97-572Council File # ��
�T
Ordinance #
'���
� : �. . �L� . � . . ---
PYesented
1
2
3
4
5
6
7
8
9
10
I1
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Referred To
RESOLVED:
Committee: Date
59
That application, ID #B-05039, for a new State Clasa B Ga[nbling Premise
Permit by Star Swim Club Inc. at Plums Neiqhborhood Bar & Gri11, 480
Snelling Avenue South, be and the same is hereby approved.
Requested by Department ofo
� - - R- R ' •}_ .}•
t •�11'} � - •}
i
1Y � �r
��
Form Approved by City Attorney
BY= T��M� • _c� �BY �-�-!'i'�..C/Z
Approved by Mayor: Date �3 ��"� �—
By: �--
Green Sheet # �5328
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
� 1� �
Approved by Mayor for Submisaion to
Conncil
By:
Adopted by Council: Date M�,,, �y,�qQ��
— �T —
Adoption Certified by Council Secretary
� N �� s�M�flz�-��.y�
TOTAL # OF SIGNATUHE PA6ES
FOfl
�t� - s'��
GREEN SHEET N_ 35328
INITIAVDATE INITIAVDATE
DEPARTMENT DiREGTOR � CISY CAUNCIL
CIN ATfORNEY O CITY CLERK
BUWET DIREGTOR � FIN, & MGT. SERVICES DIR.
MAYOR (OR ASS4STAN� O
ALL LOCATIONS FOR SIGNATURE)
Revin 0'Connell on behalf of Star Swim Club Inc, requests Council approval
of their application for a new State Class B Gambling Premise Permit, ZD I6B-05039, at
Plums Neighborhood Bar & Grill, 480 Snelling Avenue South.
_ GB COMMITTEE _ '
_ STAFF _ '
� DISTFICTCWRS _ '
SUPPOfiTS WHICH COUNCIL OHJECTIVE?
PERSONAL SERYICE CONTRACTS MUST ANSWER iXE FOLLOWING QUESTIONS:
1. Has this persoMirm ever worketl untler a contrad for this department? -
YES NO
2. Has this person/Firtn ever been a city employee?
YES NO
3. Does this person/firm possess a swll not normally possessed by any current ciry emp�oyee?
YES NO
Explafn al! yes answers on separate sheN a�xl attneh to green ahaet
When, Where, Why):
� - • - �F.cs:••_ .,
?
� I i ( � ,
•
. '.�i •'.. .
M W . 1 �* `^'°' �•
#,$"ij Ci �� t��d
TOTALAMOUN70FTRANSACTION $
COST/flEVENUE BUDGEiEO (CIRCLE ONE)
YES NO
FUNDIfdG SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION: (EXPLAIN�
Greensneet# ssszs L.I.E.P. REVIEW CHECKLIST oate: qj�"���
ln Trackef? APP n Received / nPa'n arocessed
license ID # B-05039 - State �l License Type: State Class B GamblinQ Premise Permit
Company NBme: Star Swim Club Inc. DBA: Star Swim Club Inc.
BUSiuess P,ddresss: 480 Snellin¢ Ave. S, (Plums) Business Phoae: 772-7331
Contact Name/Address:_ Revin 0' Connell/CEO Home Phone: 483-8271
Date to Council
Pu6lic Heazing Date: '}'11c� i�'r . ]9G %
Notice Seni to Appliran� �}�� f 9`7
120
Labels Ordered: N/A
District Council
Notice Sent to Public: Ward #: 03
Department/ Date Inspections Comments
C'rty AttomeY � l'.17�1 � �1"i7� � ��
!
Environmental
Heaith
�l�
F��e
N�/�
License Site Wan Heceived:
Lease Received: '
� � �
Police �COYY� (�-/ �� !7"A�--Cl�
Q�
Zoning
' "��
LG214 , _ _.� ..., ..- . ..,- �. - �aA� '`f.;:-. :. , . -.:.�r%.
nas�vti> -z
;U .
