88-2043 WMITE - C�7V>CLERK COI1flC1I
PINK • - FINANCE G I TY OF SA I NT PAU L
BLUERV - MAVORTMENT File NO• �� '�O�
Council esolution - .39 ��
Presented By —1
C �__...-
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID #85045) for the transfer of a
Gambling Manager's License by Kathryn Bondurant DBA
Hayden Heights Booster Club currently licensed at
the Westsider, 429 So. Robert Street, be and the same
is hereby approved for transfer to the Kick-Off at
1347 Burns Avenue.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
Lo� [n Favor
Goswitz
Rettman d
sche;n�� Against BY
�n
-iiSFsen
J�N - 5 1989 Form Ap oved by City At ney
Adopted by Council: Date ' r ',�/��/
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Certified P s by Council Sec ry By
gy.
Approv d A+lav . at`e _ � S � Approved by Mayor for Submission to Council
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_ By
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ORIOrFA - �..-- �o . � �. � .. DATE NUMTED OATE . . _ . ` ���.
�'� �' C�i�E�l� �HE��' No.�0 2 5 A��3
Mr. J. Carc i
c;�*AC* o�arn�e+r o�croA ,�vo�roA�►�wn
C ASSKiN �.�r�arc�roa cm aFwc �
cor�r r�a�wo. Nl1MBER FOR � �.. �
� euooErox�CroR � 111 -1� �PSPA1"Gb_�
�Fa na�rcie &;. 298-5056 � '
� �CRY ATTpiNEY- -.
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Appl�ication for a Gambli�g Manager's License: �
!
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lV���fication Date:
�riolw:tRVwwe tN or�a(R)► c�n+c��t�vonr: ,
� PLANIMJ(i OOMIM�ION . CIVIL SEHVICE COMM13810N DA7E W � DATE OUf � ANAlY6T � � . . PWONE fq. .
. . . . , . .. , . � . � � . � f.
mlYN6 001�1N�ION � � ISD 82.5 8C1qOL 80AHD . : . . . . . . f`.
. . . SIAFF� � - �CHARTER COhRWBSiON COMPLE7E AS I3.� . ADD'11NF0.ADDED* � � RETO TO Cd7TA�T . . �COP16RR1@R :- -
: . . . � � . . . _ . � _ ... ' . _,.FOR ADDt MFO. __�FDBi1pC�ADOED• ��_ .
DIBrA1f.T OOUNCII. ..
*EXPLANATION: ' . � . !
- _ -�.&JP�ORB-NIlNCH COUNf�L�OBJlCTIVE4 � - . . . . . .. . . . . . . r.�.. .
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MiYttwl6/RO�Y,NMIi.O�ORTUMffiF iWho.NT�t,Whsn.Where,rNM:
/ �.
K�athryn Bondurant DBA Hay�Qn Heights.. Booster Club reques:ts C�unci] �
approval of her application for the transfer of a Garr�ling Manager's
License to the Kick-Uff Bar, 134�7 Burns Avenue from the Westsider, ;�
429 So. Robert St. �
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,�,r�c+►no�r.t�a.ue.n�..�e�wr.o...�..u�: . .
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All fees and applications have .been submitted. `
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�.�wn.r.+t�w+..�e wwao�►: . , - :
If Counci 1 approval i s gi ven, Hayden Hei ghts wi 11 hav� Katfiryn Band�rant ;
as :its gambiing manager at �he Kick-Off Bar. '
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: , _ . , �c�:;;��� �es��rcf� C��ter c �
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NOTE: Nayden Neights has not o rated at the Westsider s1 e 10-30-88. ��
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DtVISION OF I.ICENSE AND P�:RMIT ADMINISTRATION llATE �°�� �� / /� 1 � ' o�
. IN`TERDF.PARTMFfiTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant KC'�'nry ►'� �Qh�(,�,r�n"� Home Address �075 �-�- U�
Rusiness Name �U �/��'S .��US`K�SHome Phone � � � 370�
--i-
Business Address �l(.,� b Type of License(s) �`�(t�.y� b�iYl� I ( �j.f�
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Business �'hone
Public Hearing Date ��'J� � License I.D. 4� �����
at 9:00 a.m. in the Council Ch uibers, �
3rd floor City Hall and Courthouse State Tax I.D. �C N �'
llate Nutice Sent; � 1� �} Dealer 4� JU �'
to Applicant � ��
Pederal F3_rearms �� � a
Public Hearing ��
DATE TNSPECTIUN
REVIEW VERFIED (GOMPUTER) COMMENTS
A roved Not A roved
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Bldg I & D �
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Health Divn. '
�1�4 '
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Fire Dept. , �
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Yolice Dept.
