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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