87-641 WHITE - CITV CLERK
PINK - FINANCE G I TY O F SA I NT PA U L Council
CANARV - OEPARTMENT
BLUE - MAVOR File NO. ��_ ��
Counc ' o ti -
� �� ;
Presented By . .
Referred To Co ittee: Date
Out of Committee By Date
RESOLVED: That Application (I. D. #16907) for a City of St. Paul Gambling Location
License by Wallace's Westsider, Inc. DBA Wallace's Westsider at
429 South Robert Street be and the same is hereby approved.
COUNCILMEIV Requested by Department of:
Yeas Drew Nays �
Nicosia [n Favor
Rettman
Scheibel
Sonnen � __ Against BY
i�leess
W ilson 1
�Y � ^ Ig�� Form Approv d y City Attorney
Adopted by Council: Date
Certified P• •s d ou .il Se t BY
B}�
Approv Mavor: Date `�' f Y ��8� Approved Mayor for Submission to Council
By By
P�^aev'c`.a�i7 �x9riY 15 198�
. � ��-��r
- � _ication No. Date Received By
CITY OF SAINT PAUL, MINNESOTA
CHARITABLE GAMBLING LOCATION
Directions: This form must be filled out with a typewriter or by printing in ink by the
sole owner, by each partner, by each person who has interest in excess of
5� in the corporation and/or association ir. 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,r..)�;��'S (J�lr-s� S�L�/=� �/��
2. Located at (address) �f�� _�: ��,(�E'V� �! S! `t-�iac�.L .�� (D�l
3. Name under which business is operated ���A c.,(�WCES (n�fS TS.�J C-K'
4. True Name �p NA� � 1�Y1��G� �-C I"f� Phone �"71� '�0�/�
� (First) (Middle) (�n) (Last)
5. Date of Birth (o � �2v -- ��, Place of Birth S 1 �ACrC.L
(Month, Day, Year)
6. Home Address %��v0 � (x(�l K�1 /� h'j,Q/I�Fl�}OC�CI Home Phone �-� �-Sf
7. Have you ever been convicted of any gambling violations? /V�D
8. List licenses which you currently hold at this location. / ��}u,�/.! � 1�C�t,''���
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�\ ,: ' , i ... � � �� i . y � , _. .
� '.< ���-� % _.. � .�.j C,<_G'; l _ l. ��' '�.--
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9. SUBMIT A SITE PLAN WHERE THE GAMBLING BOOTH WILL BE LOCATED
ANY FALSIFICATION OF ANSWERS GIVEN OR MATERIAL SUBMITTED 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 under oath that I have received no money or other considerations,
directly, or indirectly, in connection 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 ) 1
� , , ;'��
Subscribed and sworn to before me this ��,a-,�,.y��'�, � � �(�`-;' ��.�c-�..�
,,, � (Signat�re of Applicant)
l� day o f j �i�:� ,���' �V'�, 19 �'� ' �
� F 1 \ -
� 't� �'��1.� �
Notary Public,- Ramsey County, Minnesota
���:� �,_ .:.�. ._� .
My Commission expires
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' F I L E N 0• L1�6as
Dear Property Owner: • ' P A� E
Application for a Gambling Location (to allow charitable y�ut}1
�U� � � S� organization to sell pulltabs)
. r
�
�PPL��A�T Wallace's Westsider �
. � I
L O C AT I O t� 429 South Robert Street
. May 6, 1987 10:00 A.M.
�CLt,y Co�incil Chamhers, 3rd Floor City Hall - Court House
H E�R l t�� ;._ ---
f3y License and Permit Division� Department of Finance anci
NOTtCE SENT �lanagement Services Room 203 City liall-Court liouse
S;iint Paul,htinnesota
298-5056