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87-1391 WHITE - CITV CLERK _! PINK - FINANCE GITY OF SAINT PAiTL Council ��Q.r CANARV - DEPARTMENT C� � BLUE - MAVOR File NO. a � Co ncil R olution Presented By - � ` - �� Referred To Committee: Date Out of Committee By Date RESOLVED: That Application (I.D.#56341) for a Gambling Manager License applied for by John Dullea DBA St. Andrew's Youth Athletics at 1013 Front Avenue (Half Time Rec) be and the same is hereby approved. COUNCILMEN Requested by Department of: Yeas Drew Nays Nicosia Rettman �- in Favor Scheibel ���n � _ Against By Weida Wi130n �EP 2 � 1987 Form Approved Ci Attorn Adopted by Council: Date Certified Pass ouncil Secr ry BY gy� ��' A,pprove 14avor: Date � S�� � '1 h�t77 Approved by yor for Submission to Council B BY P(��.;y�.� .: � . -- i987 . . �-�.. �,,�����i DIVISION.OF LICENSE AND PERMIT ADMINISTRATION DATE INTERDEPARTMENTAL REVIEW CHECRLIST Applicant SO�n �G . L.��,tlp � flome Address �`S �( ��ifs�S�. . Business Name �-�,- �p�Ye�, �5 �pt�'Yl ��I►IIYH"'omZ� Phone '7���/- �Da� , Business Address 10 L?��rc�r,� �� . Type of License(s) � �, Business Phone ���� g�a� ('�_y� C Q�,�ex�C� Public Hearing Date License I.D. #� �� � �' at 10:00 a.m. in the Coun il am ers, 3rd Floor Citq Hall and Courthouse State Tax I.D. # �� REVIEW DATE DATE INSPECTION APPN REC'D VERFIED (COMPUTER) COI�IENTS roved Not ed Housing & Bldg � Code Enforcement I� �� � I Public Health � ' I � � I I Fire Prevention � �� � I I Police � � i City Attorney � ! I ENS � I � � � 300 Foot Notice � �� I 1 1 License Inspector's Comments: I HAVE BEEN GIVEN A COPY OF THIS NOTIFICATION AND UNDERSTAND THAT MY ATTENDANCE AT THE PUBLIC HEARING IS REQUIRID. CURRENT INFORMATION NEW INFORMATION Current Corporation Name: New Corporation Name: Current DBA: New DBA: Current Officers: Insurance: Bond: New Officers: Stockholders: ,., ��-�7- /� 9/ ,", � �.�� ' City oc Sa�nC Paul - � � ' . . • Deparcr.►enc oc rinance and Managesenc Services Division oE L±cense and Permit �egistration INFORMATION REQUIRED T.�ITH AP�LICATION rnR P°RMIT TO CONDUCT CHAR.ITABLE GAi�iBLING G?.ME IN SAINT PAUL 1. Full a:�d comolete name of organizacion ahich is appiying for license �T ,�,v,o/LE� ,$ i�Bri�1� �T,�L. �i-iCS � S/D 2. Address where games wi11 be held /Di3 �'�y1T - �i-�� � -� .� Vumber Screec Cicy Zip 3. Name of nanager signing this applicacion wao will conduct, operate and managa Gambling Games �,�s�✓ C• llyc,G E.�9 Date oi 3irth 7- d ' .3� (a) Length Of �ZIIB TIIdII2Q?r has bea*� membe= o� ?7D??Ca[1C OL'�ZP.:22L'�GA S�,jv' d� 4. Address of Manager /���� /C /� �T -- �T; ��q-t/G — ��'"// 7 �(umber Screec Cic� Zip 5. Day, dates, and hours this dDDI1C2Cicn is zor ,3— �d�i �r' �GC� �-�'`�c/� � 6. Is the applicant or organization organfzed under c�e laws u= c�.e State o: `�(? /ES 7 . Date or incorporation ! Q—l�^ O,(� 8. Date when registered with che Stace or �_r.nesoca �— /� � �/ 9. How long has organizat�on been ia e_tiscance? � ����� 10. How Iong nas organizacion been in e_t�stenca iz St. ?�u'? � ���f 11 . What is the purpose oT the or�an_zat:or.? scl�,�6��` ��T'� /�T�GET�G1� !�^J C� �i4.0� �.1 �,�dac C�EUG�G I2. Off�cers o= apoiicant or;ar.;�ac:o:c /� Name �.Jc..�fc>.cJ�� /���iY� � V�e i'//%CE �s�.e.C�s Address ��av � " �'= �'4��� �ddrass /U�Z � • /���'T��°c/� Y Title !��S . DOB � ���'S / �'i=?e ��ES- �OB �' Z�- y� `Tame �i�1 i�"�Z ?�ase Address ��lo `U- ��'T�"�� �cd.ess T'itle �/2ES- DOB �/�=,37 :'���a �OB 13. Give names oi o*ficers, or any cc`:er �erscr�s •�ao �a_; �or �er-___s _o _ze or3an�:_at;on. \ame %��y �"�' Vame � " `� c �ddress ���re_s Tic1e ._�:a (Ac�ac� 58i72TCC2 .