88-1848 WHITE - CITV CLERK COUflCll / y G
PINK - FINANCE G I TY OF SA I NT PAU L , p p
CANARV - DEPARTMENT �""
BLUE - MAVOR File NO• � -
Council Resolution ,,���
Presented By —�� G.�' � � �__ '.
�
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #15661) for a State Class B Gambling
License by Harding Area Hockey Association at Sundance Lanes,
2245 Hudson Road, be and the same is hereby approved�.
COUNCIL MEMBERS
Yeas Nays / Requested by Department of:
Dimo6d VJ
�ng In Favor
Gosw�tz �
� B
Scheibel A gai n s t Y
Sonnen
Wilson
NO� 2 2 '� Form Approved by City Attorney
Adopted by Council: Date - .
Certified Pas b uncil S ta By " _� • �
B�, J
Appr by Mavor: Date �— N 2 5 Approved by Mayor for Submission to Council
By
��kC'� 'V L� 3198a
i Nv�.�J
: _ ��'/��� �
. . ORI9MIAlOit� .. . . . � � . . DATE Y61NTlf3. � DI1TE t:OAA�Lt1W . _, � � �
: an�. ,�. car�nea; . fif�EL�'�i- �W��1` �.0 0 2 5� 5
�T s oeP�ar�rr ou�croa M+wn lan�er�
Christine. Rozek "�1°" � �•��� ��«� �
. Caar P►+or�No. NUTABER FOR - °
RamNO �� ,. �Counci 1 Researc
�inance & M t,;_ . 29 -� 56 �'` ��,,�„�„
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Application for a State Class B Gambling LicensE.
#�tification Date: 11-8-88 Hearing Date:
�no�a:t�cpor.'(�)or R.l.a tR)) cotnicn.aES�d�t�ro�rr:
PLANIMq OOMM8810N CML SERVICE COM�AISSION DATE NJ� -DATE OUT � ANACYST , � - � � PIId1E NO. �
� � 2�ONINO.COMN�SION ... . 18D 825 SCNOOL 80ARD .. . . . .. � .
. . �$TAfF . . � � ClIAR7ER CA6MAI3810N . , � COMPLETE AS IS � -ADDL IIIFO.A�ED� ._F�A Di�.f ... _F� �� • �..
dBffilCi COWNCL . . . . �EXPIAl44TION: � . � � . , .
. . . . . . . _: �.� .
..�-8NrP0lBS 4Mi1CFf COUNdL 0lJfiCTIVE7 . . . . . . . . . - . . .
C�;.i�cii �esearch Center
frGV l 0 i988
.nu►�vno�t.ey.�orro�t�rxrr(wno,wn.�.vrr�en,v�e.�r. , `
Danna Sperr, on behalf of Harding Area Hockey, requests Council approval
of her application for a Class B Gambling License at Sundance Lanes,
2245. Hudson Road. proceeds fraro `the pulltab sales wi11 be used to _
-� su�.part a youth hockey program .in the. Harding Area. :
<.. �IIi�9�A#oNlCo.tr�a.IMe.�a�pss.A�I�r: _ : . � = '._ . .
R11 fees and applications have been submitted.
�OU�B011B�lt fWt�t.wrisi►.ana 7o v4hom): . , °• �. -
If Council approval is given, Harding Area Hockey will sell pulltabs
: at Sundance Lanes. '
K�MIiC11Yli: : PNO� CONS _ :
Sundance Lanes has had no gambli g violations. This is th first o�ganization
to apply for three (3) pu'tltab `l cations in St. Paul . Ma ing has a1r�ady been:
approved for .pu]lt�b saTes at Mi. nehaha Tavern (Ciass A) a d .,Pub East� (C]ass A) '
Sundance Lanes will be a Class 6 loca�ion. Qur City Ordin nce #409.22 (h)
� allows an arganization to have t ree (3) pulltab locations - 2 Class A's and
1 Class B ar C. Harding's appli ation meets the requireme ts of this orginance
�*�► � ave receive no comp a�n s regar ing r ing s pu a oper �o �
Minnefiaha Tavern, (Pub East is not yet in operation). tlarding is current in it;
10� payr�ents to th`e Gity Wide Youth`Fund: '
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UIVISION OF LICENSE AND PERMIT A.I)MINISTRATION DATE � �/ /� 'f
INTr,RDF.PARTMFNTAL KEVIEW CHECKLIST Appn rocessed/Received by
Lic Enf Aud
Applicant Qrdjr� /�� Home Address
�
Rusiness lvTame �U 1���.�L/,� �'(pS Home Phone
Business Address aa ys t�Cql,SOn ,� Type of License(s) �'!�5`�j � � S��
Business Phone Q � �.1 U1✓�S-{�
Public Hearing Date � � � � License I.D. �F 15 ��I
at 9:00 a.m. in the Counci Cham ers, n'
3rd floor City Hall and Courthouse State Tax I.D. 4t ��/"�
llate Notice Sent; � ��q� Dealer 41 ��J�
to Applicant ( ��g� �, O �-1� , l
rederal I'irearms 4� Y �
Public He�_�ring
DATE INSPECrIUN
REVIEW VERFIED (COMPUTER) CUMMENTS
A roved Not A roved
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Bldg I & D � �
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Health Divn. � '
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Fire Dept. � j ,j� ( ,
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Yolice Dept.
