97-975Council File # � � - 1 l�
Ordinance �
Green Sheet # 37901
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�`1R��'"��1
� � �°` t ;��' ,
Presented By
Referred To
Committee: Date
RESOLVED: That applications £or new Gambling ManageY's Licenses by Sandra L. Joyce DBA
Johnson Area Hockey Association, ID �69677 at Governor's, 959 Arcade Street
and III #22667 at Louie�s, 883 Payne Avenue, be and the same are hereby
approved.
Requested by Department of:
• -.-. -
n-: - •�
� , � ►)'/
Form Approved by City Attor
Adopted by Council: Date ,, (, By: �
Adoption Certi£ied by Council Secretary Approved by Mayor £or Submission to
Council
By: .��� . �__,�^-
•/ By:
Approved by Mayor: Date � (x5�
By: �
RESOLUTION
C1TY OF SAINT PAUL, MINNESOTA
$7
q�-��S
L DEFMR741EMiOFFICHCOUNCIL OATE INITIATED GREEN SHEE 3 7 g n 1
CONTACT PERSON & PHOPIE INITIAUDATE INITIAVDATE
� DEPARTMENTDIRECTOR � CI7YCOUNCIL
William F. Gunther - 266-9132 ^��" CRYATfORNEV CRVCLERK
MUST 8E ON CAUNCIL AGENDA 8V (DATE) NUMBEF FOfl O O
flOUiING � BUDGE7 DIRECTOR O FlN. & MGT. SERVIC D IR.
Hearin : ( ORUER � MAYOR (OR ASSi5TA1Jn O
TOTAL # OF SIGNATURE PAGES (CIIP AI.L LQCATIONS FOR SIGNATURE)
ACT{ON REQUESTED:
Sandra L. Joyce DBA Johnson Area Hockey Association requests Council approval
of her applications for a new Gambling Manager`s Licenses, ID �f69677 at Governor's,
954 Arcade Street and I➢ 4122667 at Louie's, 883 Payne Avenue.
RECOMMENDA710N5. Approve (A� or Reject (p) pERSONAL SEHVICE CONTRACTS MUST ANSWER TXE FOLLOWING �UESTION5:
,_ PLANNWG COMMISSIQN _ CIVIL SERVICE COMMISSION �� Has this person/i'vm ever worketl under a cornract for this tlepartmeM?
_ CIB GOMMITfEE _ YES NO
2. Has this persan�rm ever been a city employee?
_ siqFF — YES NO
_ DISTRICT COUR7 _ 3. Does this person/Firm possess a skill not normally possessed by any current ciry employee?
SUPPORTS WHICH COUNCIL O&IECTIVE? VES NO
Explain all yes answers on separate sheet anE attach to green sheet
INITIATING PROBLEM, ISSUE, OPPOqTUNITY (WM1O, Whaq WPen, Where, Why): �y :% �
���"�� �_' �
JtfL 3 a i°`��
���� �..4,,��;�����
ADVAN7AGES�FAPPROVED�
DISADVANTAGES IF APPROVED�
4i���i�� 'y'�;�i;;j���'4�� aa,+S�[i���
J�JL 2 3 3g�7
_.
DISADVANTAGES IF NOTAPPflOVED: '� � -
TOTAL AMOUNT OF 1RANSAC710N $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO
FUNDIfiG SOURCE ACTIVITY NUMBER
FINANCIAL INFORM"ATION: (E%PLAIN)
Greensheet # 37901 L.I.E.P. REVIEW CHECKLIST Date: /�� "�� 5
In Tracke�'? 2� App'n Received / app�n Processed
LicenselD # 59677 � Il22667 License Type: GamblinQ ManaQer Licenses
Company Name: Sandra L. Jovice DBA: Johnson Area Aockev Association
Business Addresss: 959 Arcade St. (Governors) Susiness Phone: 772-3088
Cornact Name/Address: 1442 Hoyt Ave E 55106 Home Phone: 772-3088
Date to Council Research: > ��9�/ /
Public Hearing Date: L`��7 Labeis Ordered: /✓J!�
Notice Sent to Appiicant: ��R � Disirict Council #: OS
Notice Seni to Public: �� Ward #: 06
Department/ Date inspections Comments
Gity AttorneY f 0 �:'/y �T�7u � h� ���� 9%
�l�f �g'7 �
Environmental
Health
l V��
Fire
�/�
License Site Pian Aeceived:_
Lease Received:
/ "��
Police ��C�"7"� �1�'C„-' jr? _!J ��S`'S.
n � !
� f�.���7
Zoning
N ��
�i�i-`l�5
East STATE OF:1?INNESOTA POR BOARD USE ONLY
GAMBLING CONTROL &OARp AMT . PAID
GAMBLING MANAGER LICENSE RENEWAL APPLICATION CHECK #
LG 63l11/97 DATE
INITIALS
Incomplete, false, or misleading application information may resuli in denial of a license.
