87-1685 WHITE - CITY CLERK �
PINK - FINANCE ��
GANARV - OEPARTMENT � G I TY OF SA I T PAU L F 1e C1 N0. ��-/��� -
BLUE - MAVOR " �
1
Council Re olution
Presented By
� ��.��
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D.#74105) fo a Class A Gambling License ($ingo,
Raffles, Paddlewheels, Tipboards, and Pulltabs) by Tenth Street
Boxing Club Inc. at 1324 E. Rose (Phalen Park Hall) be armd the same
is hereby granted.
COUNCILMEN Requested by Department of:
Yeas .�,� Nays
Nicosia [n Favor
Rettman
Scheibel �_ Against BY
Sonnen
weiaa NOV i 9 1987
WilsOri Form Approv by City Attorn
Adopted by Council: Date
Certified Passe o il Secret BY
By +/
Appro by iVlavor: Date N0 r � � _� Approve b Mayor for Submission to Council
By
�� k �
, �¢7 �� .;
���a�d�s' p7288
, Finance'& Manag�ent Servic�es �DE PRRTMENT: �y► _ .
� Kris� Sr.h�ixil.�r � CONTACT
298-5056 PHONE
Navgnber 10, 1987. DATE . ��� Q Q
ASSIGN NI�IBER FOR ROUTING ORDER Cli All . Locatians. r �Si nature : - -
Depar�tment Directar Director of Nlanagement%Mayor
Finance: and Management Services Director � „ 3 City Clerk
Budget Diretctor . . , � Cc�arincil_Re..Search �: ,
1 City Attorney .
�
4�iAT WILL BE�ACF�IEYEU BY TAKIN6 ACTION ON THE ATTACH D MATERIAlS? (Purpase/
Rationale) :
Mr. La�z Danna., Jr., an behalf of the Tenth St. Club, Tnc., is requesting approval
of their appl.3.catioaz for a Class "A" State of ' esota Charitalile Czambling .Permit
(Birxao ar�l Pulltabs) . The sessions will be hel on Thta�sday even.i,rigs betw�een the �urs of
7:00 p.m. ar�d 11;:00 p.m, at Phalen Park Hall at 324 East l�se. Tl�e manager is Joanne
Furliti, ar�cl �th�e proceed.s will be used t;� yauth baxir�.
COST BENEFIT BUDGETARY AND PERSONNEL IMPACTS ANTIC PATED: .
N/A
FI�iAANCIN6 SOURCE AND BUDGET ACTIVITY NUNBER CHARGE OR CREDITED: (Mayor's signa-
. � ture not re-
Tata 1 Mwur�t of 'Transact i on: N/A qu i red i f under .
� �10,000)
Fu�di�tg Source: N/�i .
Activity Number: N/A
ATTACNI��ITS (Li st and Numt�r A11 Attachments) :
Degart�nent CY�ecklist
R�eso�tion _ � _
. �PQI��.,4;,,,�
DEPARTMENT REVIEW _ CIT1f ATT4ttNEY REVIEW
Yes No Council Resolution Required? ` Resolution Required? �Yes No
Yes �Na Insurance Required? Insurance Sufficient? Yes No
Yes _,,�Ko Insnrance Attached:
(SEE •REVERSE SIDE FOR IN TRUCTIONS)
Revised 12/84 -
� �� ��i���
TIIVISION OF I,ICENSE AND PERMIT ADMINISTRATIO DATE ����� � /
INTERDF.PARTMFNTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
A�plican�, X�.�/h � � ��� . ome Address ��� 3 ;��)
�c�c� �
Rusiness Name �,� � ome Phone�
Business Address i 3 a� � �_ ype of License(s) � ���.� � ,�}���,
Business Phone � . �i,
Public Hearing Date 5�� icense I.D. �� '��-{� l (��
,-
at 9:00 a.m. in the ounc Chambers,
3rd floor City Hall and Courthouse tate Tax I.D. 4� � l;�
llate Notice Sent ��� � ealer 4� ►� � ,c�-
to Applicant S D �
ederal F3.rearms 4� � �
Public Hearing
~ DATE INSPECTION
REVIEW VERFIED (COMPUTER COMMENTS
A roved Not A r ved
�
Bldg I & D `n I� �
r1
Health Divn. '
�
V1 (� �
,
Fire Dept. � �
i n �� �
I
Police Dept. I
License Divn. �,,� �
�
City Attorney ��' . �
'D �
Date Received:
Site Plan ;L�l-�� � ��
To Council Research 1 , I ld � $�
Lease or Letter Date
f rom Landlord ( d �ZO � �`'I � � �fS
—�L.�U� C`�2;� �'l
{y , ,
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
w
Bond:
Workers Compensation:
New Officers:
Stockholders:
, . - ��7--i���
. - -� ,,,
:i;;;�o��?���,, Charitable Gambling Control Board FOR BOARD USE ONLY
��`� � � Room N-475 Griggs-Midway Building
�'�..
