96-587�� � f P� �
`..t` i : t �a.! r � `, � •,
Presented
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
2A
25
26
27
28
29
30
Referred To
RESOLUTION
SA1NT PAUL, MINNESOTA
Council File # �s�7
Ordinance ¥
Green Sheet # 34979
��
Committee: Date
RESOLVED: That application, ID #23430, for a new Gambling Manaqer's License by Marlyn
Datc¢nan DBA I,ady Slipper Chapter of American Business Women's Assoc. at
Gallivan's, 354 N. Wabasha St, be and the same is hereby approved.
Requested by Department of:
Of£ice of License Inspections and
Envi omm � a� P ot +on
By: L 4/.[�Qr�, � ��
Foxm Approved by City Attorney
By' �� � / \ l
By: �//iiPy.�i�u.`� / it �
Approved by Mayor: Date �Z L �
� Approved by Mayor £or Submission to
$y _ �LC < �r2.�" ^' � Council
J
By:
Adoption Certified by Council secretary
q �. - 5��7
DEPARTMENT/p�ICFJCOUNpL DATEINITIATED GREEN SHEE �O 34979 `
LIEP - --
CONTACTPERSpNSPHONE �DEPARTMENT�IRECTOR OCiTYCAUNCIL INITIAVDATE
W" 'a ther — 266— 32 ^��x []cmnrroaNer �cmc�RK
MUST BE ON CqUNGIL AGEN�A BY (DAT� pOM��� � BUDGET DIRECTOR � FIN. & MGT. SERVICES �IR.
� ORUER � �,�pYOfl (OFi ASSISTANn ❑
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SI6NATURE)
ACTION REQUESTED:
Marlyn Damman DBA Lady Slipper Chapter of American Business Women's Assoc.
requests Council approval of her application for a new Gambling Manager`s License, ID �i23430
at Gallivan's, 354 N. Wabasha St.
RECOMMENDA710NS: npprove (A) w Reiect (R) PEHSONAL SEFiVICE CONTRACTS MUST ANSWER 7HE FOLLOWING QUESTIONS:
_ PLANNING CAMMiSSION _ CIVII SERVICE CAMMISSION �� Has this personHirm ever wmketl under a coMract for this deparlmeM? -
_ CIB COMMRTEE _ YES 'NO
_ S7AFF 2. Has this person/firm ever been a cify employee?
— YES NO
_ DISSAICf CpuFiT _ 3. Does this persoMirm possess a skill not normally possessed by any current city employe9?
SUPPORTSWHICHCOUNCILO&IECTIVE7 YES NO
Explain all yes answers on separate ahaet anC ettaeh to green sheat
INITIATING PROBLEM, ISSUE, OPPORTUN17Y (Who, Whet, When. Where, Why):
-� �-r�--- -��__
.