LICENSE NUMBER: G00756 001 EFFECT3Vb DATB:09/01/95 EXPIRATION DATE: OS/31/97
ORGANIZATION INFORDIA'IZON
NAME OF ORGANIZATION: Hockey St Paul Johnson Area Assoc
CEO NAMfi; Steve Younghans
GA!�1BLL�'G M.4*IAGER L'�'FOft,'�iA'I'Ipn+
B�aee�i=i�Fier��egen S�NqQq 1.. �oyc2
-�493 e�i�IfaF,rCm�AV�-g (4ua �"}Ioy7 DATE OF BIRTH: }$7ISI62 12 �IS/y�/
'�'ga�l$G'- ST. Pr� N L� W1M. SS ( U 6 SEX.•�F- �.
SOCIAL SECURITY NUMBER: 4?GA0-i3gg �� - yH _ a� �`�
DAYTIME PHONE NUMBER: 612 �86$897 'I'1 �. - 3 0 � � � 'j ��- �o f 3
MEMBER SINCE: 11f30/82 /-?6
EDUCATION INFOR�4IATION
MOST RECENT CONTINUING EDUCATION CLASS YOU ATTENDEB: q`7I�'�
BOND INFORMATION
BOND CQMPANY NAA4E: State Surety Co BpND NUMBER: RPS290481A
G�1IBLING MANAGER CHAIVGE
When your organiza�ion is using this renewal applicacion to change its gambling manager, camplete one of the following seccions:
Ecnec�eacy "1;:t; �e • A!;ow ap :n fve r,,c;k(rg Other Chan e- Atlow ��
da s Yot rocessin � F tc� ten w?�ks for r.rnr.es;in,,^,
x P S The new eambfing mar,ager's iicense snouid hecome
The chief executive oFficer, by signing be]ow, effec[ive (check pne};
affirms that the emergency application is due
to the following reason (Check one and fill in date): The day afrer che current gambline mana�er's license expires
,Death of gambling mana er on ^ (for ezample, if the cuaent gambfing manager's license expires
� —�_t� 07/31/97 the new gambling manager's license becomes
�bisabiliry"oFgam6ling mazia er on effective on 68l03l97, provided that all application information
, 8. ____!�1 is complete).
Termination of emplo�anent,bY �am6(in --�en the appiicacion has been processed by the Gambling
�manager on.- / .� --' � � Conuol Board-•the effeccive da�e will be che first daV of
.. .. .,....--.., ,..-,,,^r � the mon[h.
Note: A New gambling manager may not assume du[ics un�il he/she has recei��ed the gambling manager's license from tha
Gambling Conaol Board.
ihz current ch�e* executrve ��lflee; ot your orgznization musc sign tl�is appi�cation in ,hc p: esence of , c;:,;ary
SIGNA'I;�RE pF CHIEF
r
i
OFFICER (CEO)
Notary Public Information. Notary Public Sea]
must be cunene and wrrecc; seai may not be altered.
Jotarized Signature of CEO i
)AGLYN PEAF .
9#RYPUBLIC �.h�,�,.
RAMSEY COUN
Subscribed and�ssvorn to before me chis �
day of ___;(;�_ �� Ig f"i 7
� !
.,, ,.� .��/j. _ �r/..�,.,_.,.,
Public
�� �' � 7 ��<Q�`��Linued on Back)
p � 1 LG212GMi
��� i 4� P � g �09/��
Gambling Manager Renewat Application (continuedJ
Affidavit and Consent Stptement:
I,(princ name)_Cp„�,� �� �. �c r� E- ,under oath state that I have never;
1. been convicced of a felony oz crime involving gambling;
2. committeA a violazion of law or Boazd rule thac resulted
in the revocation of a license issued by the Boazd within
five years before the date of the license application;
3. been convicted of a criminal violarion involving fraud,
theft, ta�c evasion, misrepresentation, or gambling;
4. been convicted of (i) assault, (ii) a criminal violation
involving the use of a firearm, or (iii) making terroristic
threats;
S, been, oz azn now, connected with nor engaged in
an illega] business;
6. had a sales and use tae pernut revoked 6y the commissione:
of revenue within the past two yeus;
7. afrer demand, fai]ed to file, cax recums required by che
commissioner of revenue.
I do not owe 5500 or more in delinquent taxes as defined in sec[ion 270.72.
In addition, I understand, agree, and hereby irrevocably consent that suits and actions relating to ctte subject matter of the attached
gambling manager license apglication, or accs or omissions arising from such applicaeion, may be commenced againsc me or my
organi7acion and I wi11 accept the service of process in any coun of competenc jurisdiction in Minnesota by service on the
Minne;ota Secretary of State of any summons, p:acess, or pleading authorized by the laws of Minnesota.
By signamre of this documeat, the undersigned authorizes [he Departments of Public Safery and Revenue to conduct a criminal and tax
background check or review and co share ehe resul[s with the Garnbling Control Boazd.
Failure to provide required informacion or providing false ot misleading informacion may resuIt in the denial or revocation of the
license.
FURTAER AFFIANT SAYETH NOT, except �ha� this Affidavi[ and Consent Statemenc aze submitted in support of the application for a
gambling manager license from che Gambling Con[rol Board.
SIG�ATUIZE OF GAMIBLING b�tA,'�`AGER APPLICAN'I' Notary Pubfic Information. Nocary Public Seai
�t--- n � mus[ be currenc and correct; seal may no� be altered.
