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96-7601 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (�RI��l�'�� OF SAINT PAUL, Presented Referred Council File ��' t b U ordinance # Green Sheet # 34984 _ A S� Committee: Date RESOLVED: That application, ID #75770, for a new Gambling Manager's License by Sheri J. Zigan DBA Neighborhood House Association at Born's Bar, 899 Rice Street, be and the same is hereby approved. Requested by Department of: • - • -�-- :-�- •.- -.�e _ } _If' R - • } � ' � � ��r. Fprm Approved by City Attorney By � ���� �Y = `Z r f,'Oi/i�tGr:�- ) l � r:� Approved by Mayor: Date � � �� `^ ��_/�� // Approved by Mayor for Submiesion to �� A� Council By: Lt,/,+�fJS By: Adopted by Council: Date 3��,9. Adoption Certified by Council Se etary qL-�Gv �EPARTMENT/OFFICE/COUNCIL OATEW�TIATEO GREEN SHEE - N_ ' LIEP i�rtiavan --- - � � iNmnvoa� CONTACT PERSpN & PHONE O DEPAflTMENT DIRECTOR O CITY CAUNdL William Gunther 266-9132 �'�N �cmanoaNer OCITYCLERK MUSTBE ON COUNCILAGENDA BY(DATE) R � BUOGEf DIRECTOR � FIN. & MGT. SEflVICES DI OPUER Q MAVOR (OP ASSI5L4Nn O e r" TOTAL # OF SIGNATURE PAGES (CUP ALL LOCATIONS FOR SIGNATURE) na�oN ac-QUesreo: Sheri J. Zigan DBA Neighborhood House Association requests Council approval of her application for a new Gambling Manager's License at Born's Bar, 899 Rice Street, ID ��75770. RECOMMENDAnoNS:Approve(A)wReject(R) PERSONALSERYICECONTRACTSMUSTANSWERTXEFOLLOWlNGQUESTtONS: _ PIANNING COMMISSION _ CIVIL SERVICE GOMMISSION �� Has Mis person/Firtn ever worked under a coMract for this tlepartment? � � CIB COMMRTEE _ YES NO _ S7AFF 2. Has this person/firm ever been a criy employee? — YES NO _ DISTRIGT COUAi _ 3. Does this persoNfirm possess a skill noi twrmall y possessed by any curceM city employee? SUPPORTSWHICHCOUNdLOBJECTIVE7 YES NO Explain all yes answers on separate sheet and attach to green sheet INITIATING PROBLEM, ISSUE, OPPE»RTUNITY (WM, What, When. Where, Why�: ���� �� p;� � @� MAY 15 i996 ���� ���� �� ADVANTAGES IFAPPROVED: DISADVANTAGES IFAPPqOVED' , DISADVANTAGES IF NOT APPROVED� Ys'� �v%�wi'�� �y�.rC�'^'E�� {YiY47 (d �� ^_„^.••• TOTAL AMOUN7 OF TRANSACTION S COSi/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDING SOURCE ACTIVITV NUMBEH FINANC�AL INfpqMAT10N: (EXPLAIN) Greensheet # 34984 1nTrackef? 5�l License ID # 757 L.I.E.P. REVIEW CHECKLIST Date: /' � ��� APP'n Received / APP'n Processed License Type: GamblinQ ManaQer Company Name: Shar; r_ �igan DBA: NeiQhborhood House Assoc. Business Addresss: 899 Rice Street (Born's Bar) Business Phone: ZZ�-9291 ContactName/Address: ll9 E. R bie St. 5Siu7 Date to Council Researc � �� Public Hearing Date:��t9`bt Notice Sent to Applicant: /% Home Phone: zz7-9291 Labels Ordered: District Councit #: 06 Notice Sent to PuWic: J � 7 a Ward #: OS Department/ Date Inspections Comments City Attorney Environmental Heafth Fire License Site P�en aeceived: lsase Received: Police D,�+ ����� ��_ � /�- ���s�`l',� ��� e�� �� l' Zoning a�-��� 3ast STATE OF XINNESOTA FOR BOARD U5E oNLY GAXBLZHG CONTXOL BOARD AMT. PAID GAMBLZNG MANAGER LZCEXSE RENEF'AL APPLZCATZON CAECIC # ?.G212GHI2 PRIHTSD: O1/02)96 � DATE - �ZCENSE NIIHBfiR: fi-02537 003 EFFECTIVE DATE: OS/O1/95 E7CYIRATION DATE: 06/30/96 ?=P.tf% OF ORGANIZATZON: Neighhorhoad St Paul Hpuse Assoc GAMBLZNG MANAGER YNFORMATION sheri Jean Sigaa 1638 Evans 3outh St Paul 74H 55075 DATE OF BZRTFi: 10/14/59 SEX: F SqCIAL SECQZ2ITY ATIIMBER: 476-84-4511 �AYTIME PHON% 2NMBER: 512-��'��22] `^�'MSER SINCE: 10/21/85 :AST DATE YOU A2TENDED A GAMBLZNG MANAGERS SEMZNAR/CONTINUZNG EDUCATION CLASS: 03/14/95 30ND COMPANY NAME: Allied Group Insuran BOND NUMBER: BD7900552001 Z DECLARE THAT: • I HAVE READ THZS APPLICATION AND ALL 2NFORMATION SUBMITTED TO THE GAMBLING CONTROL BOARD; • ALL INFORMATION IS TRUE� ACCURATE AND COMPLETE; • ALL OTAER REQUZRED ZISFORMATION HAS BEEN FULLY DISCLOSED� � I AM T:iE ONLY GAMBLING MANAGER OF THE ORGANTZATION; . • 2 HAVE BEEN AN ACTZVE MEMBER OF THE ORGANIZATZON FOR AT LEAST TWO YEARS� • Z WILL FAMILIARIZE MYSELF WITH THS LAWS OF MINNESOTA GOVERNING LAWFUL GAMHLING AND RULES OF THE GAMBLING CONTROL SOARD AND AGREE, IF LICENSED, TO ABIDE TAOSE LAWS AND RUI,ES, ZNCLUDIISG AME23DHENTS TO TEiE3Sy • ANY CHAHGES IN APPLICATION INFORMATION WILL SE SUBMITTED TO TEiE GAMBLING CONTROL BOARD AND LOCAL UNIT OF GOVERNMENT WITFtIN 10 DAYS OF TAE CHANGE� � • AN AFFIDAVST FOR GAMBLING MANAGER HAS BEEN COMPLETED AND ATTACHEDp AND • I UNDERSTAND THAT FAILURF TO PROVIDE REQUIRED INFORMATION OR PROVIDING FALSE OR MISLEADING IIiFORMATION Y,AY RESULT IN TAE DENSAL OR REVOCATION OF TAS LICENSE. . - AATE -�9-9 REFER TO THE CHECRLZST FOR REQUlRE➢ ATTACHbgNTS MAZL TO: GIiMBLING CONTROL BOARD 1711 WEST COUNTY ROAD B� SVITE 3005 ROSEVZLLE, MINNESOTA 551�3 iHIS FORH WZLL BE MADE AVAZLABLE IN ALTERNATIVE FORM}1T (I.E. LARGE PRINT� BRAILLE) UPON REQUEST. 7S�7D