� -,
. ' ` ' -- ` ., r.� Y' 4 a�
MxnnesoLa Lmbful GariebIing V � �
� Premises Perinit Applicatioia�-.Part-l�°of 2`--�`°���'=
� � - � �. Renewal. -_- - . . -
Organisation base i"wense number_
, ` - Premises pertnit number � �
. , � _.. New .,
cla:s oi premises parmi[ --
- �- - ... . . ,, :, , , � �--_..: :y„.�eheek;one) �v::::
" A (S400j Pui4tabs. tiptoarc
=
� - . ..,- , ,5 �_
' - &(325D)-Pu9-tabs:Dpboart
— � _
. , . Q , C (S200J �&ngo�oniy _ ; .��
_ � • ��Q D (5150) Fafttes enly %
�`
.. . _ . . <r : ,?; x '�°` a �. �. ." ?`.' �,�
vObZ�.4`,w:,�ttS: �.. � . � /�1N.. '.a�::.�,�
chief executive o�cer (annot be your gambting.manager;
.. . � .w . i _ . ... . .... . .. :..v,
.,z ;,
:e
�f your
�
�
for a cIa'ss:S or`C' �,.imit: ifll tn da '� arid be ����'��``���-ei
If aPPh'�g P' YS, g�g
No more than seven bingo occasions may be conducted�by„youi
-Bay� Beginnfng/EndSng Hours ,- - Day - �� Beg'uining/Ending�Hovrsx
to � to
� � . , ..� �,•.'
. . �— � 2 f `�2a'..
_>:� �. _.... ��Ifbingo will not be`conduef�d; 't2
. _ _ . . . , .- � - . .. . , .�..� rn- r �i:�c're
,.o..,�..,��,o,.�,�.,...�.,...,.a,� ,. � � :...,... . ....�...�,.....�., i � . ....o.. °,
�tv,wt.s it/�i�'�Ro,eHooe 8/1 G�?i�L" �/8a S.rJECC%�i�-flvs-:
ts�the premises locatsd within ciry.km'sts? .�� - O No �.tt eo, is tawnship,:'� organized, �:u
Ciry and Counry where garnbiing premises is located Ofl Township and Counry where 9ambling premises is
S-r... P���. .� . RR.ti s� � .;
l
��., �.
Name and adAress ot legal owner of premises , Ciry, . , State ., . „
.-.. ...n P�n 1 ( ' _ �.� /1_ � .. _ _. y ,.x._ .;"1��
yow organiz2COn own the buildmg where tlt9 g3mbiing wUl be contluctea"! .. p 7tS ,.,_ � rv0 .,
.. . . .. if ra, attach the foilowin4� . - �. � _�... ` .� . ��� ".
•� a copy of the laase (form LG202) with" mrms for at�least one year -. �-
�,„�
�• a copy ot a sketeA ot the 800r plan witli dmensions, shovring what-por6onls
• A iease and sketch are rwt required tor Ctass D apptirabons �� ���„� _. �_
. ,�: .._ .s_.... ,..' .Y,._....., . .. a:1.;..'x...... _ .:�w.a'%.�.. _`Y ,c:.L.n.. .[�k
_ � .x�.rw�`
.-�..�. . �_ > . ,
��}7wS�awTr 3v ry � n rr
-;�;;.,;��.,:.,-..: -. ntf„nesocazau,Ju�c,ambtuig
- "`:�'�;Preause Permit Application - Part 2 of 2
"'F ..�-s..� ' _ "
��_.,=i�x�"3 , - - - . , ' - '
_ . - ' . OifKl1P
,. _ , . ,. . - .�,"*.;r�• ' -
-..-�.. _ _';..t��i7�� . �� _ .ri0' �/��:....�_\: .,. y
� 3 �'° �`QEFtt '�CA ZA
.�'`
...,._� �sv:pr' '
'Oic � ffvn`����
-__ ,. .� _.
: zys8 BQ�ecEview
':h_'_F_=.: _ ._ : � '-.-. � ,l
•«'�• - � zzr7 �oc.Ear � C
'�.
'ACN ""y15�"'�ei.ei?te.v
r.r :�w-:' �s7P'�:N/eA�.._:� f:
-. � ; ' .STi7B r:. . . :
/�
•P.�es.:�
ME�,.
