96-835Council File # q�-$ 3 S
ORIGII��f��
ordinance #
Green Sheet # 34987
Presented By
Referred To
Committee: Date
RESOLVED: That application, ID#40370 for a new Gambling Manager's License by Donald P.
Sianko DBA Arcade Phalen American Legion Post #577, 1129 Arcade Street, be and the
same is hereby approved.
Requested by Department of:
BY: ��,��,r.�.�„n.,..�_
Approved by Mayor: Date [ �
B �- l� X��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
�'
Office of License. Inspections and
Environmental Protection
By: Li�L�fa� � R�
Form Approved by City Attorney
B Y = — l/1'.9...ar��a ��-�^G-�,
r
Approved by Mayor for Submission to
Council
By:
Adopted by Council: Date � �y. `�9(_
T
Adoption Certified by Council Secretary
94 -�3s
DEPAWTMENT/OFFlCE/COIINCIL DATEINITIATED GREEN SHEET �O 34987
LIEP - - -
iNmavon'rE iNmnvoa7E
CANTACT PERSON & PHONE O OEPAKTMENT DIRECTOR � CfP/ CAUNCII
William Gunther - 266-9132 ASSIGN �CRYATTOflNEY �CRYCLERK
MUST BE ON CqUNCIL AGENDA BY (DATE) NUYBER FOR O gUOGET DIRECTO � FlN. & MGT. SERVICES Difl.
�/ HOUi1NG
�6dr1II : O� � g,b OIiDER � MAYOR (OR ASSISTANi) ❑
TOTAL # OF StGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION RE�UESTED:
Donald P. Sianko DBA Arcade Phalen American Legion Post �f577 request Council approval of
his application for a new Gambling Manager's License, ID 1640370, at Arcade Phalen American
Le ion Clubrooms 1129 Arcade Street.
PECOMMENDA710NS: Approve (A) or Rejact (R) PERSONAL SERVICE CONTFiACTS MUST ANSWER TNE FOLLOWING �UESTIONS:
_ PLANNING COMMISSION _ CiVIL SEHVICE COMMISS�ON �� Has Mis personlfirm ever worketl under a conhact for this tlepartment? -
_ CIB COMMI7TEE _ �'ES NO
_ Sin� 2. Has this perso�rm ever been a city employee?
— VES NO
_ DISTPIC7 CAURT — 3. Does this personrfirm possess a skilf rtoi normalf
y possessed by any curtent ciry employee?
SUPPOR'fS WHICN COUNCIL OBJECTIVE? YES NO
Explain all yes answers on seperate sheet anE attech to green sheet
INITIATING PROBLEM, ISSUE. OPPORTUNIN (Who. N'het, Whe�, Where, Why):
t'�'� � ���
Sti �..*'�.f�
iEVSN � 9:iJKS
ADVANTAGES IFAPPROVED: p
��� r`�. � ��'
. _ rr�.� � ��
DISA�VANTAGES IFAPPROVED.
�tidSClG� s.�_�9t'�`! '�#p�p�
,��L d �' 1���
DISADVANTAGES IF NOTAPPPOVED' � -- - � '
TOTAL AMOUNT OF THANSACTION S COST/REVENUE BUDGETED (CIRCLE ONE) VES NO
FUNDIfdG SOURCE AC7IVITY NUMBER
FINANCIAL INFOFiMATION: (EXPLAIN)
Greensheet # 34987 L.{.E.P. REVIEW CHECKLIST Date: /�� `g 3 S
In Tracker? 9/gh � App'n Received / npp•n arocessed
License ID # 40370 License Type: Gambling ManaQer
Company Name: Donald P. Sianko DBA; Arcade Phalen Am. LeQion Post I1577
Business Addresss: 1129 Arcade St. Business Phone: 771-8778
Contact Name/Address: Donald P. Sianko Home Phone: 771-6928
Date to Council Research 907 E. Lawson Ave. 55106
Pubiic Hearing Date: ,1„ o�-�� 1R�ZL Labeis Ordered:
Notice Sent to Appiicant: District Council #: OS
Notice Sent to Public: Ward #: 06
Department/ Date Inspections Comments
City Attorney
y�
Environmental
Health
/ V��
Fire
�` �
License Site Plan Received:
�ease Receivea:
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Police /!�� ��� ����,f
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Zoning
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LG2/2
(Rev. 7/2/92)
�e o_fApp
[�New
� Renewal
Minnesota Lawfui Gambling
Gambling Manager Application
FOR OFFICE l7SP ONLY
BASE LIC 0
SEQ a
FEE
CHK
DATE
INIT
Give date that the two-0ay gambling manager seminar was completed. / /
Loeation ot training
lG�vD
Give date of traini�g received within three yeacs prior to the date of the applicaticn for renewai. _I !
Loeafion ot training
; ..: . :,.;, �� .
. : �- .. ., . s . .: � ; . :. • � �
, ;.
Gambtin Mand er in orindtion :., ' „.: ,
LAST� AME , FIRST NAME MIDDLE NAME MAIDEN Da of Birth Soc. Secvriry Number
'� ^ r
Lv i i'� ji .).,; nt f� � r� j / '�".:t� `v('�'� - �s.��' :
Address � � ;/� I � State Zip Code Daytime Phone f �
a . �> G !`. f_I �.(i: �. �' r., � � L� ��, � i � ' �y�`C./ ( ) n ✓!' � <X�.
p
MEMBERSHIP: Date gambling manager became a member of the organizatlon �/ ,/� Sex : t[� Male ❑ Female
c
�nizaGOn %1
� �,� � �/
. : . . .: .. .:.... . .