;� Licenae Number
:� .., 1821 University Avenue
• . � St. Paul, Minnesota 55104-3383 AMT
� (612) 642-0555
� 'i�' CHECK#
DATE
GAMBLING LICENSE APPLICATION
INSTRUCTIONS:
_ - A. Type or print in ink.
B. Take completed application to local governing body,obtain signa ure and date on all copies,and leave 1 copy.Appiicant keeps 1
copy and sends original to the above address with a check.
C. 1"ncomplete applicatio�s will be returned.
�T pe of Application:
Class A — Fee S 100.00(Bingo,Raffles, Paddlewheels,Tipboard ,Pull-tabs)
❑Class B— Fee 5 50.00(Raffles,Paddlewheels,Tipboards, Pull-t bs) N�kecheckapayebleto:
❑Class C — Fee 5 SO.00(Blft(�O Oflly) Minnesota Charitable GambYng Control Board
❑Class D — Fee S 25.00(Raffles only)
❑Yes No 1. Is this application for a renewal? If yes,give comp ete license number � - 0 - �
DYesf"�INo 2. If this is not an application for a renewal,has or ani ation been licensed by the Board before? If yes,give base
license number(middle five digits)
OYes o 3. Have Internal Controls been submitted previously? f no,please attach copy.
4. Appl�ant(Official,legal name of organization) 5 Business Address,of Organization,� � � � � L� �,
Y•-"t ,� .:�� ,, t� "TM.;�, �."�v ,,1. �:;�=.<_--- ,� ✓G�h � ,,
6. City,State;Zip 7 �buMy !`; 8. Business Phone Number
,�.% !�='.�� �'1�'� �=�� �`'�t'-;'�Sc 1 �:�; 1 - k'7�s,
'' 9: Type of organization: ❑Fratemal ❑Veterans ❑Religious Other nonprofit"
`If organization is an"othec nonprofit"organization,answer questions 0 ttuough 13.If not,go to question 14."Other nonprofiY'organizations
, must document its tax-exempt status.
�Yes❑No 10. Is organization incor orated as a nonprofit organi ation?If yes,give number assigned to Articles or page and
book number: Attach cop of certificate.
Yes�No 11. Are articles filed with the Secretary of State7
: �Yes�No 12. Are articles filed with the County?
❑Yes�No 13. Is organization exempt from Minnesota or Federal ncome tax?If yes,please attach letter from IRS or Department of
Revenue declaring exemption or copy of 990 or 9 OT.
❑Yes�QNo 14. Has license ever been denied,suspended o�revo ed1 If yes,check all that a ly:
ODenied ❑Suspended ❑Revoked Gi edate: -
, 15. Number of active members 16. Number of years in exist nce Note: If less than four years,attach
,,.•�. evidence of three years
.:°� .'�,
__ .. existence.
17. Name of Chief Executive Officer � 18. Name of treasurer or person who accounts for other revenues
i ;-� ,. ;-�� !� of the organization.'�:'� ,
l"`:',� �?'''. �� i ''-^. � '�• � i �:(� � / : --'`�
"1'� i i �'�,.i i '^.-'. .�-..