(���z � � o �
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License Divn.
1� ��1��! 6<<-'
City �ttorney �
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Date Received:
Site Plan Z� `l b
I To Council P.esearch 1 )�
Lease or Letter �I � I�"�![ D te
from Landlord Z � � do
. . .t y ..4 , - . . . , . . - . . . � . .
. . . . . . � ., i.. � � .. . . .,�,� . .< .. .
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
. . . .. .�_ _ . . . � -
, � ���s:
City of Saint Paul
' Department of Finance and Management Services �/�
License and Permit Division ��"A��`�`�
• 203 City Hall
St. Paul,Minnesota 55102-29&5056
APPLICATION FOR LICENSE
1 CASH CHECK CIASS NO. New fienew
jo � , _ .- - . . r� a _
; Date � � 19�
� Code No. Title of License �a_/ � f�—/
, • From 19_To 19�
"' 7.�� ����=��� ��/ �4-�� //
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� ���� �Qc�n ' Ap IlcanU�ompany/�7am . 77f-37G�
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� 100 Bus(1�esa Name O6
' �� ���7 �����C��
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Business�Address Phona No.
� ,00 o�U' �6-��.�'�'`�I � . %9
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! 100 �-- Maii to Address Phone No.
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i 100 � � � .',�cfitfiCi
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� ManaqerlOwne Na �
f . 100 � �
� . 02'075' , o�
100 AlanagerlGwner•Home Addr�ss Pho�e No.
4098 Application Fee 2, 50
� Recelv the Sum of 10a ���-e �/Yj ,
�f �/� ;y �p�. ManageNOwner•Ciry,State 3 Zip Code
�: � Total 00 � - � ,-�;,,
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` LiCenSe InSpeCtOf By: Signature of Applieant
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i Bond.
� • Company Name Policy No. Expintion�at�
i Insurance:
I Company Name Policy No. Expintion Oate
� Minnesota State identification No. �S � 7/S�_ Social Security No.
� Vehicle Information: �
� Serlal Number Plate Number
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` Other.
� THIS IS A RECEIPT FOR APPLICATION
1 THIS IS NOT A LICENSE TO OPERATE.Your applicatfon for Iicense will either be granted or rejected subject to the provisions o(the zoning
� ordinance and completlon of the inspections by the Health, Fire,Zoning andlor License Inspectors.
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$15.00 CHARGE FOR ALL RETURNED CHECKS
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` . Ci�y �: Saint Pau1 ��Q�D�-3
� „ ,. , Deparcment oc rinance and Management Se:v:ces
( � , ���� � Division of License and Permic Registracion
INFORMATION REQUIRED WITH APPLICATION FOR PER.'!IT TO CONDUCT CHA.R?'?'aBLE G?,M3LIVG G�'� I*1
S?.INT PAUL
1. Full and complece name of orRanization whfch is applying for license
C t' f-��/9�3 �%�iC�P✓' � CLCb
2. Address where games will be held E�`[ �l-1/`1lIS � �/y�
vumber Screec ity Zip
3. Name of manager signing this application who will conduct, operate and manage
Gambling Games 9 Date of Birth ��-�rf' ��
(a) Lengch of time manager has been member of applicanc organization L
4. Address of Manager �� ]�' ���./ �°'2� � -�T/`���4 � �l� :.�J [�9
Yumber Screec Cic� Zi?
