87-1007 WHI7E - CITV CLERK
PINK - FINANCE G I TY OF SA I NT PAU L Council .
CANARV - DEPARTMENT /
BLUE - MAVOR F11C NO. �i '" ���
�
Cou il Resolution --
Presented By ` �
Referred To �� Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D.#17980) for the renewal of a Class B
State Gambling License (Raffles, Paddlewheels, Tipboards, and
Pulltabs) by Tanners Lake VFW 8217 at 1795 E. 7th Street be
and the same is hereby approved.
COUNCILMEN Requested by Department of:
Yeas Nays
D rFUa�
�/Q���� [n Favor
�3�cos+a
�� �_ Against BY
Sonnen
��eeee I.��IL�'
w��� JUL �i �� 1987 Form Ap rov d by City Attor y
Adopted by Council: Date
Certified Ya b}nCoµ�{1 Se r BY
�,i,.iy�� �
By
A►ppro e iVlavor: Date
�� � 7 Appr ed y Mayor for Submission to Council
B BY
ptiR�ISkED J U L � � 1987
Y �;�' �7�do�
�...-
DIVISION 0'F LICENSE AND PERMIT ADMINISTRATION DATE U�,C a�j � �"�
INTERDEPARTMENTAL REVIEW CHECRLIST
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• Applican��-y�y�e�� rA .t�,P. V � (,J. �o�11 Home Address �] ,5 C� Ci,� G �-�
Business Name �j.v, ,� Hame Phone ! ��" 3�a-�
!�
Business Address �"� G.�j �, �'��'' t5-�. 1�pe of License(s) _C �,(�SS � ��
Business Phone `�3� - � � �� �-,��► v�n�l.�n c, ��c�et� RwC�i�l,
Public Hearing Date License I.D. � ��� �(�
at 10:00 a.m. in the unc �l Chambers,
3rd Floor City Hall and Courthouse State Tax I.D. #
REVIEW DATE DATE INSPECTION
APPN REC'D VERFIED COMPUTER) CO1�Il�iENTS
�oved Not raved
Housing & Bldg (� �/� �
Code Enf orcement 'a 3 r � I� (
i
Public Health � �
� (� `a� �' I
I
I
Fire Prevention � �
� � la� � �
, �
Police � '�� �
i
City Attorney � � �
1
I
ENS n I�' I
►
300 Foot Notice � I
1�- ,
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License Inspector's Commen � .� �l
• I HAVE BEEN GIVEN A COPY OF THIS NOTIFICATION AND UNDERSTAND THAT MY ATTENDANCE AT
THE PUBLIC HEARING IS REQUIRID.
, ,. _ . . _
TION NEFI INFORMATION •
CURRENT INFORMA
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond: -
New Officers: • `
Stockholders:
.
. (��'=' ��7 ��'�'7
' - , �� , • � ' City of Saint Paul �
�� . Department of Finance and Management Services
Division of License and Permit Registration
INFORMATION REQUIRED WITH APPLICATION FOR PERMIT TO CONDUCT CHAR.ITABLE GAMBLING GAME IN
SAINT PAUL
�; _ - . _ .
� 1:.. Full and complete name oE organization which is applying for license
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2:: Address where games will be held i 79.s � �� rT, j'��� �-r
vumber Screec __ Cicy Zip
3.::• Name of manager signing this application vho will conduct, operate and manage
Gambling Games ,�.�tiieR, �/�d��-.SD/� Date of Birth �'
ia l�
(a) Leng�h of tiae man�ger has be�n member ot app7.icant organization �,,y�
_ �� 1•
4. Address of Manager /`�a �dRP,�d }� .�J.�-.if ' :��fd �
Number Stree ity Zip .
, .. _ . .: : _ _ . __ . _ _
5. Day, dates, and hours this application is ior ��.S�a��
_ _ .- - _ .
. _ _ .___ .__.. .._
-_ _ __ ._._�._ .
6: Is the applicant or organization organized under the laws o? t:�e State ot �i? �. -e�'
� __ _ _ _,_- -- � - -1�G _
7:_ Date of incorporati�n �� - 3" �
, ' :..-_ _ _ �: .
