96-1514 Council File # �{
Ordinance #
Green Sheet# 35410
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA v,Q
7 ..
Presented By i���
Referred To Committee: Date
1 RESOLVED: That application, ID #25364, for a new Gambling Manaqer's License by
2 Lee J. Hoffman DBA Multiple Sclerosis Society at Campus Sports Grill &
3 Night Club, 2554 Como Rvenue, be and the same is hereby approved.
4
5
7 Nays Abaent Requested by Departtaent of:
8 B a e,y
10 Haer�n office of License, Ina�ections and
11 f Environmental Protection
12 Re �an �—
13 Bostrom �
o I BY. �� ����
Adopted by Council: Date Dv.� .��r`qq�
Adoption Certified by Council Secretary
Form Approved by City Attorney
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By: / LJ
Approved by Mayor: Date U � �`
��� `I��`'""J Approved by Mayor for Submission to
By:
Council
By:
Gl (�- �5 ��{
LIEP � ���N� � �REEN SHEET _N_ _3 5 410
E �DEPl1RTMENT�IRE�� �CITY COUNCIL ��u��
William F. Gunther - 266-9132 � �CITYATfORNEY �CITYCLERK
IL ( pp�� �BUDf3ET DIRECTOR �FlN.3 MN3T.BERVICEB OIR.
Hearin :
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TOTAL#f OF SIGNATURE PAGES (CUP ALL LOCATIONS FOR SKiNATURE)
ACTION REOUESTED:
Lee J. Hoffman DBA Multiple Sclerosis Society requests Council approval of
his application for a new Gambling Ma.nager's Lic�ense, ID ��25364, at Campus Sports Grill
& Night Club, 2554 Como Avenue.
RECOMMENp�T10NS:Appiws(A)a Re�sct(R) p�pgONAL SERVICE CONTRACT8 MUBT ANSWER THE FOLLOMIINd WIESYIONS:
_pLA�p,IC1 COMM�ggpN _GyiL gEpy10E ppu�M�gg�N 1. Hes thia psnonlHrm a�ror worked ur�dar a conVact for this dspartriwnt?
_���E _ YES NO
2. Has thb ps►son/ffrm ever been a dty employse?
—�� — YES NO
—D���T�T — 3. Does this person/firm possesa n skill not normaly posseased by My cwrreM dty employes?
SUPPORTB NAlICN 1lbUUNCk OBJEC7NE4 YES NO
Explain ell y�s�nswus on s�pfnb�hMt and attaoh to pran�hNt
MIITIATN�K9 PRO�EM.188UE�OPPORTUNITY(YVho�Wh�t.WMn�Whsre.WhyY
ADVANTAdES IF APPROI/ED:
DISADVANTA(iE81F APPROYED:
DIBADNIINTAOES IF NOT APPRONED:
TOTAL AMOUNT Of TRANSACTION � COSTlREYENUE BUD�3ETED(CIRCLE ONE) YES NO
FUNDIHfi 80URCE ACTIVITY NUMBER
FlNANCUIL INFORMATION:(EXPWN)
35 '� i o `5 \
Greensheet # L.I.E.P. REVIEW CHECKLIST �ate: [ ��° � �
In Tracker? a- 9.6 App�n Received / npp'n Processed
Llcense ID # 25364 License Type: Gamblin� Mana�er
Company Name: Lee J. Hoffman DBA: Multiple Sclerosis Societv
Business Addresss: 2554 Como Ave. (Campus Sports Grill) Business Phone: 870-1500
Contact Name/Address: 55404Fiome Phone:
Date to Council Research: ��/f�9,6
Public Hearing Date: o.e. i 1� 1 4`l� Labels Ordered: N/A
Notice Sent to Applicant: District Council #: 12
Notice Sent to Public: N�A Ward #: 04
Department/ Date Inspections Comments
,
Ciry Attorney �,� � � � •-� ��� ��rh P� /����q�
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Environmental
Health
/y /�
Fire
N l�'
License s�te�an Recei�ed:
Lease Reoeived:
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Police ��c.o rd ���C <(� � ��'��V
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Zoning
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Northeart STATE OF PIINNESOTA FOR BOARD USE ONI,y
GAMBLING CONTROL BOARD AMT. PAID
GAMBLING MANAGER LICENSE RENEWAL APPLICATION CHECK ,f`
LG212GMR PRINTED: 07/11/95 DATE
LICENSE NUMBER: Ci-00562 002 EFFECTIVE DATE: 06/O1/94 EXPIRATION DATE: 12/31/95
NAME OF ORGANIZATION: Multiple Sclerosis Minneapolis Chapt North Star Soc
GAMSLINC3 MANAGER INFORMATION
Lee John Hoffman DATE OF BIRTH:
SOCIAL SECURITY NUMBER:
DAYTIME PHONE NTJMBER: 612-870-1500
MEMBER SINCE: 09/16/87
`7 `'�
LAST DATE YOU ATTENDED A GAMBLING MANAGERS SEMZNAR/CONTINUING EDUCATION CLASS: 11/12/$��
BOND ZNFORMATION
BOND COMPANY NAME: Western Suretp Co BOND NUMBER: 585I1471
ACRNOWLEDGMENT
Z DECLARE THAT:
• I HAVE READ THIS APPLICATION AND ALL INFORMATION SUBMITTED TO THE GAMBLING CONTROL BOARD;
