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88-2047 T �" WHIS�E - CI7V CLERK PINK - FINANCE GITY OF SAINT PALTL Council �( IIIJJJ CANARY - DEPARTMENT ��i_/O�/ BLUE - MAVOR File NO• � �J� � , � uncil Resolution r� Presented By Refe o Committee: Date Out of Committee By Date RESOLVED: That application (ID #16138) for a Gambling Location License (Class B) by Robert E. Jensen and Allen D. Doriott DBA The Stahl House at 586 Rice Street, be and the same is hereby approved/�. COUNCIL MEMBERS Requested by Department of: Yeas Nays �,_ Dimond r-�- -� [n Favor Goswitz Rettman �he1�� D _ Against BY —�we�r Wilson ��p �C+ 2 7 p� Form Appro ed by City ttor Adopted by Council: Date — / /� � Certified Pas e o ci Se eta y BY By, � A►pprov y lVlavor: Date ���' � R 1�Q Approved by Mayor for Submission to Council y By ;�,�iStIEO � -' ;'.v '? i989 I {� ! �, o„��„� aR� . a , . _ c���t� �Ir�� �:o 0�2�4 . Mr. J. Carchedi . . ���T- . . .. ' OEPARTM&JT � .. . � t�1YOR(OR A6616fMR)� . ; Christine RozEk � Fo�, i �.���� 3�a.� � � � . �,.� — ��� � 2 Council R�s�arch � Fi n & M mt. 298-5056 ; °R°�' — «r�„� i _ , Applacativn for a Class 8 Gambling Location L�cense. � �: : ; Notification Date: 12-14r88 Hearin Dates 12-22-88 ' �►ria+s:c�va�•c�>«��ea c�f 1 ca,recM.nES�cN ncno�er: ruuuuwo�ar� crvw�oo�rn�or� oa�a� o�re avr n►u�vsr �rm. � � m►Mro oo�wasaoH reo e�a scHOO�earm � ss� a+w�rEa oorw�oN c�oMV�rE ns is �om.r�o.�ooEO� �r�o ro ca+r�r ooNSmuErrr - — — _��oot�o. —�oe�ac�oo�* oistnK.�r oat�ew �- ,. . � •EXP6ANA710N: . . . � . . BUPPOft18.YMMC/1 C011NCL OBAECTIVE? � . . � . . . . . � .. � . . � k , 1 . �, . � � .� . � � . . . . - ' . �. .. . . .. � . . , . . � � ... . j� �. . � . . - � �� � �� � . - . � � . i:. . .. . . . . . . . � . . \ � , . ._ . . . . . � .. . � . �}�T���:���(�Kb�.Y�11M��Y�Mf9. �� .. . � ' . . . � . . . . . : . . �. . - . .t. .. Robert E. Jensen and All�n Doriott DBA The Stah3 Fbuse, 586 Rice Street, `` requests Council approval of their applicati;on for � C1ass B.Gambling � Locat,ion ticense. . This license will allow a charit�b1e arg��ization � jRice.Lawson Booster Club) to sell pulltabs and tipb�ards at The Stah1 Nouse. : � � r; � ; . �w+atsqG►71a,tCo.ue.n.Me,Aw�r.ges,.R�RS�: . . . . _ , : .. - � All fees and applications. have been submitted. Notic�s .have been sent. ` Al] r.equired departments !- ��oning, Fire, Police and Licensing have given � � their. approval . ` ,' F .. - � . . . . . . . � . � -4- �. . ��' �.-��l�JyYllMklOf��T41�1101l1�:�" . ' .. �..�. ._ - . ;..�. •, .:'.�..�. '�.. '.. . . .. .: -. ..., . :. ... . _ . . .r � ' : � � _ ' ... � . . � � . . . � . . . .. . . . . . _ ,�.;. . . . . . . . .. . ( If approval is given, a charitable organization wii� be able to sell ! puTltabs and tipboards at: The Stahl House. . � i . � �u.�uanrEa: _ : vnos ,�t; ° - ' �at� :��f �e�earcn Center , � , D L C 15 i��8 � . � � � , ; �►,�,�: . . _ . � �.�: : ' � �. } , . ,-- _ _ ; _ , . .�y„ -s."•s � � . . - _.. , . ... ,�.�.,,...,.._, . . . ,. ... .+.i-�: .. -. . . . . . � .:_._ .., ., . . .• _ -3 _ .. . _ . , _ , , . . _ , , _ , ��=��0�7 i =- _ T 9 ,31 �'`� � �� �'� . ,��VIS.I,ON� OF L.,CENSE AND P�RMIT ADMINISTRAT DATE / J INT�RDF.PARTMEfiTAL REVIEW CHECKLIST l� Appn Proce�ssed/Received`by _ � Lic Enf Aud - Applicaut �}J�p �� C � 1 Q/; SP/'� Home Address � ��,� � (����- r�,, �; �-v�-- . `-� _ ,f, � � u � � -� �/_ Uy � 7 Rusiness Iv'ame f►�: Q, 5-�-'�r- �^i L.. 7-t�} S-2� Home Phone Business Address S g� +�1�� d� Type of License(s) ��Q m �l r'� ^ '' � �C7 � n --� l Business Phone � `��� '� �-- ���C<,c � ���`1 " l.