Title Title '
_ �- '. (^ �;:�
Business Phone Number Business Phone Number ,
—, - --
—, ._ .f ;• - ---, w
-�. i
� � � , ti _ _ ( - � , � _ .,
19. Name of establishment where gambling will be 0. Street address(not P.O. Box Number) -
conducted" �� �, , : f`f r ; ..t 'i ; j��`.
, _ 1 , ; ;�. �, ! } ; , t � � ,
' 21. City, State,Zip 2. County(where gambling premises is Iocated)
5 T. ��j� i� � �'�.�_' ;�`��, i._, ., _-�_.-- .�-
CG-0001-0218/86) White Copy-Board Canary-Applicant Pink-Locat Governing Body
; _ r _ . ;� . �.. . . _ . ��,,,��_
Gambling License Application Page 2
Type of Applieation:� 1�Class A ❑Ciass B ❑Class C 0 Class D
�YesONo 23. Is gambling premises located within city limits?
I�Nes ONo 24. Are all gambling activities conducted at the premise listed in #19 of this application? 1f not,complete a separate
application for each premises lexcept raffles)as a se arate license is required for each premises.
❑Yes(�No 25. Does organization own the gambling premises?If no attach copy of the lease with terms ot at least one year.
QYes L�'1No 26. Does the organization lease the entire premises?.If n ,attach a sketch of 27. Amount of Monthl Rent
' the premises indicating what portion is being leased.A lease and sketch $ " '"
is not required for Class D applications. f % ��
es�No 28. Do you plan on conducting bingo with this license?I yes,give days and times of bingo occasions:
Y � ,�y�
Da s�....�-;n�l�l <,�``�(1 C ��, �'. /� ` t � f•t1 �' r ' !
t'�
. s❑No 29. Has the S 10,000 fidetity bond required by Minnesot Statutes 349.20 been obtained?Attach copy of bond.
30. In��e Company Name ` ,- �, ; �. �` � ,�. S, ,, �,: 31...y Bond Number
.-� t � � r ,� ; 1 �
32. Lessor Name 33. Address 34. City,State,Zip;
i�. r"i' 1'„1��,, . - - . -. � � .
35. Gambling Manager Name � 36. Address 37. City,State,Zip
. . . , .
,, ,, ._ .- .,
;. _ _ ,
38. Gambling Manager Business Phone 39. Date gambling man ger became
.. —�
� _ � `_ member of organiza ion: _ —� ' � , :
GAMBLlNG S1TE AU HORIZATION
By my signature below,local law enforcement officers or agent of the Board ace hereby authorized to enter upon the site,
at any time, gambling is being conducted, to observe the gam ling and to enforce the law for any unauthorized game or
r -•: Practice. : ' _ _, .
- � BANK RECORDS'AU HORIZATION �� �` -�� ° -
By my signature below,the Board is hereby authorized to inspe t the bank records ofithe Genecal Gambling Bank A�ount.
�: whenever necessary to fulfiU requirements of current gambling rules and law:
OAT "- _.
� 1 hereby declare that:
1. I have read this application and all information submitted t the Board;
2. All information submitted is true, accurate and complete;
3. All other required information has besn fully disclosed
4. 1 am the chief executive officer of the organization;
5. I assume full responsibility for the fair and lawful operatio of all activities to be conducted;
6. I wiil familiarize myself with the laws of the State of Minne ota respecting gambling and rules of the Board and agree,
if licensed,to abide b those laws and rules, includin am ndments thereto.
40. Official,Legal Name of Organization :- �� 4 . Signature(must be signed by Chief Executive-Officer)
s �•, � ..t, ` , i..., � . � v� (.� ._ + Y,-�"; J; � .