10 �� 0 ,�.�
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License Divn. '
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City Attorney �
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Date Received:
Site Plan 1" � �j (�l�
To Council P.esearch �� � DO
Lease or Letter ' / �� D te
from Landlord N
; . 1 Slo(�/
k� ` City of Saint Paul
. "` . " Department of Finance and Management Services
� '., . �• _ License and Permit Division �
203 City HaIP � (�
f - . St. Paul, Minnesota 55102•298•5056 �/ '
� _ APPLICATION FOR LICENSE �
.r.CASH CHECK CIASS NO. . � • New Renew
£ -k,� ..
oc� �. �� , . - i �� YWoa _ . � - - �j ��
. . . . . Date r 19
Code No. � Title of License • _ - ; �( �(�(
�From � 19�!"To �1 � 19�
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�a 3 C 5 - �n�P�� 33 , ov � � � ( rr
,00 � �-t�� �r� , raa h�1��P . �
' � , APPIIeanUCompany Na + :
100 . ...
. . dG h ,�4 �-�5
� 100 . Busin�ss am�
,� a a �5 �--��ISO� ��
� Business Addrsss Phon�No.
100
sj,�� c1 /, /��� -5511� -
100 Mafi to Addross Phone No.
. ,00 � . S .P y � �q q '
@---
• ManaqeNOwner•Name
100
� _ - l� � s (� or� r>9� �n �D
, -100 AlanapedGwner•Flome AdT� Phone No.
_ - .
�; 4098 Applicatton Fee � 2. 50 � ( j�
Received the Sum of . _ . f 100 S� �C/(�l ! . (`"(/�7 5 S�v�O
s.. ' • . - � l'�( •S� . - ManayedOwner•City.State 3 Zf�Codt
_ . ,, , . . .. .. 100 Total 100 ' . . . � . _ .
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•.:license Inspector By: Siqnaturo ot Applicant
�`Bond• .. .
. Compa�y Name . - Policy No. Expiatfoe Dat� - _. .
Insurance:
. . Company Name PWicy No. Expintion Date
Minnesota State Identification Na _ Social Security No.
Vehicle Information: iacsrrwnwr
Serial Numbar w
Other. ' —
THIS IS A RECEIPT FOR APPLICATION
THIS IS NOT A LICENSE TO OPERATE.Your application for I(cense will either be granted or rejected subject to the provislon�of the zonin9
ordinance and completion ot the inspections by the Health, Fire,Zoning and/or License Inspectors. _
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� . $15.00 CHARGE FOR ALL RETURNED CHECKS
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" ..;o;�o�N�?g; Charitable Gambling Control Board FOR BOARD USE ONLY
' ` �•� Room N-475 Griggs-Midway Buiiding
1821 University Avenue� �°°i°N�'°`
_ St. Paul, Minnesota 55104-3383 �T
� _- - (6121642-0555
� " �'i�' 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 o�iginal 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-tabsl �.�
�Class B — Fee S 50.00(Raffles,Paddlewheels,Tipboards,Pull-tabs) Nlakechsckspeyablsto:
' ❑Class C — Fee 5 50.00 IBingo only► Mi�mesota dwitabts GambNng Control Board
- ❑Class D — Fee S 25.00(Raffles only)
❑Yes,�No 1. Is this application for a renewal? If yes,give complete license number � - 0 - 0
OYes ONo 2. If this is not an application for a rene�wal,has or9anization been licensed by the Board before? If yes,give base
license number(middle five digits) L_ . � ��
, Yes�No 3. Have Internal Controls been submitted previously?If no,please attach copy.
