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87-1344 N�HITE - CITY CLERK PINK - FINANCE GITY OF SAINT PAUL Council CANARV - DEPARTMENT � � BLUE - MAVOR , File N 0. Council Resol tion � r� � , � Presented By Referred To Committee: Date Out of Committee By Date RESOLVED: That Application (I.D.#14410) for renewal of a Gambling Managers License by Steven Younghans DBA Johnson Area Hockey at 955 Seminary Avenue (Minnehaha Lanes) be and the same is hereby approved. COUNCILMEN Requested by Department of: Yeas D�eW Nays �s _� In Favor Rettman Scheibel Sonnen _ Against BY Weida W11SOA SEP � ; �g� Form Approv y City Attor y Adopted by Council: Date Certified Pa• ed by Council S retary BY r Bl' l SEP � 7 �S7 Approve by ayor for Submission to Council A►pprove by iVlavor: Date , B By T�UB�IS�D ��P � 6 1987 ����� ' DIVISION OF LICENSE AND PERMIT ADMINISTRATION DATE �� (���.� �,��I �("� INTERDEPARTMENTAL REVIEW CHECKLIST Applicant �j�-���_�pc.�,ti etiti5 Home Address J5���� (� v Business Name �o��S�„ � a _ �r-�_ Home Phone �33 - a �5 �1 Business Address � � � � e of License(s) �S S �J �m�y��.,�,�-c,o,/�P T"i _ Business Phone I�Q ,�.� � Public Hearing Dat License I.D. # ���� U at 10:00 a.m. in the Cou cil Chambers, -r 3rd Floor City Hall and Courthouse State��. # r g REVIEW DATE DATE I CTIO APPN REC'D VERFIED (COMPUTER) CO1rIlrIENTS �aved Not raved Housing & Bldg � Code Enf orcement � I(-Y I I Public Health � n �� � � � Fire Prevention 4 � �� � � Police i � ��"� + f City Attorney � I ENS � n ( � � � 300 Foot Notice � I � � 1 I License Inspector's Comments: I HAVE BEEN GIVEN A COPY OF TIiIS NOTIFICATION AND UNDERSTAND THAT MY ATTENDANCE AT THE PUBLIC HEARING IS REQUIRED. _ . ., . .: ,, .. . . ti� ' ' � .� . - . . . . . . , . . .. .. . .. . , . .. . ., .. . CURRENT INFORMATION NEW INFORMATION Current Corporation Name: New Corporation Name: Current DBA: New DBA: Current Officers: Insurance: Bond: . New Officers: Stockholders: � -� ����� .�- '�l� '��' ` �� �' - - City of Saint Pau1 /,J,`,G..j ���� � i ' Departme�it oE F�rt�nce and FSanagement Services �/�` d �� Division of��sicer�s,e .a�d Yermit Registration {,�- i .,..':;i L�.. .'.�_..._ .,. INFORMATION RE UIRED WITH APPLICATION OR ,�F.,RM�T` TO CONDUCT CHAR.ITABLE GAMBLING GAME IN SAINT PAUL ►J�'. !'t'J�.: L � . � ` - 1. Fu11 and complete r.ame of organiza[ion whfch is applying for license �OV�11SdV1 l��f"2.G._ t'1 OGi���I A O G . _ 2_. Address where games will be held �S 5 � �� v�c�v�1 .�.J"G'•T'a'^-� SS�b�1 vumber Streec City 2ip 3. Name of manager signing this application w'r.o will conduct, operate and manage Gambling Games S-k�21/2. �O�✓�q��r�S Date o f Birth � � ' ��—5�v (a) Length of time managsr has been member oL applfcant organizztion �Q V��,r-S "� 4. Address of Manager � 5� 1 m�' Q'��'��, �-E-.Qa�� 551oe� Number Street Cic� Zip 5. Day, dates, and hours this application is ror $ '" g� —' � " O� 6. Is the applicant or organization organized under the 1a*«s o= t;�e State of �1? � e, 7. Date ot incorporation ��" � 3 8. Date wnen registered with the State or �!ir.nesota � � -- �] � 9. How long has organization been in esiscence? �� �A,4/Lp� 10. How long has organization been in existence ia St. Pau1". �(� �! 