!— 7���' Subscribed and sworn co before me this �,��
Notarized Signarure of�lpplicant day oi �.,�,; � ,19�
' l'� , �
Date �,� `� ,-'�, , ' _ " , �iti,: �i'.
, � .�'otary Public � .. _. .... ----_--. •
This publuauon w�11 be made a��a�iahle in al�zmarn e tortnat (i.e. Iarge pnnt. Braille) upon reques�. If you use a TTY, yo u�y��,:(�
Reiay Semce at (61:) 39�•S35i or I-800-b37-35?9 xnd ask �hem eo piace a call io i61?) 639�000. ae7 v TY
. MY Comta E�nt J�n. 31. 2000
.
Tne mPortnanon requesied on �his form wili be used by �he Ganbhng Control Board (Board) �o de�ermme your compliance with Minnesota statu[es and rules goveming
tawPoi gambling acnvieies. All of the infortnanon J�a� you supply on this fortn wdl become publm infortnanon when rcceived by the Board.
You are required io provide yaur social securiry number on �his form, Your social secunry number will be used to deeermine your compiiance wi�h the rax laws of
Minneson. Au`honzation for requinng your soc�al secunrv number is found at 42 U.S.C. 405(c)(i). •
The mfoma�ron reyuesied on this fortn Uncludmg any aanchmenuj will be used by Ne Board m de[ermme your qualificanons m be involveJ in tawtu! gamblmg
acnvities in Minnesota, and ro assise the Board in wndocnng a background invesngaeion of you.
You have thz nghc ro refuse ro supply the mformanon requesced; however, i(you refuse ro supply Nis mfortna�wn, the Board may r.ot be able to derertnme your
qualifiwuons and, as a consequence, may rzfuse to �ssue you a license. If you suppiy rhe mformauon required. �he BoaA wdl be abk ro procees your applicanon.
Your name and addre55 wi0 he pubhc mforniadon whzn recervtd hy the Bnard All the o[her mtortnanon abou{ you ihat you pronde wiq bn privaee data unni the Board
issuey vour 6cen6e, When �he BoarJ usues youn c�enst, zIl of ihe mfnrmauon }nu have provNed m ihe Be�arJ ro Ne pmce55 Vi applymg for youn c�enst wdl
become pubtic excep� Por your sociai sncuriry number. which remams pnva�e.
If the Bnard does noe issue ��ou a Lcense, alt thz iNOm�anon yn� ha�z provided m the process nt appl}'ing for a hcensrremams pmate, wrth [he excepnon of your name
anJ adJress. which witi remam pu�Lc.
Pn�ace data abnut }'ou is available oniv Io tht toilowme: Bonrd members, staff ot fie BoaN whost work assignmenc reqmres Nat chey have acces5 to the inFormation:
t4e Mrnneoota Bepanmrn� ot Public Snierv, ihe Simneso�a Atromey Oeneral: ihe nimnesnea Cummus�nners of AJmimsrrsnon. Finance and Revenue; che Legislanve Audiror
na�ioqal nnd miemaunnal eamhhng reFui�iory ucene�rs: anyane pursuane to court otclrr, uther indivlduak and agencies chat may ne spzcificaliy audionztJ by sea�e
or Icdera{ kiw m have uc�eis m woh �m�miauon. mJ���iduttl� and a�enaes 1'+�r wAxh f.iw ��r Irc:d ��rQcr auUn�nzes a ncw use nr �h:inne i�t �hu inlormpuon aR�r lhi5
n��uCe +s yrvtn, ruu .mJ amune ..nh �our mnnen �nmrni,
Council File # � � - 1 l�
Ordinance �
Green Sheet # 37901
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31
�`1R��'"��1
� � �°` t ;��' ,
Presented By
Referred To
Committee: Date
RESOLVED: That applications £or new Gambling ManageY's Licenses by Sandra L. Joyce DBA
Johnson Area Hockey Association, ID �69677 at Governor's, 959 Arcade Street
and III #22667 at Louie�s, 883 Payne Avenue, be and the same are hereby
approved.
Requested by Department of:
• -.-. -
n-: - •�
� , � ►)'/
Form Approved by City Attor
Adopted by Council: Date ,, (, By: �
Adoption Certi£ied by Council Secretary Approved by Mayor £or Submission to
Council
By: .��� . �__,�^-
•/ By:
Approved by Mayor: Date � (x5�
By: �
RESOLUTION
C1TY OF SAINT PAUL, MINNESOTA
$7
q�-��S
L DEFMR741EMiOFFICHCOUNCIL OATE INITIATED GREEN SHEE 3 7 g n 1
CONTACT PERSON & PHOPIE INITIAUDATE INITIAVDATE
� DEPARTMENTDIRECTOR � CI7YCOUNCIL
William F. Gunther - 266-9132 ^��" CRYATfORNEV CRVCLERK
MUST 8E ON CAUNCIL AGENDA 8V (DATE) NUMBEF FOfl O O
flOUiING � BUDGE7 DIRECTOR O FlN. & MGT. SERVIC D IR.
