96-1127 Council File # �`� �" ��
Ordinance #`
0 R I G I N A L Green Sheet #` 35231
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA 'L�
T
Presented By
Referred To Committee: Date
1 RESOLVED: That application, ID 75941, for a new Gambling Manager's License by
2 Judith M. Ryser DBA Minnesota Licensed Beverage Assoc./Children's Fund
3 at Porky's, 1080 Payne Avenue, be and the same is hereby approved.
4
5 Requested by Department of:
6 �g� Navs_ Absent
7 B a e,y �
8 Guer.zn Office of License, Insrectiona and
10 �i. — Environmental Protection
12 t ___�
Bostrom
Adopted by Councils Date
e b By= �'�/�r.� � s�cv�
Adoption Certified by Council Secretary
Form Approved by City Attorney
By: � � /
BY� v
Approved by Mayor: Date 7� Z�
Approved by Mayor for Submission to
By: � ` Council
By:
L DATE INITIATED O �� 4�,��
LIEP GREEN SHEET _N- _3 5 2 31
� �n�r��r o�croR"��wo�►re �cm courrci� �►mnue��
W 1 am Gunther - 266-9132 ��� �ciTVarro�ev �CITYCLERK
(� ) pp�pp �BUDQET DIRECTOR �FIN.8 M(aT.SERY�EB DIR.
f/ % ORDER �MAYOR(OR A8813TANn �
TOTAL#E OF SIONATURE PA�ES (CLIP ALL LOCATIONS FOR SIGNATURE)
�cr�AEOUESrEU:
Judith M. Ryser DBA Minnesota Licensed Beverage Assoc/Children's Fund requests Council
approval of her application for a new Gambling Manager's License, ID �75941, at Porky's,
1080 Payne Avenue.
pECOMMENDATION$'Ap�o����°r iiy�t�R� PERSONAL SFRVICE CONTRACT�MU�T ANSWER TNE FOILOWINA QUESTIONB:
_PLAI�MIING f�MM18810N _CIVIL SERV�E COMMIS810iV 1. H88 this pM60nRkm�er w0►ked undsr 8 OOIIkeCt f�tl116 depafhnent? -
_C�OOMMIITEE _ YES "NO
2. Has��peroon/flrm eve�been a city employee,?
—�'� — YES NO
_018TRICT COURT _ 3. Doss thie person/tirm postess a aklll not nOrmeNY v�e�br u►r���v�M��
BUPPORTB Wlildi c�UNCiI OBJECfIVE7 YES NO
Explaln dl ys��nsw�n on s�p�nb N�t and�thoh to pewn shwt
MIfTIATINQ PROSLEM.188UE.OPPORTUNITY(Nllw.WIW.YVINn.Whsn.WhYY
ADVANTAtiE81F APP�IED:
D18ADV1WTAOES IF APPR0IIED:
. �/ya�1CiN flv:ft7�lril {/�IIli1
� JUL 31 1996
oie�ovMrr�s iF�or�vvriovEO:
TOTAL AMOUNT OF,TRANSACTION S COST/REVENUE BUDGETED(CIRCLH ONE) YES NO
FUNDINO SOURCE ACTIVITY NUMBER
FINANCUIL INFORMATION:(EXPL.AIN)
Greensheet #3�a�3/ L.I.E.P. REVIEW CHECKLIST Date: / ��+ `� �a�
In TraCker? o'� App'n Received / App'n Processed
License ID # � License Type: \ / ''� �'
Company Name: � DBA: � e S��
�1 ��" ,` .S /�
Business Addresss: /D D �° iTVY' � O I' Business Phone: �8'8''�9�'�
Contact Name/Address: •/v. Home Phone: !r�'8"�.�9�3
Date to Council Research: ;7��L�1�
Public Hearing Date:�I� .��I� Labels Ordered: /V �
Notice Sent to Applicant: District Council #: �l�
Notice Sent to Public: Ward #: � �
Department/ Date Inspections Comments
�
City Attorney
� �.�/9.� 7 '.�/ 9 �
�
Environmental
Heaith
���
Fire
N�� �
License s��e�an aeceived:
Lease Received:
�/ �
l
Police Q /� �J ��C���
/L �j�2� //°`Lo�L-�Q,b
�/��q,� � ��
Zoning
N�/�'
' �� 4 I 1��
ST1lTE OF XZNNESOTA rQR BOARD VSE ONLY
QAl78LINQ CONTROL BOARD AMT. PAID
OAMBLINQ XANAGER LICENSE RENEWAL APPLZCATION CHECK #
LG212G1�t BRINTEDz O1/10/95 DATE
LICLNSE NUMSERs ti-04067 001 EFFECTIVE DATEs O?/O1/94 EXPIRATION DATEs 06/30/95
NAME OF ORGJINZZATIONs �varaq� Miaa�spolis Nina Lic�ased Cbilds'�ns lruad
QA1+�LINO I�UWAOER INFORMATION
Judith Masi� RYi�r DATE OF BIRTH: OS/ZS/38
. siod s8ac: a
. Taaoaite ]Ot SS7H6 SOCIAL SECURITY NVMBERs 474-36=7768
� DAYTZI+� PIiONE NtJl�SBERs 218-245-1713
MEMBER SZNCEs 11/IO/85
u� l�l��-
� LAST DATE YOII 11TTENDED A GAldBLING MANAGERS SEMZNAR/CONTZNUING EDUCJITZODT CLASS: �fi$
� BOND ZN1rORMATION
• 80ND COMPANY NAt�t Old R�public Sur�tp 80ND NUMBERs RNS437Z94
11C1Q10WLEDGMENT • .