��.
nt�osization- -:' �, .t am tha ehief oxecutive of(�car of the organizaYpn; .
bcal law anforcomeM officen, tha .i assume futi rosponsibiliy for the iair and Iawfui opara-
r baard, or the commissionac ot tion of att activrties to be conduded;
Pry, or agenu et tha commissb�ers, �,� �� ��d��e myselS with the taws ot Mintfesota .
es Jo enforeelha law."r`< �_ "�`<" -, �'�verning 4awtul gambl+ng and rules of the board'and :,
formatloa _ ',�_ _:: ,:; - : .. __ agrea. 'rf ticeased. to abide by those laws and rules:- �- � � _
pd-to tha bank reoords of iha �uuding amendmenu to them; '
enevx nacassary iqfu�U; ." e;�-� ,<?. in appiication information wiU be submitted
nt'gambGng tuks"and law: ';=, "' � :to tMe board and bcal unit ot govemment within.l0 days
J' of the ehange; and
`�:t';'°'. , °- ' �I undarstand that failure to provide required intormafwn
ication.and a11 infotmption submkfed_ : or providing talse or misleading informatian may result in -.�
xuratdafx3 mmptete: `'`' '. �e denial or ravxatwn of tha 1'icense.
xmaGoa has baen fupy dsdosad; `
' e.ottiear '',',:,-{ .;.:.. ,. ` Date "
:
� �, - ,: `� �__- � ` ' � _ _ � ,_
__� :� �°-,�- l�<: �� , " : _,--=#.,. _ _ � - 7 . C' - - �i �
" ` ' ` "'`" s � � °"` '`' ' � " 4 "A eoov o} the loeal unit oi yovernmenYS resolution ao- `
ieation it iha gambling (xem- ����a this ao�lication must be atteehed to this aeolicafron
°" '`'' S, ft this application 'a denied by the bcai unh of govemment,
'•-.must sign this application rf it should not be wbmitted to the Gambling Condoi Board.
�dwAfiina.townsli�. .€�.':ae�� z�,.� _.. . �. �.a�,•,�,: �' .
city�oi county}'�ust pass a _ ` ;�qownsh3p: By sgnature bebw, the township acknowledges
�.o� de�Yic�q this apP�icat�°M .. ' the organization is appVying tor a premises permit within
*� „ = Y ' iownship fimits. .
..a r_ . . ., .. ' . .. . . , . . . . . .
ti. � _ , _ ___ _., , Townshtp . . _ .:
-- 7ownst�ip Name �
.-,.. ..,'`�i, ' -_-� - . : .. .... . �.. �
�fi ' '.: � T.. _ , r,. ..,� - . �f13Wf@ O( PBff0/1 f!C@IVIl1� 2Pp�iCit1011
� y, : rnn�.. y ,
� ._ e ,. . ,,,..� .,., .• '
!'
�� � � Date Reoaived " -r � �� s, <� ' ".. :_ . . . Date Aecerved .... :
r�s:-=q�u £ I
�iw_re��rea�naetm,.ns.`` _.
:� � _ . _ � . � _
ConUOlBoard -' --� �. �� '
I PLr� South, Ad Floor .,- �
ounry Rud e . . ,.,;
,� .,,,, _ :;.__ -
7dN;iSf13';:.:;,-' . �, ; .
� , ' " �s
lG2)�(PaA 2)
tw.�m�a+>
9 ��-3 ?�.
�
Council File # ��
�T
Ordinance #
'���
� : �. . �L� . � . . ---
PYesented
1
2
3
4
5
6
7
8
9
10
I1
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Referred To
RESOLVED:
Committee: Date
59
That application, ID #B-05039, for a new State Clasa B Ga[nbling Premise
Permit by Star Swim Club Inc. at Plums Neiqhborhood Bar & Gri11, 480
Snelling Avenue South, be and the same is hereby approved.
Requested by Department ofo
� - - R- R ' •}_ .}•
t •�11'} � - •}
i
1Y � �r
��
Form Approved by City Attorney
BY= T��M� • _c� �BY �-�-!'i'�..C/Z
Approved by Mayor: Date �3 ��"� �—
By: �--
Green Sheet # �5328
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
� 1� �
Approved by Mayor for Submisaion to
Conncil
By:
Adopted by Council: Date M�,,, �y,�qQ��
— �T —
Adoption Certified by Council Secretary
� N �� s�M�flz�-��.y�
TOTAL # OF SIGNATUHE PA6ES
FOfl
�t� - s'��
GREEN SHEET N_ 35328
INITIAVDATE INITIAVDATE
DEPARTMENT DiREGTOR � CISY CAUNCIL
CIN ATfORNEY O CITY CLERK
BUWET DIREGTOR � FIN, & MGT. SERVICES DIR.
MAYOR (OR ASS4STAN� O
ALL LOCATIONS FOR SIGNATURE)
Revin 0'Connell on behalf of Star Swim Club Inc, requests Council approval
of their application for a new State Class B Gambling Premise Permit, ZD I6B-05039, at
Plums Neighborhood Bar & Grill, 480 Snelling Avenue South.