Hearin : ( ORUER � MAYOR (OR ASSi5TA1Jn O
TOTAL # OF SIGNATURE PAGES (CIIP AI.L LQCATIONS FOR SIGNATURE)
ACT{ON REQUESTED:
Sandra L. Joyce DBA Johnson Area Hockey Association requests Council approval
of her applications for a new Gambling Manager`s Licenses, ID �f69677 at Governor's,
954 Arcade Street and I➢ 4122667 at Louie's, 883 Payne Avenue.
RECOMMENDA710N5. Approve (A� or Reject (p) pERSONAL SEHVICE CONTRACTS MUST ANSWER TXE FOLLOWING �UESTION5:
,_ PLANNWG COMMISSIQN _ CIVIL SERVICE COMMISSION �� Has this person/i'vm ever worketl under a cornract for this tlepartmeM?
_ CIB GOMMITfEE _ YES NO
2. Has this persan�rm ever been a city employee?
_ siqFF — YES NO
_ DISTRICT COUR7 _ 3. Does this person/Firm possess a skill not normally possessed by any current ciry employee?
SUPPORTS WHICH COUNCIL O&IECTIVE? VES NO
Explain all yes answers on separate sheet anE attach to green sheet
INITIATING PROBLEM, ISSUE, OPPOqTUNITY (WM1O, Whaq WPen, Where, Why): �y :% �
���"�� �_' �
JtfL 3 a i°`��
���� �..4,,��;�����
ADVAN7AGES�FAPPROVED�
DISADVANTAGES IF APPROVED�
4i���i�� 'y'�;�i;;j���'4�� aa,+S�[i���
J�JL 2 3 3g�7
_.
DISADVANTAGES IF NOTAPPflOVED: '� � -
TOTAL AMOUNT OF 1RANSAC710N $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO
FUNDIfiG SOURCE ACTIVITY NUMBER
FINANCIAL INFORM"ATION: (E%PLAIN)
Greensheet # 37901 L.I.E.P. REVIEW CHECKLIST Date: /�� "�� 5
In Tracke�'? 2� App'n Received / app�n Processed
LicenselD # 59677 � Il22667 License Type: GamblinQ ManaQer Licenses
Company Name: Sandra L. Jovice DBA: Johnson Area Aockev Association
Business Addresss: 959 Arcade St. (Governors) Susiness Phone: 772-3088
Cornact Name/Address: 1442 Hoyt Ave E 55106 Home Phone: 772-3088
Date to Council Research: > ��9�/ /
Public Hearing Date: L`��7 Labeis Ordered: /✓J!�
Notice Sent to Appiicant: ��R � Disirict Council #: OS
Notice Seni to Public: �� Ward #: 06
Department/ Date inspections Comments
Gity AttorneY f 0 �:'/y �T�7u � h� ���� 9%
�l�f �g'7 �
Environmental
Health
l V��
Fire
�/�
License Site Pian Aeceived:_
Lease Received:
/ "��
Police ��C�"7"� �1�'C„-' jr? _!J ��S`'S.
n � !
� f�.���7
Zoning
N ��
�i�i-`l�5
East STATE OF:1?INNESOTA POR BOARD USE ONLY
GAMBLING CONTROL &OARp AMT . PAID
GAMBLING MANAGER LICENSE RENEWAL APPLICATION CHECK #
LG 63l11/97 DATE
INITIALS
Incomplete, false, or misleading application information may resuli in denial of a license.
LICENSE NUMBER: G00756 001 EFFECT3Vb DATB:09/01/95 EXPIRATION DATE: OS/31/97
ORGANIZATION INFORDIA'IZON
NAME OF ORGANIZATION: Hockey St Paul Johnson Area Assoc
CEO NAMfi; Steve Younghans
GA!�1BLL�'G M.4*IAGER L'�'FOft,'�iA'I'Ipn+
B�aee�i=i�Fier��egen S�NqQq 1.. �oyc2
-�493 e�i�IfaF,rCm�AV�-g (4ua �"}Ioy7 DATE OF BIRTH: }$7ISI62 12 �IS/y�/
'�'ga�l$G'- ST. Pr� N L� W1M. SS ( U 6 SEX.•�F- �.
SOCIAL SECURITY NUMBER: 4?GA0-i3gg �� - yH _ a� �`�
DAYTIME PHONE NUMBER: 612 �86$897 'I'1 �. - 3 0 � � � 'j ��- �o f 3
MEMBER SINCE: 11f30/82 /-?6
EDUCATION INFOR�4IATION
MOST RECENT CONTINUING EDUCATION CLASS YOU ATTENDEB: q`7I�'�
BOND INFORMATION
BOND CQMPANY NAA4E: State Surety Co BpND NUMBER: RPS290481A
G�1IBLING MANAGER CHAIVGE
When your organiza�ion is using this renewal applicacion to change its gambling manager, camplete one of the following seccions:
Ecnec�eacy "1;:t; �e • A!;ow ap :n fve r,,c;k(rg Other Chan e- Atlow ��
da s Yot rocessin � F tc� ten w?�ks for r.rnr.es;in,,^,
x P S The new eambfing mar,ager's iicense snouid hecome
The chief executive oFficer, by signing be]ow, effec[ive (check pne};
affirms that the emergency application is due
to the following reason (Check one and fill in date): The day afrer che current gambline mana�er's license expires
,Death of gambling mana er on ^ (for ezample, if the cuaent gambfing manager's license expires
� —�_t� 07/31/97 the new gambling manager's license becomes
�bisabiliry"oFgam6ling mazia er on effective on 68l03l97, provided that all application information
, 8. ____!�1 is complete).