Z DECIARL T871Tt
• Z HAVE READ TFIIS APPLICATION AND ALL ZNFORMATION SUBMITTED TO TIiE GAMBLING CON'i'ROL 80ARDj
• ALL SNFORMATZON ZS TRUE, ACCURATE AND COMPLETEj
• ALL OTHER RLQUZRED INFORMATZON HAS SEEN FULLY DISCLOSED;
• I AM TFiE ON'LY G1IMBLING MANAGER OF THE ORGANIZATIONj
• I �iAVE BEEN AN 11CTIVE 1�M8ER O!' THE ORGANIZATZON FOR AT LEAST TWO YEARS;
• I WILL Fl1MILI1IRIZE MYSELF WZTH THE LAWS OF MINNESOTA GOVERNZNG LAWFUL GAMBLING AND RULES OF
THE GAMSLING CONTROL BOARD AND AGREE, I8 LICENSED, TO ABIDE THOSE LAWS AND RULE5,
INCLUDING AI�II:NDI+�NTS TO TIiEM j
• ANY CHANGES ZN ]IPPLICATION ZNFORMATZON WILL BE SUSMITTED TO THE GAMBLING CONTROL 80ARD AND
LOCAL IINIT OF GOVERNMENT WITHIN 10 DAYS OF THE CHANGEj
• AN 1RFF2DAVIT FOR GAMBLING MANAGER HAS BEEN COMPLETED AND ATTACHEDf AND
• I UNDERSTAND THAT FAILtJRE TO PROVIDE REQUIRED INFORMATZON OR PROVIDSNG FALSE OR MISLEADZNG
INFORMATION MAY RESULT IN THE DENIAL OR REVOCATION OF THE LICENSE.
SIGNATtJRLr O! GAI�LZNG NANAGER DATE
— _ n��
r
REFLR TO TSE CHECRLIST FOR REQUIRED ATTAC�Ii1TS
W1ZL TOi GAISSLING COIVTROL SOARD
1711 WEST COUNTY ROAD 8, SUITE 300S
AOSEVZLLE, �IZNNESOTA 55113
THZS FORM WILL BE I�3ADE AVAILABLE IN ALTERNATZVE FORMAT (I.E. LARGE PRINT, BRAILLE) OPON REQUE�
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�.G��.�(/Ll�� ���� �-��� .
��� ' � � �la �
�
LICENSED GAMBLING ORGANIZATIONS
SL���L���L�eLL��L�LLLLLLLL���LLLL���L���LL�LLLLLL�L�LL�L�L����LLL��L���LLL���Lt
° NAME: MN LICENSED BEVERAGE ASSN-CHILDRENS FUND NUMBER OF SITES: 1 °
° ADDRESS: S00 42ND AVE NO MINNEAPOLIS MN 55412 °
° STATE LICENSE #:04067 PHONE �`:588-3953 LIC CLASS: B STATUS: AC °
o � o
° CEO LAST NAME: POPPENHAGEN FIRST : KEITH � t °
° ADDRESS: 14964 NORTHERN BLVD ANOKA MN 55303 °
° HOME PHONE: BUSINESS PHONE: 753-2164 DOB: 07/04/43 °
0 0
° TREASURER LAST NAME: APITZ FIRST: JAN ��\ °
° ADDRESS: °
° HOME PHONE: BUSINESS PHONE: 484-9273 DOB: 05/13/43 -• °
o . o
° MANAGER LAST NAME: RYSER FIRST: JUDITH M ��� °
° ADDRESS: B104 TACONITE '-' " MN 55786 °
° HOME PHONE: 245-1713 BUSINESS PHONE: DOB: 05/25/38 °
0 0
° LAST RECORD CHECK: 05/10/93 * * * Notes Exist * * * °
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