_ GB COMMITTEE _ '
_ STAFF _ '
� DISTFICTCWRS _ '
SUPPOfiTS WHICH COUNCIL OHJECTIVE?
PERSONAL SERYICE CONTRACTS MUST ANSWER iXE FOLLOWING QUESTIONS:
1. Has this persoMirm ever worketl untler a contrad for this department? -
YES NO
2. Has this person/Firtn ever been a city employee?
YES NO
3. Does this person/firm possess a swll not normally possessed by any current ciry emp�oyee?
YES NO
Explafn al! yes answers on separate sheN a�xl attneh to green ahaet
When, Where, Why):
� - • - �F.cs:••_ .,
?
� I i ( � ,
•
. '.�i •'.. .
M W . 1 �* `^'°' �•
#,$"ij Ci �� t��d
TOTALAMOUN70FTRANSACTION $
COST/flEVENUE BUDGEiEO (CIRCLE ONE)
YES NO
FUNDIfdG SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION: (EXPLAIN�
Greensneet# ssszs L.I.E.P. REVIEW CHECKLIST oate: qj�"���
ln Trackef? APP n Received / nPa'n arocessed
license ID # B-05039 - State �l License Type: State Class B GamblinQ Premise Permit
Company NBme: Star Swim Club Inc. DBA: Star Swim Club Inc.
BUSiuess P,ddresss: 480 Snellin¢ Ave. S, (Plums) Business Phoae: 772-7331
Contact Name/Address:_ Revin 0' Connell/CEO Home Phone: 483-8271
Date to Council
Pu6lic Heazing Date: '}'11c� i�'r . ]9G %
Notice Seni to Appliran� �}�� f 9`7
120
Labels Ordered: N/A
District Council
Notice Sent to Public: Ward #: 03
Department/ Date Inspections Comments
C'rty AttomeY � l'.17�1 � �1"i7� � ��
!
Environmental
Heaith
�l�
F��e
N�/�
License Site Wan Heceived:
Lease Received: '
� � �
Police �COYY� (�-/ �� !7"A�--Cl�
Q�
Zoning
' "��
LG214 , _ _.� ..., ..- . ..,- �. - �aA� '`f.;:-. :. , . -.:.�r%.
nas�vti> -z
;U .
� -,
. ' ` ' -- ` ., r.� Y' 4 a�
MxnnesoLa Lmbful GariebIing V � �
� Premises Perinit Applicatioia�-.Part-l�°of 2`--�`°���'=
� � - � �. Renewal. -_- - . . -
Organisation base i"wense number_
, ` - Premises pertnit number � �
. , � _.. New .,
cla:s oi premises parmi[ --
- �- - ... . . ,, :, , , � �--_..: :y„.�eheek;one) �v::::
" A (S400j Pui4tabs. tiptoarc
=
� - . ..,- , ,5 �_
' - &(325D)-Pu9-tabs:Dpboart
— � _
. , . Q , C (S200J �&ngo�oniy _ ; .��
_ � • ��Q D (5150) Fafttes enly %
�`
.. . _ . . <r : ,?; x '�°` a �. �. ." ?`.' �,�
vObZ�.4`,w:,�ttS: �.. � . � /�1N.. '.a�::.�,�
chief executive o�cer (annot be your gambting.manager;
.. . � .w . i _ . ... . .... . .. :..v,
.,z ;,
:e
�f your
�
�
for a cIa'ss:S or`C' �,.imit: ifll tn da '� arid be ����'��``���-ei
If aPPh'�g P' YS, g�g
No more than seven bingo occasions may be conducted�by„youi
-Bay� Beginnfng/EndSng Hours ,- - Day - �� Beg'uining/Ending�Hovrsx
to � to
� � . , ..� �,•.'
. . �— � 2 f `�2a'..
_>:� �. _.... ��Ifbingo will not be`conduef�d; 't2
. _ _ . . . , .- � - . .. . , .�..� rn- r �i:�c're
,.o..,�..,��,o,.�,�.,...�.,...,.a,� ,. � � :...,... . ....�...�,.....�., i � . ....o.. °,
�tv,wt.s it/�i�'�Ro,eHooe 8/1 G�?i�L" �/8a S.rJECC%�i�-flvs-:
ts�the premises locatsd within ciry.km'sts? .�� - O No �.tt eo, is tawnship,:'� organized, �:u
Ciry and Counry where garnbiing premises is located Ofl Township and Counry where 9ambling premises is
S-r... P���. .� . RR.ti s� � .;
l
��., �.