2..c�.tr'S _� 11. What is the purpose of the organization? C e,G�`� �l pC•�-}-� �pG��,i 12. Officers of applicant organizatioa Name � a..✓'o� � 1� �.✓'-��� va�e J 2�� {�Gt✓"�'y 6'2 Address l ��� � �„�-N� :�ddrass p� 3 �l � Gc.���r ��Q�v Gr'�f- . Title P ' DOB °) —a.'" �Jd Tir?e ~ �— � ! rL�.c.�-e..�n+— l r'e5�-�� DOB �—�o Name l l a.y� ��Cp rnv�01� Name �r1 t l (�o�T 2.1r' r � /� � address �•`��''��-� l= /`F���(Jf-� :lddress ��� �S V [�✓'►�" � Title lit.���'.<-r 'J%� DOB •� '"'/r —'`�`1/ Ti�le . S�G.. DOB 13. Give names of officers, or any otaer ?ersons �no paTd :or ser-r�ces to t�e or�ani�ation. � �ame . Vame � Address � � L�'���' � �dcress ��� ���� , i Title __�?e (Attach sepzrate s:�e�_ '_.- a��-==.,,.__ ..�=�� . � 14. Attached hereto is a list of names and addresses of ali members of �he organization. 15. In whose custody will organization's records be kept? Name ��,r o� � I � �Qr"�`�� Address � �„ �'{'V� c.. 16. .Persons who will be conducting, assisting in conducting, or operating the games: Name e,V� ` Dl�V� 1n.G.v� S Date oi. Birth � � ' �, � 5� � Address � 5 p I �C Q-�-�� � Name of Spouse Date oF Birth Dates when such person will conduct, assist, or operate � " � � --�t'� � -^ � a Name C ���p� \I �U V� v Date of Birth �D—p� L! `- �� Address 1 Ll� � �-�� Nane ot Spouse �- Date of Birth r Dates w�ea suc?� person �ai11 concuct, ass:st, or ope=ate .�-- 17. Have you �ead ar.c do ^ou thoroughly understand the provisions oE a11 laws, ordinances, and regulatioas �c��e-ni�; the operat_on o= Char�table Ganbi:n; games? 18. Attached here�o c.^. �!�e fo�: �ur::ished 'o�� the City o� S�. Paul is a Financiai Report whic� ice�izes ai1 receiacs, e:��eases, ar.d d;sburseaer_cs o� the applicant organization 23 We?� gS 21i O.rdP._ZdC'_OTIS �i110 :12�T� _?C�_TEQ =*uI1QS �Or L,'12 D:'�CZG�iZ�F calendar year whfc:� has bee;! s'_s-:ed, p;272r?d, ar.d �re__�'_ed �v � me ��ci ► I 1� ��� :ilyQ�BSJ who is t?�e �' �,�„�b��,,,�p� � AY... o� che applicant Organi2ation. Vame � Oi==ce ' 19. Operator of oremi;es �rhe-e �anes :r�?_ be he?c� : Name �1i I � � � o r�-t- B�esiness address q 5 � ��y� �'n�V. �� p`� � Home Address lV�� 20. Amount of rer.t aaid by a�ni:canc O�gz.^.;�a�ion �or re�c o= the hall; specify amount paid oer 4-hour ;e-c:on� 1 �1. U� � , ; ���3c�� ,,. �: , 21: The proceeds oi the �a�aes will be disbursed after deducting prize layout costs and operacing espenses for the rollowing purposes and uses: Gd c�.J o m�v�.�l"' t� g- -� �'✓v�� � n 5 �-�.v'�,tn c..� � I 1'A2�n�.�-E-�,a►�- •�-e o"'� �-✓, �1 D l.."t`�. _�.Cr c tJ t��t-��e�� 2Z. Has the premises where che games are to be held been certified for occupancy by the City or Saint Paul? e� �S Z3. Eias your organ�zation riled cedera' �orm 990-T'. � IL answer is yes, piease attacn a copy wit;� t;,is apoiicat�on. I: answ�er is no , e:colain why: Any changes desirec �;� t�e a�ol=cazc .'.ssoc�ac�on m�f be �ade on1;r wit?� t;;e conser.t o� the City Council. �'V��n r-e� oc.l`�e. , Or�az'_za�ion �ate O�°��'� � � ( By: S-�,2V�° v� �� 'faa �e: in c . rge oi game .7 .�7 rT £ = Z I �^' :I� r- — ^• .-. � n cn :� � � � '-G J ' � I — - .. rr rr rJ rt� �``�` .T , :a r.' , � I C C� (D !D ^t � �� . I V �\ ;/� � r- '... v � /l _^. (9 �t � l ;� � C ... I iJ�, r D — n - •� r � - � �! 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