� Title of Signer _ _, , �- �' D te � . "
; -. � � � �
�
� ACKNOWLEDGEMENT OF NOTICE BY LOCAL GOVERNING BODY
I hereby acknowledge receipt of a copy of this application. B acknowledging receipt, I admit having been served with
notice that this application will be reviewed by the Charitable ambling Control Board and if approved by the board, will
become effective 30 days from the date of receipt(noted belo !,unless a resolution of the local governing body is passed
which specificatly disallows such activity and a copy of that esolution is received by the Charitable Gambling Control
Board within 30 da s of the below noted date.
42. Name of City or County(Local Governing Body) If site is located within a township,item 43 must be completed,in
;-� , � a dition to the county signature.
L:�—.� -�*-..,
",�, ,
' Signature of person receiving application 4 . Name of Township
_`` _ ��-
. - + ' '4- '
X� �,� � �: . _ �; � .�
Title` � �"� Date received'(30 day period gnature of person receiving application
�F . begins from this date)
�, _ ��`.:u- I',�� i.:.�. c,i : ��,
` 44. Name of Pe�son delivering,application to Local Governing Body tle
—' �,. - ._.''' .
CG-0001-02 (8/86) White Copy-Board Canary-Applicant Pink-Local Governing Body
� ��i���
�:' � • - ' � City of Saint Paul
• Department ok rinance and anagement Services
' Division of License and F' rmit Registratioti
i
IIvFORMATION RE UIRED WITH APPLICATION FOR PERMIT 0 CONDUCT CHAR.ITABLE GAMBLING GAME IN
SAINT PAUL
. 1. Full and complete name of organization which is applying for license
� �J�u- �`�r� �X/�� .�'
2. Address where games will be held - ' , ��� ��'Vt I �S(�
Yu er •Streec -, City Zip
3. Nama of manager signiag this application who will conduct, operate and manage
�� L1 � w n
Gambling Games _��"�-�p T�� � �. . Date of Birth �^ ' J �� �
�
(a) Length of time manager has been member o apclicant organization y�
� � � ��/
4-.. Address of Manager ��� �U�P� ! �• � /� ���U_ t ��� �� _
Number Sc:e t City Zip
S. Day, dates, and hours this aoplication is �o //((/�J���/�� ��P��%1� ��J '�� JC�
P�
6. Is the applicant or organization organized u der ��:e Iaws o: t�e State oi `4N? �
7. Date of incorporatian �/
o. Date w�2n :egistere3 witz the State o* �=:�ne ota �1
1 1�7
9. :3ow long has organization been ir. e:{istence? �__Y ,�f�y����, ����(��G 1�/��/r1