° ALL ZAIFORMATION IS TRUE, ACCURATE AND COMPLETE;
• ALL OTHER REQUIRED INFORMATION HAS BEEN FULLY DISCLOSED;
° I AM THE ONLY GAMBLING MANAGER QF THE ORGANIZATION;
• I HAVE BEEN AN ACTIVE MEMBER OF THE ORGANIZATION FOR AT LEAST TWO YEARS;
• I WILL FAMILIARIZE MYSELF WITH THE LAWS OF MINNESOTA GOVERNING LAWFUL GAMBLING AND RULES OF
THE GAMBLING CONTROL BOARD AND AGREE, IF LICENSED, TO ABIDE THOSE LAWS AND RULES,
INCLUDING AMENDMENTS TO THEM;
• ANY CHANGES IN APPLICATION INFORMATION WZLL BE SUBMITTED TO THE GAMBLING CONTROL BOARD AND
LOCAL UNIT OF GOVERNMENT WITHIN 10 DAYS OF THE CHANGE;
• AN AFFIDAVIT FOR GAMBLING MANAGER HAS BEEN COMPLETED AND ATTACHED; AND
• I UNDERSTAND THAT FAILURE TO PROVIDE REQUIRED INFORMATION OR PROVIDING FALSE OR MISLEADING
INFORMATION MAY RESULT IN THE DENIAL OR REVOCATION OF THE LICENSE.
SIGNATURE OF (�AMHLINC� KANAGER DATE
�,
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' /, ��. �J � `�-I l `,^
REFER TO THE CHECKLIST FOR REQUZRED ATTACHt�NTS ,
MAIL TO: GAMHLING CONTROL BOA.RD
1711 WEST COUNTY ROAD 8, SUITE 300S
ROSEVILLE, KINNESOTA 55113
THIS FORM WILL BE .MADE AVAILABLE IN ALTERNATIVE FORMAT (I.E. LARGE PRINT, BRAILLE) UPON REQUEST.
�5���1'
�c2,3 Minnesota Gambling Confrol Board
�•- .. �"8�95 Gambling Manager Affidavit J
Attach to the Gambiing Manager Appiication, Form LG212 � b-`S � y
STATE OF Minnesota )
AFFIDAVIT OF QUALIFICATION
) s.s. FOR GAMBLING MANAGER LICENSE
COIJNTY OF H e n n e p i n } AND CONSENT STATEMENT
(Pursuant to Minnesota Statutes and Rules)
�, L e e H o f f m a n , Under oath state that:
(type/print name)
1. I have never been convicted of a felony or a crime involving gambiing.
2. I have not, within five years before the date of the license application, committed a violation of law or
Boarci rule that resufted in the revocation of a license issued by the Board.
3. I have never been convicted of a criminal violation involving fraud, theft, tax evasion, misrepresentation,
or gambling.
4. I have never been convicted of (i) assault, (ii) a criminal violation involving the use of a firearm, or (iii)
making terroristic threats.
5. I am not, nor ever have been connected with or engaged in an illegal business.
6. I do not owe $500 or more in delinquent taxes as defined in section 270.72.
7. I have not had a sales and use tax permit revoked by the commissioner of revenue within the past two
years.
8. I have never, after demand, failed to file tax refums required by the commissioner of revenue.
In addition, I understand, agree and hereby irrevocably consent that suits and actions relating to the subject
matter of the attached gambling manager license application, or acts or omissions arising from such applica-
tion, may be commenced against my or�anization and I will accept the service of process for my organiza-
tion in any court of competent jurisdiction in Minnesota by service on the Minnesota Secretary of State of any
summons, process or pieading authorized by the laws of Minnesota.
By signature of this document, the undersigned authorizes the Department of Public Safety to conduct a
criminal background check or review and to share the results with the Gamb(ing Control Board. -
Failure to provide required information or providing fafse or misleading information may result in the denial or
revocation of the license.
FURTHER AFFIANT SAYETH NOT, except that this Affidavit and Consent Statemeni are submitted in
support of the application for a gambling manager license from the Gambling Control Board.
NOTARY PUBL/C INFORMATION � "
Notary Public Seal mus'. be current and correct. �/�� ` ' ����`
Seal may not be aftered. (signature of applicant)
Subs ribed and sworn to before me this
� (�
n day of \,\ 19��
i
ORGAN/ZATlON lNFORMATION
U ,
��� . � Name of Organization
otar�b��f
���� Multiple Sclerosis Society
M� 1.N�
Base License Number
A-00562