�1AY �g �996
C � ��t. G _ �xr c <. � ye
ADVANTAGE$ IF APPROVED:
DISADVANTAC+ES IFAPPROVED'
�3lii3C� 4. ��9'�8 .#�i
{vlr�'f �. d ����
- -- - �'
DISADVANTAGES IF NOTAPPROVED:
TOTAL AMOUNT OFTqANSACTION $ COST/NEVENUE BUDGETEp (CIRCLE ONE) YES NO
FUNGIHG SOURCE AC7INTY NUMBER
fINANCIAL INFORMATION: (E%PLAIN)
Greensheet # 34979 L.I.E.P. REVIEW CHECKLIST Date: / 9`— 5�7
In TraCkOfl__�z�1�Z�f4r., il�— APP'n Received 1 APP'n Processed
T'�
License ID # 23430 License Type: Gambling Manager
Company Name:_Marlvn Damman DBA: Lady Slipper Chapter of ABWA
Business Add�esss: 354 N Wabasha (Gallivan's) Business Phone: 379-8075
CoMact NameJAddress: 2700 N. Dale St. �1208 55113 Ftome Pfione: 374-8075
Date to Councit Research:
Public Hearing Date: ��.vn.t SiltiY94
Notice SeM to Applicant:
Labels Ordered:
District Council
Notice Sent to
Ward
Department/ Date Inspections Comments
City Attomey
Environmental
Health
Fire
License Site Plan Received:
Lease Received:
Police ry��' �� t
f� �2�or� �%�ec,�—
�'��(le 9�S
Zoning
_ 9�-5�'7
EasE STATE OF NINNESOTA TOR BOARD U88 ONLY
OAtfBLZNf3 CONTROL BOARD AMT. PAID
CiAMBLIHQ XANJlGER LIC6N38 REX6WAL APPLICATZON CHECR #
LG212GMR PRINTED: 02/OB/95 , D11T8
LICENSE NUMBER: 0-03162 OOZ EFFECTIVE DATEs 01/O1/96 EXPIRATION DATSt 07/31/9S
NAME OF ORGANlZATION: _ Ladp Slipper Chdpter ABWA
Q�?J,H�IN6 NANI�OER IN!'ORNATIOI[
Marlpn Julianne Daaaan DATE OF B2RTHs 11/ZO/36
2700 N Dale Street #208 SEX: r
'"'" °"' -' "" Rosevi110 MN 55113 sOCiAL SECURITY NIJMBER: 372-36-5396
DAYTZME PHONE NUMBERt 611-379-8075
MBMBfiR SINCSt 09/12/85
ACM Convention Duluth 11/99
LRST DATE YpU ATTENDED A GAMBLTNG MANAGERS SEMINAR/CONTINUING EDUCATION CLASSt .O�f-}Qf�93
BOND COMPANY NAME: United Fire i Caaual BOND NUMBER: 5108Z790
I D6CLARE THATs
• I HAVE READ THIS APPLxCATION AND ALL INFORMATION SUBMITTED TO THB GAMBLIN6 CONTROL BOARDp
• ALL INFORMATION T3 TRUE� ACCURATE AND COMPLETEp
� ALL OTHER REQUIRED INFORMATION HAS BEEN FULLY DISCLOSEDj
� I AM THE ONLY GAMBLING MANAGER OF THE ORGANIZATIONj
� I HAVE BEEN AN ACTIVE MEMBER OF THE ORGANIZATION FOR AT LEAST TWO YEARS)
• I WILL FAMILIARIZE MYSELF WITH THE LAW3 OF MINNESOTA COVERNING LAWFUL CAMBLING AND RULES OF
THE GAMBLING CONTROL BOARp AND AGREE� IF LIC�NSED� TO ABIDE THOSE LAWS AND RULES�
INCLUDING RMENDMENTS TO TNEM;
• ANY CHANGES IN APPLICATION INFORMATION WILL BE SU8MI1'TED TO THE GAMBLIN4 CONTROL BOARD AND
LOCAL ITNIT OF GOVERNMENT WITHIN IO DAYS OF THE CHANGEj
� AN AFFTDRVIT FOR GAMBLING MANAGER HAS BEEN COMPLETED AND ATTACHEDi AND
• I UNDERSTAT7D THAT FAILURE TO PROVIDE REQUIRED INFORMATION OR PROVIDING FALSE OR MISLEADSNG
INFORMATION MAY RESULT IN TFIE DENIAL OR REVOCATION OF THE LICENSE.
BI6KATVRE OF 6AMSLIN6 MANA6�R _ 9ATE
3-a�� qS
REFER TO THS CBECI¢,IST FOR REQUIRED ATTAC
HAIL TOi OAM8LIN6 CONTROL BOARD
1711 WEST COVNTY ROAD 8, SUITB 3008
ROSBVILLE, MINNESOTA 55113
THIS FORM WILL BE MADE AVA2LABLE ZN ALTERNA2IVE FORMAT (I.E. LARGE PR2NT� BRAILLE) UPON REQUEST.
0(3 �t3