnc)
Yolic� Nu�bee or S�Lf-Inauraae� Passit N�b�r
Date� of Cmrag� Eff�eti��: Fspisaeians
- OR -
L o noe rsquized to ha�� vork�zs' co�p�uu�atios ltabilit� eorysa;� b�cws�=
� �� I hav� no uplo���� eov�red b� t6� ls.
n —� p� !'7
( ) Oth�e (Sp�eif�) �Ul�iY� ��D l�i � L/1 G r1n!1��1 /���/
I HA�E BLAD i1M0 UNDERSiAND !R RIQRS AtID ODLZGA7IOA3 ilLTH RLC�p TO EUSINESS LICIIISLS.
MR?!I'fS. AMD SiORRERS' COl�IIPSA?ION CAVEAAGE. AIp 2 CEi2IF! '!B�?TBt INlOOlAiIO� PROtIIDID
IS TRU6
j '•�- �,3�:� t �'�
i signaeus� dau
� � `• . ��-i 7��
TO BE C�LETID BY
ORGANIZATION PRESIDENT AND GA2�LING MANAGER
I understand and will uphold Saint Paul Ordinance 409, Sections 409.21
and 409.22 relating to pulltabs and tipboards in bars.
Further, I understand that my jarbar must meet city standards; that lOZ
of the net profit from pulltab sales must be returned to the City-Wide
Youth Athletic Fund on a monthly basis; that monthly financial state-
ments must be filed with the city; and that alI proceeds from pulltab
sales must be used for youth athletics.
� /
, . � � ��
, , c..
Signature - Manager
Signature - Org�n z tion President
• ����
� '
Organizati ame
✓
Gambling Location
• �/ ���J
Da�
Please retain the attached ordinance for your records.