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87-642 N�HITE - Ci7v CLERK PINK - FINANCE COUACII ry ///� CANARV - OEPARTMENT GITY OF SAINT PAUL File NO• •J • �• � BLUE - MAVOR Counc ' 'o �� Presented By Referred To C mittee: Date Out of Committee By Date RESOLVED: That Application (I.D.#16291) for a St. Paul Gambling Location License by Awada, Inc. DBA Awada's at 199 E. Plato Boulevard be and the same is hereby approved. COUNCILMEN Requested by Department of: Yeas p�� Nays � Nicosia [n Favor Rettman Scheibel � Sonnen __ Agei(lst BY �edexe Wilson ; ��Y ��j' — �7 Form Appr by City Attorney Adopted by Council: Date Certified Pa s y Counc�l S� r BY B}� _ Appr by :Navor: Dat � Approve y Mayor for Submission to Council sv - — By PL�����p �,�aY 15 1987 s � . . � � �7-1��� pplication To. 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 57 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) �1 (,1 �� I�/� �/(;�� ,• , � `/ F 2. Located at (address) �r� � /'��/-�/ G' �L�L� Y��, ; ` �l � u%�I.t�-1 /�/fu� '��/0 J � , 3< Name under which business is operated �-�v i-1 >>r� � �'/��= � ��S T!-)����/�A�;/� 4. True Name ,�c f-1 ti� � � �� �'�- � �7 � Phone c� j� " �l�/� (First) (Middle) (Maiden) (Last) -2 C S� ( �%�N�c L_ /<7/��. 5. Date of Birth �� — � J — .� � Place of Birth � � (Month, Day, Year) 6. Home Address � Z� �l �r /��-V/ �� Home Phone �-� � 5 ' � t f 7. Have you ever been convicted of any gambling violations? /��f � 8. List licenses which you currently hold at this location. �� �� �� � �� �',�. S /�1����1 �� � , � .� �� l�' (��}Y .l_ � C� l,1 c�(`� , �-( � (-�(JZ�� 7 / ,E , 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 ) % � ° �' �7, l��' �'-- Subscribed and sworn t before me this � , �` ,� � _� �,� (Signature of Applicant) � day o f � - ' �' " 19 �� , -=�--�-- � . /���"�-.l"._��,� { � . ..., ' .. , �+.�.�.:�.t!"6`fi.fi'.x"iN9� fi�- � ,,-. � .a.,s..r�o,{�.rldi«`ri•� � . %� � � �� � ��;, � i ���� � ��:'R +� Notary Public, Ramsey Coun y, Minneso �� " • � V? My Commission expires , , ,�'? f 1 . . � � � ' °�"�7 ��� �, • --�.' :9 ��� � � �' `Y � C Q � �� C E L. � ► . � . l �.� �_ . � 6-� � �, t� lf� � �IQTI � � . �-' �,.,f f� f��.. � � ' � E`� � �� � � � I� IC �, T 'tQE�� !� � G ' F I L E N0. L'16291 �ear Property Owners: � P A G E Application for a Gambling Location (to allow charitable youtli �U R � � 5� organization to sell pulltabs) . .�e ��P�"''�'A�T Awada Inc. DBA Awada Restaurant F� Liquor �Q C�T �Q (� 199 E. Plato Boulevard . b9ay 6, 1987 10:00 A.M. �Ctt,y• Council Cl�ambers, 3rd Floor City Hall - Court House H E� R 1 Ri G ;.r-__.-_ -- - =--� By License and Permit Qivision� Department of Finance anri NOTICE SENT �tanagement Services Room 203 City liall-Court House S;�int Paul,hlinnesota 298-5056