�.'12��" ".,- --"----....__ .._�__ . �-�����r `i4. 4Attac�ed hereco �s a I�st oL names and addtesses of alI members of che organization. I5. In whose custody will organization's records be kepc? Name�� ��ir/Z �ddress ��� � • �'���'T�'-��' -��/? 16. Persons wno will be conducting, assisting in conducting, or ooerating the games: Ivame �o��v �GG��4 Date ot Birth �' �l• 37 r�ddress _/.��.� ��/cE c�r- — �r �.�YiPG - SS"//� Name of Spouse Date of Birth i Dates when such person a;ili conduct, assisc, or operate 3 Q�y s � ���z Name �j,d �,y��GG�,r,� Date or Birtn �7— 2 5� G � Address /' :33� cJ�rn/1'�l�i ._ s� ��r.�c, — �// 7 Nane oL Soouse — Dace ot Birth — � Dates w�en suc': pers�:! ai'? concecc, �ss:st , o� OU2_3L2 �.r�� — /l-�-U /�'.�.�TS' �i lf/EC� _. -_ :.....*. � 17. Have ;�ou read a::c do ;�ou c�araL�nly ur.ae:staad cne prov=s'ons or a1I 1aws , ordinances, and r8�L1�dL10i:S `OV?::?f_!� �;le OD2L3C=0T1 CL C�Zc=:�cb:z C2�D'=:2� �d�25� �ES 18. Atta�hed here_o o„ c`�e =e-� ���r,ishea b�r c!:e C'c,r a= Sc. Paul �is a rinancia� Report :rhicz '_c�T�zes a?_ rece:�cs, e��eases, ar.d �_sburseWencs c:: �zz app?:cant organization as we�� as a_? o��ar.:zat'_ons ::�c :ave re�a_�e_ _�ads �or cze �r_czc:,g czlendar ;rear wh_ca �as bee� s:�re•i, _ -eoa_red� aACi 72'-='_Z� ��r �.�..+K-�.1 � U�,v-ti�� G r `'ame ��� C!J� �cu-`� �- d�: ��-C L., :iCC.°5S uho is c`�e �,�T //�GcSi/✓��v i� o: �`�e appl�car_t Or�anization. `{ame �= 0;:=_�e 19. Operator o: �re�=ses �ner� �aaes :iT_ OE ;"!2:�: Vame Go��iE �i�GSI� B�siness �ddress �4�3 �D�T — �-�;:4�rG - S—�/D� Home ��.dress /S`/.� �•vcrG�1%�/ .,s'r� �/�yL 2�. e�IIlOL1i1C Oi L�^C 7d7.Q OV d7D�_C3IIC UI',s%C�0:1 =J" _°iI[ O' C;�� Zglj� SD2CIiy amount paid per 4-ho�r ;e=�_oa �� �¢ �����- �-�����r 2I. The proceeds o= cae ;ar�es will be disbursed after deducting prize layouc costs and operating expenses cor �he iollowing purposes and uses: ��`f �.9'G/�G�S — � Y �it'�i����f � !!1 �t�i�%.t�c�l_ � i �� 5''� �C�`�l�.� �E�S' - Sci/.�a.+2T �iI/��� JG,�a c S �TiiG�/GS' !��s�-C G r . ZZ'_ Has the pre�ises wnere che oames ar� co be heLd been cercified �or occupanc;• by the City oc Saiac °au1? �C�'� 23. Eias your or3ar.�zac'_oa r:�ed 'edera' �or:� 990-T'. /�Q IL answer is ves, piease accacn a copy c:ic.`, ti;fs 2DDi:cat�on. L: answar is ;:o , e:cplain :rhy: .6� � �' ,��� 2�� �� ��-��.�. �- ��e�E r!ny cha*�ges desi_ec �3•r ��e an�1_c��� 1ssoc�2C'_OLl ma� be �ade onlv c:_cn tl;e consent oi the Ci�y Counc=l. . . . � � ,�T f��r/,�.�t� � /o�>,y.��.�s��r�c.l 0_�aa_za__on Date � �'� .��1 �. 3v: `.•iaaa;z: �n cnarge oc game ,` rt ' � :� �< � = = - � � � i o � r� �o � - : '( �� � � :v _ - _ � ^ � ��n � ; " '' _ � � � r II = � - f� d"ww�MAAAAk � ? ;� � ' - J= I v �+ J - !i � ✓.. � v .7 rT (0 � � !-n � � _ _I ��;�}�'� 9 � ; :n - _ � i � ^ - � i *' � � � - _ . a m y - I r - � ^I a����1 � I _. � � ' _ a � � � '�1 , n r _� �!, � \ Q o o � I 1I :.7 = !- _ _ �I �G � - � :o k�N a 3 �� � _ �,( ` ^ F `� ` f � - �� a � � .o D<L s _ � .. ' � w D \:�i � � , 17 (7 : '< ' p�C� Y "�\ �� E � `G ( .� v.� ^*� ^� � � � m�m > _ ( O �'' r- i m{r Cn � I ., C � � rn r rs - " ! I r- ro n �= � �p�?t � I _ � _ n � � tn � C� n ;.� ^.i � �Z z� n � ,� V ^ '-� � - � c Z � I_ n �� ' i n r- �� �' ' ' � m {m N 3a ' � i J _ > _ T I Y- , - �=, � _ o � ; n !� �T .a I I � � . > s ' _ - `-' - i i ^ :� � .� � `° � � � � � _ ;� n I� , �;qdtlCtl�"" '" ,o � � � � i _ = T rr �p � � 'D i -� � ^ s � � ... � � = � � � �� E -i -� m � � � . � �' ° ' " ( � � i i �