4. Applicant(Official,legal name of organization) � 5. Business Add�e�s of Organizatio�-�• � �
. ��t�� ,� �_ � �� � � l�-!,, = �t � a t :n ,ti !J t�i7�= � � f/�� �. IJ
6. City,State,Zip 4 �` r � � 7�County 8. Business Phone Number
,C i . � ��, ti�. :,; - . / %, q/•✓. �� �% 1(__! 1 1 '" U�
9. Type of organization: ❑Fraternal ❑Veterans ❑Religious ,�Other nonpro�it`
'If organization is an"other nonprofit"organization,answer questions 10 through 13.If not,go to questio�14."Other nonprofiY'organizations
must document its tax-exempt status.
- �Yes ONo 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.
�CJYes�No 1 1. Are articles filed with the Secreta�y of State?
�Yes�No 12. Are articles filed with the County?
�pYes O No 13. Is organization exempt from Minnesota or Federal income tax7 If yes,please attach letter from IRS or Department of
Revenue declaring exemption or copy of 990 or 990T.
❑Yes;�No 14. Has license ever been denied,suspended or revoked?If yes,check all that a ly:
ODenied ❑Suspended ❑Revoked Givedate: -
15. Number of active members 16. Number of years in existence Note: If less than four years,attach
' evidence of three years
-f ,� � � � ;� � existence.
17. Name of Chief Executive Officer ' 18. Name of treasurer or person who accounts for other revenues
/- ---Qf the organization.
�j.- � ; � 1� �� � � -C 1
Title Title
---� �..
� ^'�
�-'� }_ � / L—.hl � 1 %'�r�.. _�
Business Pho�e Number Business Phone Number
' �, � � ' � � � � � ` �? � � 1�
,t-: >_: ► ��.: � � °�. -. �� r_ � ��, � , �,
19. Name of establishment where gambling will be 20. Street address(not P.O.Box Number)
\ conducted, �
� �V e�/ ` 1 '� ,1 /� �!.., ,�i I� �� !` 1,�: ,^� / '�— 1\'^� r� �' � .'}i.�� /�� �`�
21. City,Stste,Zip 22. County(where gambling premises is located)
. /^ `�• /' / ��,
C � r' �.Jt, .�1,5 ,�� . ti,� �� �� ,'� ;., � �
CG-0001-02(8/86) � White Copy-Board Canary-Applicant � Pink-local Goveming Body
. ` � � l� �
- '.Gambling License Application � �' � " Page 2
T y p e o f A p p l i c a t i o n: ❑C l a s s A f�C i a s s B l�C l a s s C ❑C l a s s D
�Yes�No 23. Is gambling premises located within city limits?
❑Yes�No 24. Are all gambling activities conducted at the premises listed in A�19 of this application7 If not,complete a separate
application for each premises(except raffles)as a separate license is required for each premises.
❑Yes QNo 25. Does organization own the gambling premisesT If no,attach copy of the lease with terms of at least one year.
❑Yes�No 26. Does the organization lease the entire premises?If no,attach a sketch of 27. Amount of Monthl Rent
the premises indicating what portion is being leased.A lease and sketch $ �OC��
is not required for Class D applications.
❑Yea�iNo 28. Do you plan on conducting bingo with this license?If yes,give days and times of bingo occasions:
Days Times
�Yes�No 29. Has the S 10,000 fidelity bond required by Minnesota Statutes 349.20 been obtained?Attach copy of bond.
30. Inauranse Company Name--- ..84nd Numbe,r
�i ,� ;�= ,� �,, � � yLp. , � �-' SU / :� 7� �
32. Lessor Name � 33. Add�ss 34._Ci�y,State,Zip _ �
SU�. .� ., � � �:�wL�;�!��- �.������� .���1.� i-������� �� 5�� r� a�..�- r�N �� S �i�
�5. Gambling Mana er Nams- 36. Adclress 1 ` ,. — -� 37. �ity,-State,Zip � „ ,
��-,n,�.n' 1 � � 1'i= �� ; v I�;`t- (� �4 J-�/� 'J 1�,I� i� �'rl� /v�t.r' �.�i n/ �,
�..�,
38. Gambling Manager Business Phone 39. Date gambling manager became
( � : � � �> �Li �, member of organization: /�ji�l .