Name and adAress ot legal owner of premises , Ciry, . , State ., . „
.-.. ...n P�n 1 ( ' _ �.� /1_ � .. _ _. y ,.x._ .;"1��
yow organiz2COn own the buildmg where tlt9 g3mbiing wUl be contluctea"! .. p 7tS ,.,_ � rv0 .,
.. . . .. if ra, attach the foilowin4� . - �. � _�... ` .� . ��� ".
•� a copy of the laase (form LG202) with" mrms for at�least one year -. �-
�,„�
�• a copy ot a sketeA ot the 800r plan witli dmensions, shovring what-por6onls
• A iease and sketch are rwt required tor Ctass D apptirabons �� ���„� _. �_
. ,�: .._ .s_.... ,..' .Y,._....., . .. a:1.;..'x...... _ .:�w.a'%.�.. _`Y ,c:.L.n.. .[�k
_ � .x�.rw�`
.-�..�. . �_ > . ,
��}7wS�awTr 3v ry � n rr
-;�;;.,;��.,:.,-..: -. ntf„nesocazau,Ju�c,ambtuig
- "`:�'�;Preause Permit Application - Part 2 of 2
"'F ..�-s..� ' _ "
��_.,=i�x�"3 , - - - . , ' - '
_ . - ' . OifKl1P
,. _ , . ,. . - .�,"*.;r�• ' -
-..-�.. _ _';..t��i7�� . �� _ .ri0' �/��:....�_\: .,. y
� 3 �'° �`QEFtt '�CA ZA
.�'`
...,._� �sv:pr' '
'Oic � ffvn`����
-__ ,. .� _.
: zys8 BQ�ecEview
':h_'_F_=.: _ ._ : � '-.-. � ,l
•«'�• - � zzr7 �oc.Ear � C
'�.
'ACN ""y15�"'�ei.ei?te.v
r.r :�w-:' �s7P'�:N/eA�.._:� f:
-. � ; ' .STi7B r:. . . :
/�
•P.�es.:�
ME�,.
��.
nt�osization- -:' �, .t am tha ehief oxecutive of(�car of the organizaYpn; .
bcal law anforcomeM officen, tha .i assume futi rosponsibiliy for the iair and Iawfui opara-
r baard, or the commissionac ot tion of att activrties to be conduded;
Pry, or agenu et tha commissb�ers, �,� �� ��d��e myselS with the taws ot Mintfesota .
es Jo enforeelha law."r`< �_ "�`<" -, �'�verning 4awtul gambl+ng and rules of the board'and :,
formatloa _ ',�_ _:: ,:; - : .. __ agrea. 'rf ticeased. to abide by those laws and rules:- �- � � _
pd-to tha bank reoords of iha �uuding amendmenu to them; '
enevx nacassary iqfu�U; ." e;�-� ,<?. in appiication information wiU be submitted
nt'gambGng tuks"and law: ';=, "' � :to tMe board and bcal unit ot govemment within.l0 days
J' of the ehange; and
`�:t';'°'. , °- ' �I undarstand that failure to provide required intormafwn
ication.and a11 infotmption submkfed_ : or providing talse or misleading informatian may result in -.�
xuratdafx3 mmptete: `'`' '. �e denial or ravxatwn of tha 1'icense.
xmaGoa has baen fupy dsdosad; `
' e.ottiear '',',:,-{ .;.:.. ,. ` Date "
:
� �, - ,: `� �__- � ` ' � _ _ � ,_
__� :� �°-,�- l�<: �� , " : _,--=#.,. _ _ � - 7 . C' - - �i �
" ` ' ` "'`" s � � °"` '`' ' � " 4 "A eoov o} the loeal unit oi yovernmenYS resolution ao- `
ieation it iha gambling (xem- ����a this ao�lication must be atteehed to this aeolicafron
°" '`'' S, ft this application 'a denied by the bcai unh of govemment,
'•-.must sign this application rf it should not be wbmitted to the Gambling Condoi Board.
�dwAfiina.townsli�. .€�.':ae�� z�,.� _.. . �. �.a�,•,�,: �' .
city�oi county}'�ust pass a _ ` ;�qownsh3p: By sgnature bebw, the township acknowledges
�.o� de�Yic�q this apP�icat�°M .. ' the organization is appVying tor a premises permit within
*� „ = Y ' iownship fimits. .
