96-901t�R1Gl���
Council File � �Q1 - � O1.
Ordinance ¥
Green Sheet ¥ 35239
Presented By
Referred To
RESOLUTION
OF SAINT PAUL, MINNESOTA
53
Committee: Date
1
2
3
RESOLVED: That application, ID #24243, for a new Gambling Manager's License by
Scott R. Venne DBA White Bear Avenue Business Association at Hafner's,
1560 White Bear Avenue, be and the same is hereby approved.
4
5 Requested by Department of:
6 Ye s,� Nays Absent
7 s a�ey �
8 G¢eri_,,n OfP�ce of License InsQections and
9 � Harr s
10 Me ard nv� o mental Protection
12 T
�i i '
!,
Form Approved by City Attorney
B Y ° ��- �,..._.�ti'�-�—�—� �
/� By: `�rlrO,i iT �]s�11
Approved by Mayor: Date p C) �
�� <(� � Approved by Mayor for Submiesion to
By: h�Gg Council
By:
Adopted by Council: Date ��
Adoption Certified by Council Secretary
Q� -901
DEPARTMENT/OFPICE/COUNpL OATE INRIATEO {�(� 3 5 2 3 9
LZEP ��� q� GREEN SHEE _
IN�TIAVDATE INRIAIJDATE
CONTACTPERSONSPHONE �DEPARiMENTDIRECTOF OCffYCOUNCII
William Gunther - 266-9132 "��" �arvanoaNev �CRYCLERK
MU5T BE ON CAUNCIL AGENDA BY (DA7'� ���� O BUDGET OIRECfOR O FIN. & MGT. SFAVICES D�R.
H28T7.R : ONOER Q MpYOfl (OR ASSISTANn �
TOTAI # OF SIGNATLLR PAG S (CLIG ALL LOCATIONS FOR SIGNATUR�
ACTION flEQUESTED:
Scott R. Venne DBA White Bear Avenue Business Association requests Council approval of his
application for a new Gambling Manager's License at Hafner's, 1560 White Bear Avenue.
ID �124243
RECOMMENDAnONS: Approve (A) w Raject (R) pERSONAL SEHVICE CONTRACTS MUST ANSWER TNE FOLLOWING �UESTIONS:
_ PLANNING COMMISSION _ CIVIL SERVICE CAMMISSION �� Has this perso�rm ever worketl under a wntraM for this departmeM?
_ C�B COMMITfEE , YES "NO
2. Has this personHirm ever been a city employee?
— �� — YES NO
_ DIS7nICT COUR7 _ 3. Does this person/Firm possess a skill not normally possessetl by any current ciry employee?
SUPPOFiTSwHICXCOUNCILO&IECTIVE? YES NO
Explain pll yes answers on separate sheet and etteeh to green sheet
INITIATING PROBLEM, ISSUE, OPPE/HiUNITY (Wlw, What, Wtien, Where, Why):
ADVANTAGES IFAPPROVED:
DISADVANTAGES �F APPROVED.
�Dit6i"� �?��7� �
.1UL 2 � i�96
�ISA�VANTAGES IF NOTAPPROVED: ` �"�=�` � � � ^°
TOTAL AMOUNT OF TRANSACTION $ CO57/REVENUE BUDGETED (CIRCLE ONE) YES NO
FUNDING SOURCE ACTIVITV NUMBEH
FINANCIAL INFORMATION: (EXPLAIN)
Greensheet # .��
In Trackef?__�
License ID # a �a, �3
Company Name:_.y�
Business Addresss: /S/vL
Contact Name/Address:1�fi
Date to Council Research:
L.I.E.P. REVIEW CHECKLIST Date: � q` •40�
�+PP'� Reoaivad J App'n Processed
Public Hearing Date:��4'��
Notice Sent to Applicant:
Business Phone:�'J�—//l 9(� �"�
Home Phone: 7�� h
Labels Ordered: /V
District Council #: F� �
Notice Sent to Public: Ward #: C� /.�
Department/ Date Inspections Comments
City Attorney
�'�d5'`q,� ?��-��b
Environmental
Health
���
Fire
���
License Site Plan Received:
Lease Received:
���
Police O j/ �/ � / /�
��� S�iM���`.L�-�� ��CO!^Cl li/(P��C.—
���a, g �
Zoning
/ V��
LG212 � u �
(Rev. 7/7192) v��
Minnesota LasvfuI Gambting
Gambling Manager Application
. ..__. _ ...__ __
fOR OFFICE
BASE L1C i
SEQ i �
FEE � �
CHK �
DATE «-
INIT �
` €�
New Give date that the nvo-day gambling manager seminar was completed. �!�l��
LocaSon of training _ J �J12.w)
(ci:y)
� Renewal
LAST NAME
�i7
bt�l��
Give date of trainin9 received within thr=e years prior ro the date of the appfication tor renewai. / /
Location of training
(��h)
i.Qg@i'��lt�Of7ltQYi012-� - .
FIRST NAME MIDDLE NAME MAIDEN
Date of Birth Sac. Sewriry Number
A-ZG-S6 I y7�-6�' 23
MEMBERSHIP: Date gambiing manager became a member ot the organizalion �/_/� Sex :�Male ❑ Female
Address
�� -:._, : . . _. .. . . . .
