96-588�. �. � j
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Presented By
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Referred To
RESOLUTION
OF SAINT PAUL, MINNESOTA
Council File �` - 1 � � 5 8.6
Ordinance #
Green Sheet ,$ 34981
�
Committee: Date
RESOLVED: That application, ID #98070, for a new Gambling Managex's License by Daniel
W. Rietz DBA TSE, Inc. at Coach's Pub, 1192 N. Dale Street, be and the same
is heieby approved.
�1( a � ,�Q Raquested by Department of:
• - • -: - �-•- •�- _�•
: •�_��-: . - .�
By: �,�.clEt�M ��
Form Approved by City Attorney
By � J B ��_ � 1 .�
y: � ?os -v�> 2 cz. .�„�o �
Approved by Mayor: Date l,?� f b CJ
�� �� Approved by Mayor for Submission to
By . C Council
Bys
Adoption Certified by Council Secretary
N_� 3498�� �
GREEN SHEE _ . _
INITIAUDA7E INRIAL/DATE
a DEPAHTMENT DIRECTOR a CITV COUNCIL
- 266-9132 "u'�" � cmnrroaNer 0 cmc�RK
NUMBERFOfl
(DATE} ROU a BUDGET DIRECTOR O FIN. 8 MGT. SERVICES DIR.
� OflOFA � MqVOF (OR ASSISTAPln �
TOTA� # OF SIGNATURE PAGES
Daniel W. Rietz DBA TSE, Inc. requests Council approval of his Gambling Manager'
License, ID �698070, at Coach's Pub, 1192 N. Dale Street.
Apprwe (A) or Reject (R)
_ PIANNING COMMISSION _ CIVIL SERVICE COMMISSION
_ CIB COMMRTEE _
_ siAFF _
_ DISTRICTCOURT �
SUPPORTS WHICH COUNG�L O&IECTIVE?
IF
������ � .,..����t ����'
����'�' � � �ri�o
(CLIP ALL LOCATIONS FOR SIGNATURE)
PERSONAI SERVICE CONTRACTS MUS7 ANSWER TXE FOLLOWING QUE5710N5:
1. Has this persoMirm ever worked under a coMrect for this tlepattmeM? -
YES NO
2. Has this personHirm ever been a ciry employee?
YES NO
3. Does this personmrm possess a skill not normally possessed by any current city employee?
YES NO
Explefn all yes anawers on separate sheet and attaeh to green sheet
,, i s
MAY 1 �J 159�
h ;-.
w
r E
IF
TOTAL AMOUNT OF TRANSACTION $
COST/HEVENUE BUDGETED (CIRCLE ONE)
YES NO
FUNDIHG SOUNCE AC71VI7V NUMBER
FINA4ICIAL INFORMATION�. (EXPLAIN)
Greensheet # s49s� L.I.E.P. REVIEW CHECKUST oate: L��.- S8�
in Tracker?�/l5'�/9� Aac'n aeceivea / APP'n Rocessed
License ID # 98070 LicenseType: rambi �rg Mar gPr
CompanyName: Daniel W. R�etz DBA: T�, - r.,�
Business Addresss: 1192 rr Da1 .(('.oarh' c p„b) Business Phone: 489-2595
Coniact Name/Address: 2027 Rice St. Roseville 55113 Home Phone: 489-2595
Date to Council Research:
Public Hearing Date: �� � $' � i9RG Labels Ordered:
Notice Sent to Applicant: District Councii #: 06
Notice Sent to
Ward
GE
Department/ Date Inspections Comments
City Attosney
Environmental
Heaith
Fire
License Site Plan Received:_
Lease Ftecel�ed:
Police � /�-* � �
�j9�9b
�
Zoning
LG212
(Rev. 7t2192)
MAIDEN
� New � Give date tfiat the twoday garnb6rg manager seminar was compieted. �yJZ/�
Location of training EaQan, i�I�
(pb)
� Renewal Give date of training received wittun three years prior to ihe date of the appGca4on fw renewai. / /
Location of training
LAST NAME FIRST NAME MIDDLE NAME
Rietz Daniel idilliam
.ddress
2027 Rice Street, Roseville
!'v�l
Date of Birth Soc. Securiry Number
7-4-60 480-84-2432
55113 � (612 4;4-2595
MEMBERSHIP: Date gambli� manages beeame a member of tfie osganization 7! 5! 83
Name of Orgaruza6on
TSE. Inc.
FOR OfFICE USE ONLY
&4SE LJC ft
SEQ #
FEE
CHK
DATE
INIT
Sex: �Male ❑ Female
License Number
None
Address " CitylStais Zip Code I Phone
2027 Rice Stzeet Roseville, MN 55113 <612 ) 489-2595
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-- A$50,000 fide5ty bond in Savw of 2fie organiza4on must 6e obiained for the qambfing manager. .
Name of insurance company (do rwt use agenry name) Seaboard Surety Cd. - Bond Number 256988
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I dedare tliat � . - -
• I have read ttus applieation and all iniormation submitfed to the board; .
• all intorma6on is true, aaurate ar�d compieta;
• all other required infortnation has been tuily disdosed; �
• 1 am the only gambiing manager of the organiza6on;
• I wilf tamiTiacize myselt with ihe laws et Minneseta goveming law(ut gambiing and rules of the board and agree, if Gcensed, to
abide by tl�ose laws and rules, indudmg amendmenis N tbem; . -. -_ - -_
• any changes in appTiwtion intormation will be submiried to the board a� bca3 unit of govemment within 10 days of the change; �
• M affidavit tor gambfing manager has been wmpieted and attached, and " �' �
• i understand that falure to provide required informafion a providvg faise information may result in ihe deniai or revoca5an of tfie
license.
Minnesota I.a:nful Gambi'vtg
Gambliag Ma.riager Apglication
Date
_ " s/�IS
of
- _ ' Send the completad applicaYwn and afl required attacfiments io: '_ : - : ,: : . -
Gambting ConYrol Board ,
" ' SuRe 300 S. ' " °
' 1711 W. County Road B
- - - - - ''. . �°, -' poseville, MN 55113 *.,' <. , - -
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