�G��S � Public Hearing Date ,� �j �� g�License I.D. 4{ ���3 � at 9:00 a.m. in the Counc'1 ambers, 3rd floor City Ha11 and Courthouse State Tax I.D. l� � '�' �� � llate Notice Sent: I� �f��('/ ���� Dealer � j`-� j� to Applicant l�b rederai Fi.rearms �� a � ��� Public Her.�ring `=f��`, �-�r� DATE I�:SPECTIUN REVtEW VEKFIED (COMPUTER) COI�IENTS A roved Not A roved � Bldg I & D ' r � f ���J� � ���� Health Divn. -�� ' + �� � ,_ F �,� . , � _ , . _.� ,,:\; l , ..._. Fire Dept. _ ; � p j� 1� � \' � I � � �- �'�. � � ' � �►���� �� � Yolice Dept. �:�_: � ��� �1 �� I I �� �, Q � License Divn.;� �� � � 10 �s� r� � �L City Attorney - _.� . _ :� - �JI��q��� ` .. �� Date Received: ���--'l�� � Site Plan � �!� ! a� ( � i ' To Council Research Lease or Letter � � 3 /,�l Date from Landlord LS�� I :. ' ' ' C�ty.of Saint Paul . - � . �: l T ��� - Department of Finance and Management Services License and Permit Division ���a y� �203 City Hall ' _ St. Paul,Minnesota 55102-29&5056 • � := - • - - . , : APPLiCAT10N FOR LICENSE � - �}� CASH CHECK CLASS NO y x x r , New ' Renew � , �� � ��� x %:- � K�lnt, ''�.� �� }a_�4 -.r +.,, , t r- s ; _ . _ _ .._. . = . 8 - ogce� � �3 ,s O g �- _ . ... . . _A � �.; .. y� Code No. Title of License � r From '`� � 1��To ' ('� � t9� ` -o�� � ;�, I� � Y _ I. �? S ., . - . ,. ,00 ��en�n� (.r) hv,� �- ;.; . _ . _. - � -�.Q r. APPlieantlCompany Name , 100 �z: _ � x • �; �, � _ _ . �� b� _ �`t'�� s--EQ h r �u sv . 100 Buslness Name . ���� ,00 J C�lo �ic¢ `���rt211�' asSU - Business Address Pho��No. 100 s? . ��, << �, M,� 5���� . 100 Mail to Address PAOne No, � �oo � �n ��� �IPr�S-P�l � ManaperlOwner•Name � 100 / � r_ . �� �p � (.(�,P S'� N�'1 I!1/S t�'✓ S1� _ - _.. .100 AlanaperlGwner-Nome Address Plwee No. ,. c � � 4098 Applicatton Fee - Z. 50 :, ,.� ���. �,� j — �C ��Aecelved the Sum of 100 - S � � 'T"G( LL i � . � 7� �`� � .�..� � _ °, -;�3. � s , :,;r.: �: _. ;.. : ...; . .- _ �. :. " '�"-� ,` . _ ManaqeNOwner-Ctty,State 3 Zip Coda i. � �c�_ .: . , . , : _ . .. .. .l:.�,�,4100 ,,�.` _ Total S 10U ;��.�, ;; -_ ; - . ,� ` . _ r p. r . . < .; ;� iy�: . . - . .. .�<,' . - - Wy�'r � . - � : - �. . .. ' . ,� - . . i� j .. .:�_ � .. '_' ? ���r ,s,:. ,�� J... ,s �.'' .,� � ��;� �.•� /`y�, s+�;: :; :- - c:. r3.Y- -.. ..�Y � .� 7 .� - »".\ �`� }� �� . . �: , . . ' 1lcense Inspector `~ �� . �:By - - -- •Stgnacure ppiieant . r'.,: �'`:.:. _ . . ,i. .: - • _ _ .'`.. _ . , _ r'�B011d' ' _ ;. _ ;„ � r - .. :': . _ , _ � Compa�y Name . _ Policy No. Expintfon Date . lnsurance: � . � ,. ., , ,. - ., - Company Name r ,.> ,_. . ..-.; Policy No. _ -. • ;. , Expintion Oate _. .. . .. , .., _ , . . . . `Minnesota State Identificatton No. � � � ,� :Social Security No. � � � }-t� " ._ : .. .:��.�� � _. .( ..;... . .... ' . . : y - . . . � . ". � . .. . . . � - ,� . .- ' :.. - . ..:: .\ � .. ] ...� ..., ^' �f �. . . . ' Vehicie Information. � ' F - - • ' _ :. . r. _; � , , _ Serfal Number Plate Number .:.: . . . . .. . ..,. ' ' _ _ • �• Other. �: : . - - . . - • _ - , ,;;... . -- ,. � -. � THIS IS A RECEIPT FOR APPLlCATION -' - ts-� , . ,:Z: ... �r,,;� : .TH�S tS NOT A LICENSE TO OPERATE Your application for license wilt either be granted or reiected su6ject to the provisions of the mning �, - - ` ordinance and completiort of the�nspections by the Health, Fire,.Zoning and/or License Inspectors. - � K . - - , . . ., ... . . .. . � �; . ,� - • : � � . - . - _ _ ' ` . N7';{ . - ' . . . � . .. . . . . . . . . . . .. . . �! . . . . . . . .. .. . . . . ' . . .. . . . . - . � .. . ., �: .._ � ... .