95-755ORIG4
Presented Hy
Re£erzed To
committee: Date
RESOLVED: That application, ID 41041, for a new Gambling Manager License by Julie L.
Sayo1(itz DBA St. Paul Winter Garnival/Educational Fun Fair, Mr. Patom's, 945
W. 7th Street, be and the same is hereby approved.
��r—�� Requested by Department of:
Adopted by Council: Date
Adoption CertiEied by
By:
Appz
By:
Council Fi1e # �� ���
L Green Sheet # 29342
RESOLUTlON
.9�F SAiNT PAUL, MINNESOTA 3 �,
Office of License, Inspections and
Environmental Protection
By: \-, ��'�� / 1 '�'°'�K���
Form Approved by City Attorney
B � �-/�-cls
Approved by Mayor for Submission to
Council
By:
�.s-7s'Sr
DEPARTMENT/OFFICE/COUNCIL CIATE MRIATED N� 2 9 3 4 2
LZEp GREEN SHEE
CANTACT PfASDN & PHONE INITIAVDATE INRIAL/DATE
� DEPFRTMENT�IRECTOR � QTVCOUNCIL
Chri tine ozek — 266-9108 °���" �cmnnoaNev �cirvc�eK
MUST BE ON CAUNCIL AGENDA BY (DA ) NUqBER FOA O BUDGET DIqECTOfl � FIN. & MGT. SERVICES OIP.
� ROUTING
H 3 7.R : Z�� ORDEq O MAYOR (OR ASSISTAN'n �
TOTAL # OF SIGNA7URE PAGES (CLIP ALL LOCATIONS FOR SiGNATURE)
ACTION REOUESTED:
7ulie L. Sayot[itz DBA St. Paul Winter Carnival/Educational Fun Fair requests
Council approval of her application for a new Gambling Manager's License (ID �f41041) at
Mr. Patom's, 995 W. 7th Street.
REGOMMENDAiIONS: Approva (A) o� Reject (R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PLANWNG COMMISSION _ CIVIL SERVICE COMMISSION �� Has this personlfirm ever worketl under a Contrac[ for thi5 tlepartment?
_ CB COMMITfEE _ YES NO
_ SrAFF 2. Has this personNirm ever been a City empfoyee?
— YES NO
_ �IS7RiC7 CoURT — 3. Does this person/firm posse5s a skill not normalry possessea by any curreM Cky empfoyee?
SUPPORTS WHICH COUNCiL O&IECTIVE7 YES NO
Explain all yes answers on separate sheet antl ettach to green sheet
INITIATMG PROBLEM, ISSUE. OPPORTUNITY �Who, YJhat, VJNen, Where, Why).
ADVANTAGESIFAPPFOVED:
DISADVANTA6ES IFAPPROVED:
J�b'4 ,(..' 3 63ay�
OISADVANTPGES IF NOT APPROYED:
TOTAL AMOUNT OF TRANSACTfON $ COSTfREYENUE BUDGETED (CIRCLE OT7E) YES NO
FUNDIHC+ SOURCE ACTNITY NUMBER
FINANCIAL INFORMATION� (EXPIAIN) .
9S-7S�
Greensneet # 29342 L.I.E.P. REVIEIN CHECKLIST
In Tracker?
MP'n Received ( APP�n Processed
LicenselD # 41041 NEW Gambling Manager
St. Paul Winter Carnival/
Company Name: Ju1ie L. SayoYitz DBA: Educational Fun Fai_r
BusinessAddresss: 995 7th St_ W. st. Paul 55102 SusinessPhone: 297-695s
Contact Name/Address: 4� 6 �ard� g��n uo�a Home Phone: �9�-h95t
Shoreview, MN 55126
Date to Council Research:
Public Hearing Date: �1 � 1 Z� �i�
Notice Sent to Applicant:
Notice Sent to PuWic:
Date Inspections
City Attomey
�l��i �15
Environmental
Health
Fire
License
PoliCe
Zoning
���
N ��
� �V
� ��,D � �1 S
� � �F
�Ij� ��
�' �
Labels Ordered:
District Council #: 09
Ward
Comments
� t�
����
02
Si4e Plan Racaivad:
Lease Received:
/�.�
-? :
, LG2t2
_ (Rev.7l292)
` Minrtesota Lawfi[1 Gamblsng
Gambliag Manager Application
95-7�5 .-
FOR OFFICE iJSE ONLY; :'
BASE llC # -= = �
SEQ f -
FEE
CHK
DA7E
INIT
� New Give date sha2 the two-day gambAng manager seminar was compieted. S!3( !�
l.ocation os trainmg � A,C F U! 1 1� 1Yl N
(ab) r
� Renewat
� ..ar:e•n.:..