_ _ _ ._ >
_ ___ . _ __ _ , C
8: Date when registered with the State ot Mianesoca ��a 3 , j f /
,
9. How long has organization beea in esistence? ���h� .
. . _ _ _ _� . .
: .. . ..: - �
10.. How long has organization been in eYfstence .in Sc. Paul? � Jt,y
11.. What is the purpose of the Qrganizatfon? )/ �-, j�
I2.. Officers of. applicant organizatfon
', Name Y� `�� ' _ Va:ae: _ .
Add ess 6 � . Address _ '
. Title DCB '�- -l�{'—�7 Tit�e - ' I- DOB
Name ii.er Di1�rD � 1�.���" Name
_ �`�,� � � ...__} -- .�' .
Address �S'-�jl�.5�`.��.Tl� �/��f,��P �N, Add.ess . �; ,; , .
_- ,.
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Title � DOB � —$"—a�� T_itle`�, ' • �OB
13. Give names of officers, or any ot:^.er oersors �aho. paid �or ��e^�ic'es �tc t:^.e orgaaz�atforr.
Name V�N- �° at��' �/� s Vame
Address �lddress
Title T��=e
(:�ttach sepa*ace she�� :�,= ad::=:or.__ ^a=es. �
�J�'` rY 7-/��7
. ' , . � �.
14. Attached hereto is a Iist of names and addresses c ' ' --�anizatiun.
�
15. In whose custody will organization's recards be k °
,� l� �
Name C��� ����a-.-�XS Adc ` � �
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16. .Persona who will be conductin , assisting in con � � `� v
s �
�/ c a', -� �
Naae �G il�'Lf •� � L °J �
m .� n-
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Address 4- i
o `+- o
n o
Name of Spouse �� � Q � � .,.;
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, r ITates when such person wfll conduct, assist, c � '
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- , Name ' � �°
,� ` � , -
0
l. M c.>
• Address �� ^
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` Nane of Spouse � � �
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Dates when such person �.�iIZ cencect, ass:st � � �
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f / � � � s
_ c� �
l9 � � —
1T.: Have qou read ar.d do ;rou thoroughly unde:- � °a �' es,
v; �
_ and regulatfor.s �vver:�ir.g t:ie operat:on c • � . �, h � 0 3
E L N
1'8:. Attached hereto on t:�e for� £ur::�shed bv Z v�° m �'
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which iteaizes a11 recei�cs, e:s�enses, a ° ' ' itfon
as we'_I as a�i orgar.:zat_ons crno :�ave :� �''• ear
. �.
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: whfch ;�as bee:� s:g�e�, F-e?a*ed, and :�e ��..� ��r��'�~,
. '� - J` "F��A �
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who. is the �.o..-�w--,•sza,.��- ation.
Vame or Oi
19. Operator o� premises :�here �rames �ri1:
__._...__ _ _ _ ..
Name _ �j��j(/ /�os� ��`
Business Address 1? 4r �— ��� -_�
._ � j�� �a �C /�jJ/t/ .5/'l j'
2U. Amount of rer.t paid 'oy apol��an� Organ:cacion for rezc oL the halZ;. specify amount
pafd per 4-hour se�s�on _/jj.
, (�'f�" �F 7-i0 c� 7
. � -�,' ; , . . � �j"�
1 2!. The proceeds or the games will be disbursed after deducting prize layout costs and
operacing expenses for the following purposes and uses;
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/��.�' �� u10�� ea � � �'! G+""'-�— "'_ �,T• G;�%� / Q,e T2 �°-��L
2Z. Has the premises where the games are to be held been certified for occupancy by the
City oE Saint Paul? Y�e S
Z3. has your orgar.ization Li1ed :edera� �or:n 990-T' ���It answer is yes, please attacn
a co y w±t;� this applicacion. I: answzr is co, explain why:
�
G�vz�za/�'�l�.�h S Gt l�f�H. �� �J/' e � e� r i�t�
� . . . (�I� �r -�1.'e !"/ � (i(iu I�r� �' ri�7/t�[i v�.l
riny changes desirec b? t;e apolicalc �ssociac{on ma� be �sde onl;r wich the consent oi the
City CounciZ.
_ nC rr/���l� V �N/ CO�/ iT��
Organ:zacion
_ , .
� ._ �ate � '�.3 ' �� - - Bv• " �
uaaa3e: in charge or game
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