� :.._ .. . .� . .� . ... . . ....: _�._., .. . . _.. �. . .. . .. ... . . ... . . . . _._ . � . . . . - $I5.00 CHARGE FOR ALL RETURNED CHECKS � -` � - � � . - ���� � � l�i3 � :- � . . . . .�. . . � � � . C'�y��� , . 9 aa-�-��'� _ .:, • TO BE COMPLETED BY BAR OWNER G��°70�7 ' Xp.p.lica�ion No. Date Received By _ CITY OF SAINT PAUL, MINIVESOTA CHARITABLE GAMBLING LOCATION Directions: This form must be filled out with a tqpewriter or by printing in ink by the sole owner, by each partner, bq each person who has interest in excess of SZ in the corporation and/or association in which the name of the license will be issued. THIS APPLICATION IS SUBJECT TO REVIEW BY THE PUBLIC � 1. Application for (name of license) � �-�'�. �✓L L. ��� S �, � �-�,�(1S 1= 2. Located at (address) '.�� �I. G-�- s� � 1✓��iv'�-i4../ �. �✓ .��I�3 3. Name under which business is opera�d ,�Q,1�, � t,�- ,� ��/f� �c; [.j�j= c,i. �,: ,p ,G �- �tt c��r 1- 4. True Name �' �3 rn�T �-'ti j S ]� ��'$�k� Phone �9G�- ,� j�� (Fi�st�)����iddf� � (Maiden) (Last) ��L � �� 5. Date of Birth .��/1�V- � �- � �f 3 � Place of Birth S 7, �/a �/L �►,i/,t�R.- � �!ont� �Day, Year) sj v ��� �z� � � �_ ! y ��L�.� �t C3 t� r- -s ` r V s- ��=L-S 3� G 6. Home Address � � /� �J"fZ .S 7,j'�1� 1�!S T� S T Home Phone � 7 �� G; y� � 7. Have you ever been convicted of any gambl.ing violations? /v � �� > 8. List licenses which you currently hold at this location. nf'r.Sfi'/�,RI�t�.Jr `-- g - I3v �.;r i- �nj �c- L r�-,� ;, . S �,� -�, , � ,� �x. -- ��� S.kc.� h, r�-�-� � �.- s ra-L r 1 � G� � �2 . 9. SUBMIT A SITE PLAN WHERE THE GAMBLING BOOTH WILL BE LOCATED ANY FALSIFICATION OF ANSWERS GIVEN OR MATERIAL SUBMITTID WILL RESULT IN DENIAL OF THIS APPLICATION. I hereby state under oath that I have answered all of the above questions, and that the information contained therein is true and correct to the best of my knowledge and belief. I hereby state further ur.der c&tr. that I hsve recei�ed na money or other considerations, directly, or indirectly, in connect�on with this license, from any person by way of loan, gift, contribution or otherwise, other than already disclosed in the application which I have herewith submitted. . State of Minnesota ) ) ss County of Ramsey ) J Subscribed and sworn cro before me this �%� � � � � �---(� (Signature of licant) V�i day o f.�':'%., j>,,v,!„�.� �i.' :'1 � -� �-. . �� � .. , /��� , 1 :—.,. 7 / �' / �..C�eX=�..�. , ; ,��;:.�-:�;C�` `�J�l.��,.a✓�i Notary Public, R� Countq, Minnesota G�?>.:,!�...� �. �,� My Co�ission expires� � ,°�"� DONALD A. HAWER �� ��„'.�,�°.p��QlSTRRYPUBLIC-MINNESOTA �� WASHINGTON COUNTY MYCOMMf53ION EXPIRES APR. 7, 1`79� , , . , � ��-�0�7 . �•. I � • TO BE COMPLETED BY BAR OWNER I understancl ancl wi11 uphold the ordinance amending Chapcer a0� of the Sc. Paul Legislati.ve Co�le (Incoxicacing �iquor) . I Eurther underst�nd chac failure to comply may result in ctte si�spension or revocacion ot .. , On Sale Liquor and corresoonding licenses. , -� /� �, / ,/ y� � �/��- �; -� ,-�,�-�--- Signacure c ,�/ �� S ��1� 1�� , �l� � �_ ' (,� I /.: EstsbLishment � � F ' 6 �r �" / " l/� � - DaLe Recurn ca: Licertse ; Per�nic Division Room �US, Cicy Ha11 - Sc. Paul , �iN SS1UZ Please retain the attached ordinance for your records. 3�s6