5. Day, dates, and hours chis applicacion is co� G�I�C`tE�� t�Q�--�6�2
6. Is the applicant or organization organized under the Iaws o= c�e Stace oz !�IN? Gf�?
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. e o incorp�icrrr�`
8. Date when registered with the Stace o= 'iir.nesoca �-aQ � 7g
9. How long has arganization been ia esiscence? :1 d�jS•
10. How Iong has organization been in esiscence ia St. Pau�'. _�t�L-�' ��'� �(J�fs.
11. What is the purpose of the organization? �QL(.�C �L�-d��l��
12. Officers of applicant organizaciorc .
Name ,�'-�i�� LQc.�1 �am� �Q�' ��d�� on
Address �C�C�G /��T /�UC�i , CT/0 �j��ty' Address 1��� �' A-rl/}��h
Title ���1�F� DOB 1�)-�i-.,��0 Tit?e PC/'e�T[ DOB r,�.s-�
.Iame �1 i�Yi Q' /�'Z4�� vame �q.VI�C/ �C.h l'}'L i(�T
Address �Q , � eC �� ?.dd.ess ��L1�4(.9� l�''� '�P���
Title ��C''�lfS�4P.�c� DOB '3�-�/� �icle plY�c�(}y DOB
13. Give names of officers, or any ocZer ?erscns :rno ?ai� �or se:r_ces �o �ae or3ar.:_ac:cr..
`ame /� �l.�fhQ Y!`��l�.T Vame
Address d���� �=. C�t�%�Y'RL• address
Ticle �iQ�if�3Lt�t'✓ �},�' �'��(o -��?e
(,�ctach separace sne�� -..� acs:__or.a: -��as.
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� . _i4. �ctached hereco .s a iisc of names and addresses oi all �emoers o: c;e :rsar._za__�- .
15. In whose custody will organizacion's records be kepc?
Name ���,t, �,�lt�f,d`Q.t�,.�` address �o7S ��y � �� STQ���
16. Persons vho vill be conducting, assistinR in conduccing. or cper�cing che games:
Name -X.��1"�F�/ ��(� 1�L�t[l�11/ Dace oc Bfrth
addresa /�i�i 4.t�z►��' s'7��/4�. ( -/�-��
Name of Spouse �/C5�(IIP.� Dace of Birth
Dilt�i vhen such person will conducc. assisc� or oparace
LCIe-�, �i cc,v��S�-i r �cc tiJ
vama �(,�.�U` ���l�c)w'S�t Dace of 8irth S `S 3�
Address
Name of Spause �eri�y �,V/l/ti�fi (�c? I�SS isjn;:-�(�Date of Birth
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Dates vhen such person �.ri1? con�cscc. ass:st, or aperate
1/Y1�fv� � Fr`�
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17. Have you read aaC do ?ou chor�ugEtly u:td�:scind che provisiccs oE all lavs, ordinances,
and regulacior,s go��e_^..'_ag �:�e operac_on oc Cha:_tab_e GambL!ng gamss? �/��. .�/.t;�_
-�—.�
18. �ctached herec� oa �:;e fa:-r .°ur�shed bv �h� C.cy a: St. Paul is a Financial Reperc
vhic:� =�emizes a?: rece=�c�, e:t�ea�es� and d:soursamencs o= che aoplicant organizacion
as ve?� as a:= o:gaa=za:=ons vao zave :ecei�red 'unds :or c:�e or_cec':,g ca=endar /ear
uhicz ;�as beel s:3aed, r�e7dred, and va:_::ed Sy ���u' '�QG�L�
t � `ta e
�,�T�v �v����,� Cl�� , /'YIPCc,u�
:�a�:eas
Who is che �'P� oc che aoplicaac O:gan!zac:or..
Yam� at Of::ce
19. Operator af premises vEtere �ames :r:�= �e 4e?d:
Name [�Q Tl"�/ �iCrl'G --Li U,Z Jf..O�t�
B�siness Address 1�'�7 �jLLlr/��' /"�L''� ��/9"'�'�'
Home Address
20. Amounc of rene oaid by aep::�anc Or3ani:acien c�r reac o= che hal�; speci:y amouac
p a id p e r �-hou r s e�4:on �l��} �� ,�GGY�'L C�L�, � �`'�dL�. � J�l•')/`!�-��L:�
. - ,�i���q�Of�...3
• ' 21:. The proceeds oi tne games will be disbursed after deduccing prize layouc costs and
operating e:cpenses for the tollowing purposes and uses:
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22. Has the prec�ises where the games are co be held been certified for accupanc� by che
City oE Sainc Paul? �!�(%
23. Has your or3ar.:zac:on riled cederal fora 990-T? Ii answer is yes, please accacn
a copy cric:� chis appifcac�on. I: answzr is no , explain why:
�(�iU
Any changes desired b� cZe a�ol=caac �ssociac:on ma� be aade only vich che conse.^.t of the
City Council.
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0 an�zacion
Date �"" �—� By: � L
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