Termination of emplo�anent,bY �am6(in --�en the appiicacion has been processed by the Gambling
�manager on.- / .� --' � � Conuol Board-•the effeccive da�e will be che first daV of
.. .. .,....--.., ,..-,,,^r � the mon[h.
Note: A New gambling manager may not assume du[ics un�il he/she has recei��ed the gambling manager's license from tha
Gambling Conaol Board.
ihz current ch�e* executrve ��lflee; ot your orgznization musc sign tl�is appi�cation in ,hc p: esence of , c;:,;ary
SIGNA'I;�RE pF CHIEF
r
i
OFFICER (CEO)
Notary Public Information. Notary Public Sea]
must be cunene and wrrecc; seai may not be altered.
Jotarized Signature of CEO i
)AGLYN PEAF .
9#RYPUBLIC �.h�,�,.
RAMSEY COUN
Subscribed and�ssvorn to before me chis �
day of ___;(;�_ �� Ig f"i 7
� !
.,, ,.� .��/j. _ �r/..�,.,_.,.,
Public
�� �' � 7 ��<Q�`��Linued on Back)
p � 1 LG212GMi
��� i 4� P � g �09/��
Gambling Manager Renewat Application (continuedJ
Affidavit and Consent Stptement:
I,(princ name)_Cp„�,� �� �. �c r� E- ,under oath state that I have never;
1. been convicced of a felony oz crime involving gambling;
2. committeA a violazion of law or Boazd rule thac resulted
in the revocation of a license issued by the Boazd within
five years before the date of the license application;
3. been convicted of a criminal violarion involving fraud,
theft, ta�c evasion, misrepresentation, or gambling;
4. been convicted of (i) assault, (ii) a criminal violation
involving the use of a firearm, or (iii) making terroristic
threats;
S, been, oz azn now, connected with nor engaged in
an illega] business;
6. had a sales and use tae pernut revoked 6y the commissione:
of revenue within the past two yeus;
7. afrer demand, fai]ed to file, cax recums required by che
commissioner of revenue.
I do not owe 5500 or more in delinquent taxes as defined in sec[ion 270.72.
In addition, I understand, agree, and hereby irrevocably consent that suits and actions relating to ctte subject matter of the attached
gambling manager license apglication, or accs or omissions arising from such applicaeion, may be commenced againsc me or my
organi7acion and I wi11 accept the service of process in any coun of competenc jurisdiction in Minnesota by service on the
Minne;ota Secretary of State of any summons, p:acess, or pleading authorized by the laws of Minnesota.
By signamre of this documeat, the undersigned authorizes [he Departments of Public Safery and Revenue to conduct a criminal and tax
background check or review and co share ehe resul[s with the Garnbling Control Boazd.
Failure to provide required informacion or providing false ot misleading informacion may resuIt in the denial or revocation of the
license.
FURTAER AFFIANT SAYETH NOT, except �ha� this Affidavi[ and Consent Statemenc aze submitted in support of the application for a
gambling manager license from che Gambling Con[rol Board.
SIG�ATUIZE OF GAMIBLING b�tA,'�`AGER APPLICAN'I' Notary Pubfic Information. Nocary Public Seai
�t--- n � mus[ be currenc and correct; seal may no� be altered.
!— 7���' Subscribed and sworn co before me this �,��
Notarized Signarure of�lpplicant day oi �.,�,; � ,19�
' l'� , �
Date �,� `� ,-'�, , ' _ " , �iti,: �i'.
, � .�'otary Public � .. _. .... ----_--. •
This publuauon w�11 be made a��a�iahle in al�zmarn e tortnat (i.e. Iarge pnnt. Braille) upon reques�. If you use a TTY, yo u�y��,:(�
Reiay Semce at (61:) 39�•S35i or I-800-b37-35?9 xnd ask �hem eo piace a call io i61?) 639�000. ae7 v TY
. MY Comta E�nt J�n. 31. 2000
.
Tne mPortnanon requesied on �his form wili be used by �he Ganbhng Control Board (Board) �o de�ermme your compliance with Minnesota statu[es and rules goveming
tawPoi gambling acnvieies. All of the infortnanon J�a� you supply on this fortn wdl become publm infortnanon when rcceived by the Board.
You are required io provide yaur social securiry number on �his form, Your social secunry number will be used to deeermine your compiiance wi�h the rax laws of
Minneson. Au`honzation for requinng your soc�al secunrv number is found at 42 U.S.C. 405(c)(i). •
The mfoma�ron reyuesied on this fortn Uncludmg any aanchmenuj will be used by Ne Board m de[ermme your qualificanons m be involveJ in tawtu! gamblmg
acnvities in Minnesota, and ro assise the Board in wndocnng a background invesngaeion of you.
You have thz nghc ro refuse ro supply the mformanon requesced; however, i(you refuse ro supply Nis mfortna�wn, the Board may r.ot be able to derertnme your
qualifiwuons and, as a consequence, may rzfuse to �ssue you a license. If you suppiy rhe mformauon required. �he BoaA wdl be abk ro procees your applicanon.