iflTl2���Tft�':J
LAST NAME
Give date of training received w��in three years prior to the date of the app6ra4on for renewal. _! f
�
NAME MIDDLE NAME MAIDEN Date of Birth
.� l l,.= / v�i.,/ /�iPF., SI i- � 3-G
yi� C //r�/J . ���,PF�.�Ei,� mn� ss�a�
MEMBERSHIP: Date gambling manager became a member o( the organizacon �/ �/ '_l`�.�
Name o{ Organization
A.�dI855 .�'S� . Sf .e£E 1
--• • - — ---
�OttGiq�/�tYqL FuN FRr,<
City/State
Soe. SeeuritY Number
� 39P-��- 1 /�/``1
Day6me Phrne
tG�1>.�y�- G 9s
Sex : 0 Mala � Femaie
License
/'"] - V '7 J ..J
Zip Code Phone -
s.5 ���?> aa7-� 9ss
.>.ry.n..� .i:::.ti.: jWOiFaip :.rv:`:.>Fm.v4::.vYa.�.: .. 'hi'!Y^1: . ..✓�: .�.:�..i.:� %a...i..i...':.i:i•y�.:'.i.i.�D:i
n�..:� .J..... .., o.tn�.rv:
.J:O:::::.:.�� .....'So �...:..iX....4vi.<•.:1::':i�2.�.e�t
..'^a.. �:9.>.:.. ..
., .. . .
j-.. 1..,._.+ , e. .. . . . ......:..: . .. ."T.u'� i'>t.l:� i°iGi.i' >::%:i:j).`Y.•,i- '.:L:.i'>.viar^a'
. :: . ,...r,:.i:.:""<k.:=:....,..-.'.^',::y...,:...: :..
._;.,,..., v
,{:" ,:.�.
:: . .;.. ✓
.. . .::.. :.>:.... _.. , ..�r,o - a..: .,;�.:.,.
BOTtC��Ol'JTLQ�i07� _,> .>_ .z;��r.z:r;a.x:� <;7;% ''i,;�:�fG:�u..�;;%u�«�'x:...>�:�..�;v.r:.„
...,_, . >..,, . . . .,.., ,. .,,> .... .:.....:....... .< ... ... .. ...._.:., .....,._ ..
--A $t0,OD0 fideGry bond in favor of the aganizadon must be obtained for the gambling manager, � _
Name of insurance cempany {do rwt use agency name) ri L n /IFQi�I�L / C Bond Number �/�i S'L 7f
.Sll�?ETy �a/nPA�'�/
1 dedara that
• 1 have read this appLcaton and all intortnation submitted to the boarcl; .
• all infwmaBon is true. aaurate and eomplete:
• all other requued intarma6on haz been 1utly disdosed;
• 1 am the only garnbiing manager of the cxganiza5on;
• I wili famifiarize myself with tlie laws of Aknnesota goveming lawful garnbfirg and rules of the board and agree, 'rf Geensed, to
abide by those laws and rules, ind�ng amendments to them;
• any changes in appCKation infortnation wiU be submitted ro Ne board and beal unit o( govemment wiihin 70 days of the ehange;
• M affidavit for gambGng manager has been mmpleEed and atiached, and
• 1 understand that falure to provide required infortnatlon w providing faise informa5on may resuft in tfie denial or revoea6on of the
Gcense.
Signaiure of GambGng
t . .
�/4�/
the
and ail required attachments to:
Gambiing Controf Board
Surie 300 S.
17�1 W. County Road B
RasevtUe, MN 551�3
Date