,. .,,.� � . . . ,: ,. . . . : rc>. :::;;:. . � : � �,
, , : � v� t , . .
�ation
/'� r � '7 tioense Number
'�'/:' {�'{1 . r/.'r../. ....,:+^ A:^, /,i' //.9..f
Address City/State Zip Code Phone / n
• '^'7 , �•'! V e � V
6 �,�,!� , �C t�,G.;� � S� ti 1. YAt�.'_ ����r/; � ' � � 7
... :�:> .
,. ;,: , ;
aona�forntatton ;. ,.
-- A$10,009 fideiiry bond in favor of ihe organization must pe obtained for the gam m ger. �
Name of insurance oompany (do rwt use agency name) [ .i�� `"� `� `,�'(4 +�' J.?„'(.� . ��
� � r.� �' Bond Number
Acicnowteiiqment: `
i dedare that:
� 1 have read this application and all infortnaoon submitted to Ihe board;
• all intortna6on is true, accurate and complete:
� aN oUier required iniortnation has been futly disdosed;
• I am the only garnbling managar o( the organiza6on;
• I wiil famillarize myself with the laws of bLnnesoa goveming lawful gambling and rules of the board and agree, if licensed, to
abide by those laws and rules, induding amendments to them;
• any changes in applicatlon information will be submitted to the 6oard and iocal unit of government within 10 days ot the change;
° An aKdavit for gambling manager has been compieted and attached, and
� I understand that failure to provide required informaCOn w providing false informa6on may result in the de�iai or rewwtlon of the
ficense.
SignaNre of
/
I / Date �
; ��� �3
i'
Send the compleYed application and ail required attachments to:
Gambling Control Board
Suite 300 S.
1791 W. County Road B
Roseville, MN 55113
�{D37rI
LG213 Minnesota Gambling Control Board
p4118f95 Gambling Manager Affidavit q G-$ 35
Attach to the Gambting Manager Appiicat�on, Fortn LG212
STATE OF m (V }
AFFIDAVIT OF QUALIFICATION
) s.s.
COUNTY OF ',S " �
�. ��0� MJ�7 �� L� lV� U. Under oath state that:
(type/print name)
FOR GAMBLING MANAGER LICENSE
AND CONSENT STATEMENT
(Pursuant to Minnesota Statutes and Rules)
1. I have never been convicted of a felony or a crime invotving gambting.
2. i have not, within five years before the date of the license apptication, commiried a violation of law or
Board rule that resutted in the revocation of a license issued by the Board.
3. I have never been convicted of a criminai violation involving fraud, theft, tax evasion, misrepresentation,
or gambling.
4. I have never been convicted of () assault, (ii) a criminai violation invoiving the use of a firearm, or �i)
making tertoristic threats.
5. I am not, nor ever have bee� conneded with or engaged in an iilegal business.
6. I do not owe 5500 or more in delinquent taxes as defined in section 270.72.
7. 1 have not had a sales and use tax permit revoked by 4he commissioner of revenue within the past two
years.
8. I have never, after demand, failed to file tax retums required by the commissioner of revenue.
in addition, i understand, agree and hereby irrevocably consent that suits and actions relating to the subjed
matter of the ariached gambiing manager license application, or acts or omissions arising from such applica-
Yion, may be commenced against my organiZation and I wiil accept the service of process for my organiza-
tion in any couR of competent jurisdidion in Minnesota by service on the Minnesota Secretary of State of any
summons, process or pteading authorized by the laws of Minnesota.
By signature of this document, the undersigned authorizes the Department of Public Safety to condud a
criminal background check or review and to share the results with the Gambling Control Board.
Failure to provide required information or providing false or misleading infortnation may resuit in the deniai or
; revocation of ihe iicense.
� FURTHER AFFIANT SAYETH NOT, except that this A!'idavit and Consent Statement are submitted in
suppoR of the application fos a gambti�g manager Sicense from the Gambling Controi Board.
--� i
�,a�P�.���1`�Q.� ��..�/
(signature of appiicant)
ORGAN/ZATION INFORMATION
�l�' �f� I �A ,�E.tJ
License Number
��FG���Q� .�
a� -e�s
LICENSED GAMBLING ORGANIZATIONS
ieeee��eeee�eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee;
° NAME: ARCADE PHAI,EN AMERICAN LEGION POST 577 NUMBER OF SITES: 1°
° ADDRESS: 1129 ARCADE ST ST. PAUL ASN 55106 °
° STATE LICENSE �:00935 PIi023E ,�: LIC CLASS: B STATUS: AC °
0 0
° CEO LAST NAME: DAMIANI FIRST : JAMES °
° ADDRESSs 626 WELLS ST ST PAUL MN 55101 °
° HOME PHONE: 776-3546 BUSINESS PHONEa DOB: 10/22/15 °
0 0
° TREASURER LAST NAME: FRISK FIRST: RICHARD °
° ADDRESS: 7685 25TR ST NO OAKDALE MN 55128 °
° HOME PFIONE: 779-6227 BUSINESS PHONE: 779-6627 DOB: 12/21/33 °
0 0
° MANAGER LAST NAME: SIANKO FIRSTa DONALD P °
° ADDRESS: 907 E LAWSON AVE ST PAUL MN 55106 °
° HOME PHOIIE: 771-6928 BUSINESS PIi0I3E: 771-8778 DOB: 01/22/28 °
0 0
° LAST RECORD CHECK: 07/12/93 * * * Notes Exist * * * °
................................................................. ................. ................. ....... ....... ....... . ....... . ... . ... .....
'eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeef
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