Your name and addre55 wi0 he pubhc mforniadon whzn recervtd hy the Bnard All the o[her mtortnanon abou{ you ihat you pronde wiq bn privaee data unni the Board
issuey vour 6cen6e, When �he BoarJ usues youn c�enst, zIl of ihe mfnrmauon }nu have provNed m ihe Be�arJ ro Ne pmce55 Vi applymg for youn c�enst wdl
become pubtic excep� Por your sociai sncuriry number. which remams pnva�e.
If the Bnard does noe issue ��ou a Lcense, alt thz iNOm�anon yn� ha�z provided m the process nt appl}'ing for a hcensrremams pmate, wrth [he excepnon of your name
anJ adJress. which witi remam pu�Lc.
Pn�ace data abnut }'ou is available oniv Io tht toilowme: Bonrd members, staff ot fie BoaN whost work assignmenc reqmres Nat chey have acces5 to the inFormation:
t4e Mrnneoota Bepanmrn� ot Public Snierv, ihe Simneso�a Atromey Oeneral: ihe nimnesnea Cummus�nners of AJmimsrrsnon. Finance and Revenue; che Legislanve Audiror
na�ioqal nnd miemaunnal eamhhng reFui�iory ucene�rs: anyane pursuane to court otclrr, uther indivlduak and agencies chat may ne spzcificaliy audionztJ by sea�e
or Icdera{ kiw m have uc�eis m woh �m�miauon. mJ���iduttl� and a�enaes 1'+�r wAxh f.iw ��r Irc:d ��rQcr auUn�nzes a ncw use nr �h:inne i�t �hu inlormpuon aR�r lhi5
n��uCe +s yrvtn, ruu .mJ amune ..nh �our mnnen �nmrni,
Council File # � � - 1 l�
Ordinance �
Green Sheet # 37901
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�`1R��'"��1
� � �°` t ;��' ,
Presented By
Referred To
Committee: Date
RESOLVED: That applications £or new Gambling ManageY's Licenses by Sandra L. Joyce DBA
Johnson Area Hockey Association, ID �69677 at Governor's, 959 Arcade Street
and III #22667 at Louie�s, 883 Payne Avenue, be and the same are hereby
approved.
Requested by Department of:
• -.-. -
n-: - •�
� , � ►)'/
Form Approved by City Attor
Adopted by Council: Date ,, (, By: �
Adoption Certi£ied by Council Secretary Approved by Mayor £or Submission to
Council
By: .��� . �__,�^-
•/ By:
Approved by Mayor: Date � (x5�
By: �
RESOLUTION
C1TY OF SAINT PAUL, MINNESOTA
$7
q�-��S
L DEFMR741EMiOFFICHCOUNCIL OATE INITIATED GREEN SHEE 3 7 g n 1
CONTACT PERSON & PHOPIE INITIAUDATE INITIAVDATE
� DEPARTMENTDIRECTOR � CI7YCOUNCIL
William F. Gunther - 266-9132 ^��" CRYATfORNEV CRVCLERK
MUST 8E ON CAUNCIL AGENDA 8V (DATE) NUMBEF FOfl O O
flOUiING � BUDGE7 DIRECTOR O FlN. & MGT. SERVIC D IR.
Hearin : ( ORUER � MAYOR (OR ASSi5TA1Jn O
TOTAL # OF SIGNATURE PAGES (CIIP AI.L LQCATIONS FOR SIGNATURE)
ACT{ON REQUESTED:
Sandra L. Joyce DBA Johnson Area Hockey Association requests Council approval
of her applications for a new Gambling Manager`s Licenses, ID �f69677 at Governor's,
954 Arcade Street and I➢ 4122667 at Louie's, 883 Payne Avenue.
RECOMMENDA710N5. Approve (A� or Reject (p) pERSONAL SEHVICE CONTRACTS MUST ANSWER TXE FOLLOWING �UESTION5:
,_ PLANNWG COMMISSIQN _ CIVIL SERVICE COMMISSION �� Has this person/i'vm ever worketl under a cornract for this tlepartmeM?
_ CIB GOMMITfEE _ YES NO
2. Has this persan�rm ever been a city employee?
_ siqFF — YES NO
_ DISTRICT COUR7 _ 3. Does this person/Firm possess a skill not normally possessed by any current ciry employee?
SUPPORTS WHICH COUNCIL O&IECTIVE? VES NO
Explain all yes answers on separate sheet anE attach to green sheet
INITIATING PROBLEM, ISSUE, OPPOqTUNITY (WM1O, Whaq WPen, Where, Why): �y :% �
���"�� �_' �
JtfL 3 a i°`��
���� �..4,,��;�����
ADVAN7AGES�FAPPROVED�
DISADVANTAGES IF APPROVED�
4i���i�� 'y'�;�i;;j���'4�� aa,+S�[i���
J�JL 2 3 3g�7
_.