..a r_ . . ., .. ' . .. . . , . . . . . .
ti. � _ , _ ___ _., , Townshtp . . _ .:
-- 7ownst�ip Name �
.-,.. ..,'`�i, ' -_-� - . : .. .... . �.. �
�fi ' '.: � T.. _ , r,. ..,� - . �f13Wf@ O( PBff0/1 f!C@IVIl1� 2Pp�iCit1011
� y, : rnn�.. y ,
� ._ e ,. . ,,,..� .,., .• '
!'
�� � � Date Reoaived " -r � �� s, <� ' ".. :_ . . . Date Aecerved .... :
r�s:-=q�u £ I
�iw_re��rea�naetm,.ns.`` _.
:� � _ . _ � . � _
ConUOlBoard -' --� �. �� '
I PLr� South, Ad Floor .,- �
ounry Rud e . . ,.,;
,� .,,,, _ :;.__ -
7dN;iSf13';:.:;,-' . �, ; .
� , ' " �s
lG2)�(PaA 2)
tw.�m�a+>
9 ��-3 ?�.
�
Council File # ��
�T
Ordinance #
'���
� : �. . �L� . � . . ---
PYesented
1
2
3
4
5
6
7
8
9
10
I1
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Referred To
RESOLVED:
Committee: Date
59
That application, ID #B-05039, for a new State Clasa B Ga[nbling Premise
Permit by Star Swim Club Inc. at Plums Neiqhborhood Bar & Gri11, 480
Snelling Avenue South, be and the same is hereby approved.
Requested by Department ofo
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Form Approved by City Attorney
BY= T��M� • _c� �BY �-�-!'i'�..C/Z
Approved by Mayor: Date �3 ��"� �—
By: �--
Green Sheet # �5328
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
� 1� �
Approved by Mayor for Submisaion to
Conncil
By:
Adopted by Council: Date M�,,, �y,�qQ��
— �T —
Adoption Certified by Council Secretary
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TOTAL # OF SIGNATUHE PA6ES
FOfl
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GREEN SHEET N_ 35328
INITIAVDATE INITIAVDATE
DEPARTMENT DiREGTOR � CISY CAUNCIL
CIN ATfORNEY O CITY CLERK
BUWET DIREGTOR � FIN, & MGT. SERVICES DIR.
MAYOR (OR ASS4STAN� O
ALL LOCATIONS FOR SIGNATURE)
Revin 0'Connell on behalf of Star Swim Club Inc, requests Council approval
of their application for a new State Class B Gambling Premise Permit, ZD I6B-05039, at
Plums Neighborhood Bar & Grill, 480 Snelling Avenue South.
_ GB COMMITTEE _ '
_ STAFF _ '
� DISTFICTCWRS _ '
SUPPOfiTS WHICH COUNCIL OHJECTIVE?
PERSONAL SERYICE CONTRACTS MUST ANSWER iXE FOLLOWING QUESTIONS:
1. Has this persoMirm ever worketl untler a contrad for this department? -
YES NO
2. Has this person/Firtn ever been a city employee?
YES NO
3. Does this person/firm possess a swll not normally possessed by any current ciry emp�oyee?
YES NO
Explafn al! yes answers on separate sheN a�xl attneh to green ahaet
When, Where, Why):
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TOTALAMOUN70FTRANSACTION $
COST/flEVENUE BUDGEiEO (CIRCLE ONE)
YES NO
FUNDIfdG SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION: (EXPLAIN�
Greensneet# ssszs L.I.E.P. REVIEW CHECKLIST oate: qj�"���
ln Trackef? APP n Received / nPa'n arocessed
license ID # B-05039 - State �l License Type: State Class B GamblinQ Premise Permit
Company NBme: Star Swim Club Inc. DBA: Star Swim Club Inc.
