96-1203 ' � �'' � �' � f�i �
Council File # a • � �3
� ��. � i�.x
` � �� � & � ��� t"° Ordinance #
Green Sheet # 35000
RESOLUTION
ITY INT PAUL, MINNESOTA �Q
Presented By
Referred To Committee: Date
1 RESOLVED: That application, ID # 61395, for a new Gambling Manager's License by
2 William R. Schwartz DBA Twin Cities Autism Society at Over-The-Rainbow,
3 299 W. 7th Street, be and the same is hereby approved.
4
5 Requeated by Department of:
6 � Navs Absent
7 B a p�,y
9 Gaer•� � Office of License. Insvections and
10 a Lnvironmental Protection
11 e �
12 T une �
Bostrom
O O
Adopted by Council: Date (, By' �"'"�" 'r'v""'"'"'"'
Adoption Certified by Council Secretary
Form Approved by City At ney
BY� `�--� c� �'S �
By: �' ,L�
Approved by Mayor: Date ` � ��
�'��!(�J�,� , . Approved by Mayor for Submiseion to
By: ��� Council
By:
� . ��.fl3
" °��'" N_ �5 0 0 0
LIEP �REEN SHEET ___. _ . _.-- .
a a pEPARTMENT DIpECTORNrc��� �CITY COUNCIL INITIAUDATE
William F. Gunther - 26�i-9132 ��� ❑cirvnTraaroev �cmc�n�c
( TE) � �BUDqET DIRECTOR �FIN.i MOT.SERVICEB DIR.
��R �MAYOR(OR 118$18TAW7') �
I A ' �S
TOTAL#►OF SKiNATURE PAGE8 (CLIP ALL LOCATIONS FOR SIGINATUR�
ACTION REOUESTED:
William R. Schwartz DBA, Twi�t Cities Autism Society requests Council approval of
his application for a new Gambling Manager's Liciense, ID #61395, at Over-The-Rainbow,
249 W. 7th Street.
���T�'�O1"°��°f�°���� PERSONAL SERVICE CONTRACTS MUST AN8WER THE FOLLOWINO GUE8TION8:
_PIANNMO WMMISSION _CIVIL SERVICE OOMMI6810N t. Hes this persoMirm svsr worksd undsr s COnVaCt for this dep�ftmsM?
_C18 COMMm'EE _ YES 'NO .
2. Has thb personfffrm evsr b�n e oity employes?
—�F — YES NO
_o�s7wicr counr _ s. ooes axa ae►aonmrm posaess a skl��na nonnally aoesees.d by enr axwnt onr amployos9
SUPPORTS WMKiH C�OUNCIL oeJECnvE4 YE3 NO
Ezplaln all yes�nsvwn on s�rab shMt�nd athoh to�n�n�hMt
INITIATIMO PAOBLEM.188UE.OPPORTUNII'Y ryYho�YVheA,Wlhn�VYhero.WhY): ,
RE�E�v�'�
SEP 12 �
�( ATfORHEY
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CI
D18ADYANTAOE6IF AP�YED:
CpU(iC1� R8S8�+fC�1 C6tlt�1'
SEP 16 1996
_. ___ .
.,,
DISADVANTAOEB IF t�T#PPRONED:
TOTAL AMOUNT OF TRRNSACTION = COST/REYENUH dUDdETED(CINCLE ONE) YES NO
FUNDIFIQ SOURCE ACTIVITY NUMSER
FINANCIAI.INFORMATION:(EXPLAIN)
Greensheet # 3s000 L.I.E.P. REVIEW CHECKLIST oate: / � �+ ',�03
In Trackel? App'n Received / App'n Processed
Ucense ID # 61395 License Type: Gamb��ng ManagPr
Company Name: William R. SChwart2 DBA: Troin .i ti es Attti Gm Snri Pt�
Business Addresss: 249 W. 7th St. (Over-The-Rainbow) Business Phone: 641-0709
Contact Name/Address: 12762 Dover Dr. Home Phone: 641-0709
Ap�� Va�l y 55124
Date to Council Research: �!o iqG
Public Hearing Date:_S_� �5 � I��1� Labels Ordered: N/A
Notice Sent to Applicant: g�l6 9� District Council #: 09
Notice Sent to Public: � Ward #: �2
Department/ Date Inspections Comments
,
City Attorney
��3 9 0� �l��q�6
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Environmental
Health
/V !/
Fire
/V /�
License Site Plan Received:
Lease Received:
/V �
Police QK S� �/�1�9,1'j /e1°Cl�� �-s/1� !T[/���
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Zoning
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�G2�Z FOR OFFICE USE ONLY
(Rev.7/2/92) . BASE UC�
sEO� —� �7.03
. Minnesota Lawful Gambl�ng FEE
Gambling Manager Application cHK
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Locadon of traininy T ��`^�
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� Renewal Give date of training received within three yeara prior to the date of the applicatio�for renewal. / /
Locadon of tralning
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LAST NAME FIRST NAME MIDOLE NAME MAtDEN Date of Birth Sx.Sewrity Number
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qddress State ip Code Daytime Phone
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MEMBERSHIP:Date gambiing manager became a member of the organization �/�/q� Sex:�e ❑ Femele
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Name ot Organiza6on Ucense N bef
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Address City State Zip Code Phone
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--A$10,000 fidelity bo�d in(avor of the organiza6on must be obtaihed for I�e ga blin manager. �
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Name of insurance company(do not use agency name)��� Bond Number e ��
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i dedare that:
• I have read chis applicatlon and all infortna6on submitted to the board;
• all infom►aoon is aue,aca�rate and complete;
• all o�er required infortnation has been lully disdosad;
• t am tl�e only gambling manager of the organization;
• {will famil'�arize myself with Ihe laws of NGnnesota goveming Iawful gambling and tules of the board and agree,if licensed,to
abide by those Iaws and rules,induding amendments to them;
� any changes in applica0on information will be submitted to the baard and local unit of govemment within 10 days of the change;
• An a�d2�vit for gambling manager has been oompleted and attached,and
� 1 underatand that tailure to provide required informadon ar providing false information may result in the denial or revocation ot the
license.
Signature of Gambling Manager _. Date
��� � � �
Send the completed application an I required attachments to:
Gamblfng Control Board
Sufte.300 S.
1711 W.County Road B
Rosovllle,MN 55113
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