,
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 �
1 hereby declare that:
1. I have read this application and all info�mation 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 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,Le�al Name of Organization ,,.� 41. Sign r�ust be si �r"ed by Chief Execcitive�Officer)
�/aK l�ii l_ l� Kr �� _ �S�o��.�/� i �n�� x - `�� %� — " �
'���^ J � Date
�itle of Signer� � , (� �
-.
' `� ,��. - �..;. ;1�1���V;a.(y �:= t ' —�(J— 1� ;/
� . ACKNOWLEDGEMENT OF NOTICE BY LOCAL COVERNING 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 reviewed 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 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
t ! addition to the county signature.
Signature of person receiving application 43. Name of Township
X .�/ '
Title Date received(30 day period Signature of person receiving application
;� begins from this date)
� ' � ' 1R � X
l44! Name of Ferson delivering application to Local Goveming Body Title
_J�..�-�,�_�.. _„_--�.��--
CG-0001-02 (8186) White Copy-Board Canary-Applicant Pink-Local Governing Body
. Cicy o: Saint Paul {�
. , Deparcment oE Finance and Managemenc Services � ��� 0
' Division of License and Permit Registracion � �
INFORMATION REQUIRED WITH APPLICATION FOR PERMIT TO CONDUCT CHAR.ITABLE GaMBLi�G GAME I�
SaINT PAUL
1. Full and complete name of organizacion which is applying for licease
��a.��;,.; '� �'3;�. 1��-���,/ 1�.S� `�.�, h1 I t•��1
2. Address where games will be held �� ��� ��� .��-,�/ ��_ S�i r I'livt-- �-S�S�/%q
Number Screec � Cfcy Zip '-
3. Nam� of manager signing this applicacion who will conduct, opsrate and manage
Gambling Games ��ti.�INA l�. <� t��=� tZ Date of Birth �j�/ �-�� �7
(a) Length of time manager has beea member o= applicanc orgaaizacion f �' �-
�
4. Address of Manager �l. 7 S� (�/���jZ ��^I ci� lZ!�. ��1�,�i���L � � �/[` �"`�
Yumber Screec Cic� Zi2
�� ��.:;a
5. Day, dates, and hours chis application is cor ' �� �.,�}�,���;l���T�irT�-5� I �
6. Is the applicant ar organization organized under c:�e laws a: t;�e State cL �IId? ���--
7. Date of incorporati.an 1 �j� � '
8. nate When registered uich the Scate cf �i�anesoca l lL�
9. How long has organization beea ia existence? ��i��� S
10. How long has crganization been in e.Yiscence in Sc. PauS.? ��� '"a'�S
I1. What is the purpose of the organization? �. t}�1 j� /�^ _� i=�
I2. Officers of applicant organization �-►-n�YmG�d�� �-lo� iS �''� � �;�u��us E�°-��
Name Vame
Address Address��
Title DOB Titla- � DOB
vame �f ame
Address �ddress
Title DOB iiLlz DOB
!3. Give names of of�icers, or any oc^er ?ersans �rao ?aid :or ser�=ces co �^e or3ar.:�ac=cr,.
`ame Va�a�
Address ?,ddress
Ti=le --='-e
(,�ccach separace sazM^ '^.' ac�=_:or.a: -==as. �
• ���
. . , . �6`�" �
' 21. The proceeds oi che Aames will be disbursed afcer deduccing prize layouc costs and
operacing expenses for the Eo1loWing purposes and uses: �
� ��.. .�Z�- ,
22. Has che pre�ises where che games ara co be held been certified for occupancy by che
City oE Sainc Paul? �j� �
23. Has your orgar.ization =iled cederal Eors� 990-T? ��� If ansWer is yes, please accacn
a copy vich this applicacion. L: answar is no, xplain vhy:
Any changes desirea �v ��e a�ol:caac associac=on may be Wade on1� vich che conseat of the
City Council. �
`'� � 1 e-t.. i; SS�C_ �
• \ • Organizac�o
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Date �-�,�L� °-� � Bp: _
� '�taaagez ' cha� of game
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TO BE COl'�LETID BY
ORGANIZATION PRESIDENT AND GA1�ffiLING 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 �y jarbar must meet citq standards; that 10�
of the net profit from pulltab sal.es must be returned to the City-Wide
Youth Athletic Fund on a monthly basis; that monthly finaacial state-
ments must be filed with the city; aad that all. proceeds from pulltab
sales must be used for youth athletics.
ignature - Manager
1 �
Signature - Organization President
�
Organization Name
�
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Gambliag Location
�^017-���
Date
Please retain the attached ordinance for your records.