BUSiuess P,ddresss: 480 Snellin¢ Ave. S, (Plums) Business Phoae: 772-7331
Contact Name/Address:_ Revin 0' Connell/CEO Home Phone: 483-8271
Date to Council
Pu6lic Heazing Date: '}'11c� i�'r . ]9G %
Notice Seni to Appliran� �}�� f 9`7
120
Labels Ordered: N/A
District Council
Notice Sent to Public: Ward #: 03
Department/ Date Inspections Comments
C'rty AttomeY � l'.17�1 � �1"i7� � ��
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Environmental
Heaith
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F��e
N�/�
License Site Wan Heceived:
Lease Received: '
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Police �COYY� (�-/ �� !7"A�--Cl�
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Zoning
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MxnnesoLa Lmbful GariebIing V � �
� Premises Perinit Applicatioia�-.Part-l�°of 2`--�`°���'=
� � - � �. Renewal. -_- - . . -
Organisation base i"wense number_
, ` - Premises pertnit number � �
. , � _.. New .,
cla:s oi premises parmi[ --
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" A (S400j Pui4tabs. tiptoarc
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chief executive o�cer (annot be your gambting.manager;
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for a cIa'ss:S or`C' �,.imit: ifll tn da '� arid be ����'��``���-ei
If aPPh'�g P' YS, g�g
No more than seven bingo occasions may be conducted�by„youi
-Bay� Beginnfng/EndSng Hours ,- - Day - �� Beg'uining/Ending�Hovrsx
to � to
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_>:� �. _.... ��Ifbingo will not be`conduef�d; 't2
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�tv,wt.s it/�i�'�Ro,eHooe 8/1 G�?i�L" �/8a S.rJECC%�i�-flvs-:
ts�the premises locatsd within ciry.km'sts? .�� - O No �.tt eo, is tawnship,:'� organized, �:u
Ciry and Counry where garnbiing premises is located Ofl Township and Counry where 9ambling premises is
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Name and adAress ot legal owner of premises , Ciry, . , State ., . „
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yow organiz2COn own the buildmg where tlt9 g3mbiing wUl be contluctea"! .. p 7tS ,.,_ � rv0 .,
.. . . .. if ra, attach the foilowin4� . - �. � _�... ` .� . ��� ".
•� a copy of the laase (form LG202) with" mrms for at�least one year -. �-
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�• a copy ot a sketeA ot the 800r plan witli dmensions, shovring what-por6onls
• A iease and sketch are rwt required tor Ctass D apptirabons �� ���„� _. �_
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- "`:�'�;Preause Permit Application - Part 2 of 2
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nt�osization- -:' �, .t am tha ehief oxecutive of(�car of the organizaYpn; .
bcal law anforcomeM officen, tha .i assume futi rosponsibiliy for the iair and Iawfui opara-
r baard, or the commissionac ot tion of att activrties to be conduded;
Pry, or agenu et tha commissb�ers, �,� �� ��d��e myselS with the taws ot Mintfesota .
es Jo enforeelha law."r`< �_ "�`<" -, �'�verning 4awtul gambl+ng and rules of the board'and :,
formatloa _ ',�_ _:: ,:; - : .. __ agrea. 'rf ticeased. to abide by those laws and rules:- �- � � _
pd-to tha bank reoords of iha �uuding amendmenu to them; '
enevx nacassary iqfu�U; ." e;�-� ,<?. in appiication information wiU be submitted
nt'gambGng tuks"and law: ';=, "' � :to tMe board and bcal unit ot govemment within.l0 days
J' of the ehange; and
`�:t';'°'. , °- ' �I undarstand that failure to provide required intormafwn
ication.and a11 infotmption submkfed_ : or providing talse or misleading informatian may result in -.�
xuratdafx3 mmptete: `'`' '. �e denial or ravxatwn of tha 1'icense.
xmaGoa has baen fupy dsdosad; `
' e.ottiear '',',:,-{ .;.:.. ,. ` Date "
:
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" ` ' ` "'`" s � � °"` '`' ' � " 4 "A eoov o} the loeal unit oi yovernmenYS resolution ao- `
ieation it iha gambling (xem- ����a this ao�lication must be atteehed to this aeolicafron
°" '`'' S, ft this application 'a denied by the bcai unh of govemment,
'•-.must sign this application rf it should not be wbmitted to the Gambling Condoi Board.
�dwAfiina.townsli�. .€�.':ae�� z�,.� _.. . �. �.a�,•,�,: �' .
city�oi county}'�ust pass a _ ` ;�qownsh3p: By sgnature bebw, the township acknowledges
�.o� de�Yic�q this apP�icat�°M .. ' the organization is appVying tor a premises permit within
*� „ = Y ' iownship fimits. .
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ti. � _ , _ ___ _., , Townshtp . . _ .:
-- 7ownst�ip Name �
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ConUOlBoard -' --� �. �� '
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