DISADVANTAGES IF NOTAPPflOVED: '� � -
TOTAL AMOUNT OF 1RANSAC710N $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO
FUNDIfiG SOURCE ACTIVITY NUMBER
FINANCIAL INFORM"ATION: (E%PLAIN)
Greensheet # 37901 L.I.E.P. REVIEW CHECKLIST Date: /�� "�� 5
In Tracke�'? 2� App'n Received / app�n Processed
LicenselD # 59677 � Il22667 License Type: GamblinQ ManaQer Licenses
Company Name: Sandra L. Jovice DBA: Johnson Area Aockev Association
Business Addresss: 959 Arcade St. (Governors) Susiness Phone: 772-3088
Cornact Name/Address: 1442 Hoyt Ave E 55106 Home Phone: 772-3088
Date to Council Research: > ��9�/ /
Public Hearing Date: L`��7 Labeis Ordered: /✓J!�
Notice Sent to Appiicant: ��R � Disirict Council #: OS
Notice Seni to Public: �� Ward #: 06
Department/ Date inspections Comments
Gity AttorneY f 0 �:'/y �T�7u � h� ���� 9%
�l�f �g'7 �
Environmental
Health
l V��
Fire
�/�
License Site Pian Aeceived:_
Lease Received:
/ "��
Police ��C�"7"� �1�'C„-' jr? _!J ��S`'S.
n � !
� f�.���7
Zoning
N ��
�i�i-`l�5
East STATE OF:1?INNESOTA POR BOARD USE ONLY
GAMBLING CONTROL &OARp AMT . PAID
GAMBLING MANAGER LICENSE RENEWAL APPLICATION CHECK #
LG 63l11/97 DATE
INITIALS
Incomplete, false, or misleading application information may resuli in denial of a license.
LICENSE NUMBER: G00756 001 EFFECT3Vb DATB:09/01/95 EXPIRATION DATE: OS/31/97
ORGANIZATION INFORDIA'IZON
NAME OF ORGANIZATION: Hockey St Paul Johnson Area Assoc
CEO NAMfi; Steve Younghans
GA!�1BLL�'G M.4*IAGER L'�'FOft,'�iA'I'Ipn+
B�aee�i=i�Fier��egen S�NqQq 1.. �oyc2
-�493 e�i�IfaF,rCm�AV�-g (4ua �"}Ioy7 DATE OF BIRTH: }$7ISI62 12 �IS/y�/
'�'ga�l$G'- ST. Pr� N L� W1M. SS ( U 6 SEX.•�F- �.
SOCIAL SECURITY NUMBER: 4?GA0-i3gg �� - yH _ a� �`�
DAYTIME PHONE NUMBER: 612 �86$897 'I'1 �. - 3 0 � � � 'j ��- �o f 3
MEMBER SINCE: 11f30/82 /-?6
EDUCATION INFOR�4IATION
MOST RECENT CONTINUING EDUCATION CLASS YOU ATTENDEB: q`7I�'�
BOND INFORMATION
BOND CQMPANY NAA4E: State Surety Co BpND NUMBER: RPS290481A
G�1IBLING MANAGER CHAIVGE
When your organiza�ion is using this renewal applicacion to change its gambling manager, camplete one of the following seccions:
Ecnec�eacy "1;:t; �e • A!;ow ap :n fve r,,c;k(rg Other Chan e- Atlow ��
da s Yot rocessin � F tc� ten w?�ks for r.rnr.es;in,,^,
x P S The new eambfing mar,ager's iicense snouid hecome
The chief executive oFficer, by signing be]ow, effec[ive (check pne};
affirms that the emergency application is due
to the following reason (Check one and fill in date): The day afrer che current gambline mana�er's license expires
,Death of gambling mana er on ^ (for ezample, if the cuaent gambfing manager's license expires
� —�_t� 07/31/97 the new gambling manager's license becomes
�bisabiliry"oFgam6ling mazia er on effective on 68l03l97, provided that all application information
, 8. ____!�1 is complete).
Termination of emplo�anent,bY �am6(in --�en the appiicacion has been processed by the Gambling
�manager on.- / .� --' � � Conuol Board-•the effeccive da�e will be che first daV of
.. .. .,....--.., ,..-,,,^r � the mon[h.
Note: A New gambling manager may not assume du[ics un�il he/she has recei��ed the gambling manager's license from tha
Gambling Conaol Board.
ihz current ch�e* executrve ��lflee; ot your orgznization musc sign tl�is appi�cation in ,hc p: esence of , c;:,;ary
SIGNA'I;�RE pF CHIEF
r
i
OFFICER (CEO)
Notary Public Information. Notary Public Sea]
must be cunene and wrrecc; seai may not be altered.
Jotarized Signature of CEO i
)AGLYN PEAF .
9#RYPUBLIC �.h�,�,.
RAMSEY COUN
Subscribed and�ssvorn to before me chis �
day of ___;(;�_ �� Ig f"i 7
� !
.,, ,.� .��/j. _ �r/..�,.,_.,.,
Public
�� �' � 7 ��<Q�`��Linued on Back)
p � 1 LG212GMi
��� i 4� P � g �09/��
Gambling Manager Renewat Application (continuedJ
Affidavit and Consent Stptement:
I,(princ name)_Cp„�,� �� �. �c r� E- ,under oath state that I have never;
1. been convicced of a felony oz crime involving gambling;
2. committeA a violazion of law or Boazd rule thac resulted
in the revocation of a license issued by the Boazd within
five years before the date of the license application;
3. been convicted of a criminal violarion involving fraud,
theft, ta�c evasion, misrepresentation, or gambling;
4. been convicted of (i) assault, (ii) a criminal violation
involving the use of a firearm, or (iii) making terroristic
threats;
S, been, oz azn now, connected with nor engaged in
an illega] business;
6. had a sales and use tae pernut revoked 6y the commissione:
of revenue within the past two yeus;
7. afrer demand, fai]ed to file, cax recums required by che
commissioner of revenue.