10. How Iong has organization been in eYistence n St. Paul^ t�,'.�1�� �j�(;�'��Gtj/ vr
11.. What is the purpose of the organ�zation? 1!�'- ���-��o ,�� �
� ��-N
12. Officers of appiicant argan�zation
Name LQ (J).�- �, �ifN �}- ��� Ya�e 1�('�� ,J�N��' S � ,
Address �� l��,�h Addrzss ��� C��h �� �n. �^�_1 � J ��
C� (� �S
Title ���-I���DOB � - � �r� (� L�C�fl �ECr�1��� DOB �-�� -
Name ��r� ��(� G� Yame
Address ll , � ' / � :�d�ress
�'� r�s�c�c�� 2
T�itle j��l{S(�t�' � D0� � - � �9 - J� T�tie DOB
13. Give aames of officers, or anv ot^er �ers�r.s Neo ?a:d i�r ser-�_ces �.7 �!7e or�anizat_on.
\'ame Va�e
Address ;�ddre�s
Title __cIe
(Attach se?arate snze- _ - acc:=--••--- -.__��. �
, ������
14. Attached hereto is a list of names and addr sses oi all members oi the organization. ,
15. In whose custody <aill organization`s record be kept?
` 1
Name (�in(`J�, 0 4�• ���.",J Address (� . E � I' l nt�'I p1 J�• ���
16. Persons who will be conductin ��� �� �
g, assistin� i conducting, or operating the games:
Name p � Date of Birth �— + � �C�
Address b � �h � �. �� � ��
Name of Spouse � e i 1 Date of Birth ��`" � �<f
Dates when such person wfll conduct, assist, or operate (/b{� �(�S�V S (� f
�ACh ��-1 �(�D� �=� P m � 1 / �Dv pM-
�'l r /
Name � � 1V{r' � � � Date of Birth � � � �' co l
Address 3 O R bef � C�. i'�2 �rne ,� �'l w� SS i/S
Nane oi S ouse �—
P � Date of Birth
Dates w;�en such persor_ �ai11 concLCt, ass=st, or ope:ate �� �� �$�/�-�j � ('�
,
�'L Vhp/l-f'�'L yr� `? �c�p _ � --� j.�:f`p �'''1 _
I7. Have you read a::a do ;�ou thoroughly unde:sta d cne orovisions or a1i Laws, ordinances,
and regulatior.s �overnin; ��e opera�=0I1 Q: C .ai�tab'e C3mDi?.^.� �Sm2S� / � J
I8. Attached here�o on t:�e co� �urn�shed bv c��e C�t� o� St. P�aul is a Financial Report
whic:� ;��mizes a?1 rece:�cs, e:c�enses, and d soursemeacs o� cne applicant organization
2S GT2;� dS di_ 0��3I1:ZdC_Oi.S wl1C ha�re _ece;v C =iIr:QS =0I' ��,2 DrDC2L�f:1Q calendar year
. � ,—
/ �
whic:� lidS 3een 5�5_^.e,^.� ��2D?_red� 8IIQ Vd���_e �V �
`'ame
�1� � �E� � �jr/(�, �'I� iPc�� /�'1�.�. �S�U �'
��d��s
who is the �° ��/ �� / o: tne applicar.t Organizatior..
vame o� O��:ce
I9. Operator o= prem=ses �ri:e-e zames N�1� �e !:eL
Name RI�l� h�'�� ��/v / ,V /
Business Address �3�L� �' ��JS� � . �(, �A,.� ���
Home Address ���d E- �h�iee �r� � �iP rnf} /'�C�(.(�� , j/j��/(�
20. :�mount of renc oaid by a�p�:canc Orgsr.i�acio :��r _-ez;. or che hall; specify anount
paid per 4-hour se�s_on 7�,OU �� S�s /^��"l�
. . ��-���s�
, . . .
2I. The proceeds ot the gacaes will be disburse after deducting prize layout costs and
,. operacing e:cpenses for the following purpo es and uses:
L!or.�.� h � !1 � , u �` �-r e � f��D ���/�� �X� P
w ���t �
2T. Has the premises where the games are co be held been certified for occupancy by the
City oc Saint Pau1? � S
�
23. has your orgar.�zac�on r:ied tedera'•_ �or� ? 0-T' �� I;: answer is yes, please attacn
a copy W�C:t this applica c�on. I: answar i ao , e:cplain why:
Any changes desirec b� ;.ze ap�?ica:�c :�ssoc:a�=o �a� be �ade on1:r wich t:;e conser.c o� �he
City Counc�i.
/v�h S f�e P P� �ox;n� CI�6 �-��c
Orga:'_zac'_on �
Date �`�U � � , (�• —
� V �
�iaaa�er in charge or game
.
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r. � ��
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-------------------------------= AGENDA ITEMS --------------------------------
----------------------------- --------------------------------
ID#: [468 ] DATE REC: [11/12/87] AGEND DATE: [00/00/00] ITEM #: [ ]
SUBJECT: [CLASS A GAMBLING LICENSE - TENT�i S REET BOXING CLUB - 1342 E. ROSE]
i
STAFF ASSIGNED: [NONE ] SIG:[WEIDA ] OUT-[X] TO CLERK�„[,p4,�89'TQO] '���:�
ORIGINATOR:[LICENSE DIV. ] C NTACT:[SCHWEINLER - 5056 ]
ACTION:[ ]
C ]
C.F.# [ ] ORD.# [ ] FILE COMPLETE="X" [ ]
� � � � � +� � � � � � �
FILE INFO: [RESOLUTION/CHECKLIST/APPLICATION ]
C 7
C ]
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