.�.c.: . :, �.., - , .-.. ..:.,
�.QLtOR � . . .. � . . . . .. . . . . . . . � � . _ .
Ciry/Siate Zip Code I Phone
, t 6rL ) 77J-
.: „ � ; . ;
Bond Inf`orntafcon .::. : . .`
-- A$10,000 fideliry bo�d in favor of the organizacon must be obtained for the gambling manager.
Name of insurance company (do not use agency name) ��t� ��lt� �Bond Number LG OO,S9'� O 1 �
.�� , ��'�S<' r ^, .;.. . _ _., .. _ . _
;, . . ,,,. �. .
Acknotuledc►inent.:. ,,.= , - • :.. - : ..
I dedare that: .
• 1 have read this appGcation and all infocmation submitted to the board;
• all infortnaGOn is true, accurate and eomplete;
• all other reauired infortnation has been tully disdosed;
• I am the only gambling manager of the organizafion;
• 1 wllt famitiatize myself xrith the laws of Mnnesota goveming tawEu{ gambiir�g and rufes ot she board and agree, it ticensed, to
abide by those laws and tules, induding amendments to them;
• any changes in appiicaoon information will be submitted to the board and local unit of govemment within 10 days of the change;
• An affidavit for gambling manager has been compieted and attached, and
• 4 understand that tailure to provide required information or providing Yafse informaDOn may resuh in the denial or revoearion oS the
license.
SignaNre At Gambling Manager
Date
� Send the completed application and all required attachment o:
' ����1 Gambling Control Board �r�
V Suite 300 S. ���
5711 W. CouMy Road B
Rosevflie, MN 55113
�.��. .rtic�— ��:�o„� 9( �I `� � � �'��d
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-11-96 THU 13:58 PREMIER BANK MAPLEWOOD FRX N0. 16127777700 P.02
Minnesota Gambling Confrol Boasd '��� �� b �
Gambling ManagerA�davit � � »;�� - - ��� �: .
Attath to the GambGng Manager Application. Fortn LGSl2 •: �:: �=
, .e:': ^i��:•r•,:�.;i,C, . :. .
STATE OF • � .���•.
�c3� �'''i::.:.
_ MtMeS��A � AFFIDAViT OF QtlAL1FICA710K j� i �,:,
FOR GAMBIING MAPtAGER LICENSE .
COUNZY OF �� s � �ND CONSENT STATEMENf :��.�=-�� �
(Pursuanc to Minnesota Statutes and Rutes)
I. Scn'�} �f.Q./t/12 , Uoder oath state that:
(typetpriM namej
t. t have nevec been ccnvicted ot a felony or a uime �nvotvir�g gamDGng.
r�;,
.. o,_
2, f dave not, within five yesrs before the date of tde Itcense applicaGon, wmmitted a violaSion ot la�r o� "
Baatd rute thal resutted in the reva�aUon of a license issued by the Baard. "`'�T
� F :. •.
3. 1 have never been convicleC of a criminat violation involv"u�g f2utl, theft, tax evasian, misreprcssrttatton,
or gambfing, , �
<, t have never 6een canviaee ot (j assaull, () a criminal violatian invotving the use of a firearm, or pi�
making terroristic threats. .
5. 1 am not, nor ever have been connecled with or engaged in an illeqai business_
6. 1 do not owe SS00 or more in delinquent taxes as defined in section 27a.72.
7. I have not had a sales and use tax pertnit revoked hy the commissioner af revenue within the past two
years. • '
8. I have never, aRer demand, failed lo file tax re:ums requireC by the cornmissioner of revenue.
in addiGcrt, l understand, agree and hereby irtevopb�y ccrtsent that suits artd actinns relating io the subjed
marier of the aKacheE garimbfing manager license spplication, or acts or omissions arising from sueh applica-
tion, may be commenced against my organization and I will accept the senrice of process for my organiza-
tion in asry eouR ot wmpeteftit jurisdidion in Minnesota by service on She Minnesota Settet2ry of State af any
summons, process or pleading autho�ized by the laws oF Minnesota.
By signature of ihis dowment, the undersigneC authorizes the Department of Pubtic Safety to conduct a
uimina! background eheck or review and to share the resufts wiih the Gambling Corrirol Board.
Fa7u2 to provide requ'ued in0ormation or prcviding Fa65e or misteading information may resuR in ltle Cenial or
ravocst�an ot the ;Eceass.
FUR7NER AFFIANT SAYETH NOT, except that this AKdavit and Consem Statement are submitfed in
support o(Ihe apptication for a gambfing manager license irom the Gambting Controt Board.
NOTARYPUBIJC INfORMRTION
Seal may not be aRered.
Subscaibed and
or
to before me ihis
;�N�
::£..�oi'.�
.. .�"n:,
/ �
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_11.: �-i _ � .
OR 6ANlZA710(�l lNFORMATfON
of Organization
11' ►U!t!C •
OAKOfA CC
14:05
t i�Pnse Number
96i
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P.