I do not owe 5500 or more in delinquent taxes as defined in sec[ion 270.72.
In addition, I understand, agree, and hereby irrevocably consent that suits and actions relating to ctte subject matter of the attached
gambling manager license apglication, or accs or omissions arising from such applicaeion, may be commenced againsc me or my
organi7acion and I wi11 accept the service of process in any coun of competenc jurisdiction in Minnesota by service on the
Minne;ota Secretary of State of any summons, p:acess, or pleading authorized by the laws of Minnesota.
By signamre of this documeat, the undersigned authorizes [he Departments of Public Safery and Revenue to conduct a criminal and tax
background check or review and co share ehe resul[s with the Garnbling Control Boazd.
Failure to provide required informacion or providing false ot misleading informacion may resuIt in the denial or revocation of the
license.
FURTAER AFFIANT SAYETH NOT, except �ha� this Affidavi[ and Consent Statemenc aze submitted in support of the application for a
gambling manager license from che Gambling Con[rol Board.
SIG�ATUIZE OF GAMIBLING b�tA,'�`AGER APPLICAN'I' Notary Pubfic Information. Nocary Public Seai
�t--- n � mus[ be currenc and correct; seal may no� be altered.
!— 7���' Subscribed and sworn co before me this �,��
Notarized Signarure of�lpplicant day oi �.,�,; � ,19�
' l'� , �
Date �,� `� ,-'�, , ' _ " , �iti,: �i'.
, � .�'otary Public � .. _. .... ----_--. •
This publuauon w�11 be made a��a�iahle in al�zmarn e tortnat (i.e. Iarge pnnt. Braille) upon reques�. If you use a TTY, yo u�y��,:(�
Reiay Semce at (61:) 39�•S35i or I-800-b37-35?9 xnd ask �hem eo piace a call io i61?) 639�000. ae7 v TY
. MY Comta E�nt J�n. 31. 2000
.
Tne mPortnanon requesied on �his form wili be used by �he Ganbhng Control Board (Board) �o de�ermme your compliance with Minnesota statu[es and rules goveming
tawPoi gambling acnvieies. All of the infortnanon J�a� you supply on this fortn wdl become publm infortnanon when rcceived by the Board.
You are required io provide yaur social securiry number on �his form, Your social secunry number will be used to deeermine your compiiance wi�h the rax laws of
Minneson. Au`honzation for requinng your soc�al secunrv number is found at 42 U.S.C. 405(c)(i). •
The mfoma�ron reyuesied on this fortn Uncludmg any aanchmenuj will be used by Ne Board m de[ermme your qualificanons m be involveJ in tawtu! gamblmg
acnvities in Minnesota, and ro assise the Board in wndocnng a background invesngaeion of you.
You have thz nghc ro refuse ro supply the mformanon requesced; however, i(you refuse ro supply Nis mfortna�wn, the Board may r.ot be able to derertnme your
qualifiwuons and, as a consequence, may rzfuse to �ssue you a license. If you suppiy rhe mformauon required. �he BoaA wdl be abk ro procees your applicanon.
Your name and addre55 wi0 he pubhc mforniadon whzn recervtd hy the Bnard All the o[her mtortnanon abou{ you ihat you pronde wiq bn privaee data unni the Board
issuey vour 6cen6e, When �he BoarJ usues youn c�enst, zIl of ihe mfnrmauon }nu have provNed m ihe Be�arJ ro Ne pmce55 Vi applymg for youn c�enst wdl
become pubtic excep� Por your sociai sncuriry number. which remams pnva�e.
If the Bnard does noe issue ��ou a Lcense, alt thz iNOm�anon yn� ha�z provided m the process nt appl}'ing for a hcensrremams pmate, wrth [he excepnon of your name
anJ adJress. which witi remam pu�Lc.
Pn�ace data abnut }'ou is available oniv Io tht toilowme: Bonrd members, staff ot fie BoaN whost work assignmenc reqmres Nat chey have acces5 to the inFormation:
t4e Mrnneoota Bepanmrn� ot Public Snierv, ihe Simneso�a Atromey Oeneral: ihe nimnesnea Cummus�nners of AJmimsrrsnon. Finance and Revenue; che Legislanve Audiror
na�ioqal nnd miemaunnal eamhhng reFui�iory ucene�rs: anyane pursuane to court otclrr, uther indivlduak and agencies chat may ne spzcificaliy audionztJ by sea�e
or Icdera{ kiw m have uc�eis m woh �m�miauon. mJ���iduttl� and a�enaes 1'+�r wAxh f.iw ��r Irc:d ��rQcr auUn�nzes a ncw use nr �h:inne i�t �hu inlormpuon aR�r lhi5
n��uCe +s yrvtn, ruu .mJ amune ..nh �our mnnen �nmrni,