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98-195council File��S Ordinance # ORIGINAL Presented By Referred To Committee: Date RESOLt/ED: 1 That application (ID #19980000439) for a Gambling Manager License(s) 2 by ROGER CHELBERG DBA ANDERSON NELSON VFW POST 1635 at 648 LAWSON 3 AVE E be and the same ie hereby approved. Yeas Navs Absent Requested by Department of: Adoption Certified by Council Secretary By: App� By: RESOLUTION CITY OF SA{NT PAUL, MINNESOTA �s Office of License, Inspections and Environmental Protection L:< /�1.� ��% Form Approv d by City Attorney �iG� J' - �S-g'� ved by Mayor for Submission to il Green Sheet � LP60022 Adopted by Council: Date �� q � DEPARTMENT/OFFICE/CWNCIL DATE W�TWTED " GREEN SHEET No. LP60022 � � � �� ONTACT PERSON & PHONE i�wvoom m�muoaro UNTHER WILLIAM (BILL) (672)266-9732 � CityAttomey UST BE ON C011NCIL AGENDA BY (DA'fE) �� r"+es-- 3—\� x�rae �z c«,�,R��u, ROUTING OROHt TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: Cou�l approval of fhe fdbwing Gcerse application: License # t9980000439, for ROGER CHELBERG, Doing Business As ANDERSON NELSON VFW POST 7635, ffi 648 LAWSON AVE E, i�xluding the following business type(s): Gambiing Manager. RECOMMENDATIONS:AppfoVe(A)RejeCt(R) ERSONALSERVICECONTRACTSMUSTANSWERTHEFOLLOWINGQUESTIONS: 1. Nas ihis persoNfirm ever worked under a coMrad fa this departmeM? PLANNING COMMISSION yES NO -- CIB COMMITTEE 2. Has this perso�rm ever been a cily empioyee? CML SVC CINN, YES NO 3. Does Nis perso�rm possess a slall not nortnaly possessed by any curte�rt ciry empbyeel YES NO 4. Is ihis persoMrtn a targeteA vendoR YES NO EzpWin all yes answers on separate sheet anA attach W green sheet INITIATING PROBLEM, ISSUE, OPPORTUNITY (Who, What, When, Where, Why): Requesting Council approval for a new gambling managers ficense by Roger Chelberg at 648 Lawson Ave. E./JL �QLt£?�S8 �??��2"c�?rh a,:R^tpt' ADVANTAGESIFAPPROVED: {� ��4b � �� ;.,, . DISADVANTAGES iF APPROVED; DISADVANTAGES IF NOT APPROVED: TOTAL AMOUNT OF TR4NSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDING SOURCE ACTIVITY NUMBER FINANCIAL INFORMATION: (EXPLAIN) �4�,de�o�, - /t/2/ss Minnesota Lawfut Gambling � �_�•___. 11R..«i.rre� �'ec�.+ Cb.e� �l e��s�e . `� �'s= �,c� �g -�g5 Annlinatleri or misleading application information may result in denial of a license. O�Pco�C LG2 �� ares � Page 1 oi Gambling Manager Information � f � Fint Name� — Full Middle NamP ��f _Lesl Name�:� / Maiden Name .� Date ot Binh�l�J� �h� �°} �° b°xea: � ❑� SocialSeWrityNUmber 73 � '�' � S� Diselosunot _ . Soeial3�cudtY Numb�r DeyGme z— 8'3 � � I became an active member of this organization on: 1 sttsndad tha hvo-day gambiing manager seminar on: You are required to p� Y�r sadal secu- riry number on Mb form. Your soeial secv- rity number will be used lo determine your oompliance with lhe tax laws of � AulM�izationfor reVUidngyou �ity pumber ia found a142 U.S.C.405(c)(i). Bond Information A$�0,000 fidelity bond in favor of the organization has been obtained as required by Minnesota Sialutes, section 349.167, subdivision t. Insurance Company Name: , f�AhJdVER IN��-'E Bond Number: }sK ►�s-�yuy (DO NOT USE THE AGENCY NAME) Gambling ManagerChange Emergency Change - nuow uP to ave days ror processing The chief executive officer, by signing below, affirms that the emergency appiication is due to the following reason (check one and fill in date): ❑ Death of gambling manager on �_�� ❑ Disabiiity of gambling manager on / / � ❑ Tertnination of employment of gambiing manager on —� �--.—= NOTE: The new gambling manager may not assume duties until helshe has received the gambling managers ficense from the Gambting Control Board. manager. Other Change - Allow up to ten weeks for procesain9 The new gamblin8 mana9e�s license should become effective (check one): • � 1`./ The �ay after the eurten� gambeng manager's license expires (for example, if the curtent gambling manager's license expires 7/31196, the new gambling managers license becomes eNective on 8/1/86, provided that all appiication infortnation is complete). When the application has been prxeased by the Gam- bling Co�trol Board–the etfe date will be the first day ot the month. I Hfl�t � qR g NOTE: 7he new gambling manager may not assume duties until helshe has received a gambling managers license from the Gambiing Control Board. 3i�gna �of CEO �a ' gnalureo( hre Exe� ` � c )elQ:,�, � � ^ 1 � y� �ECc�JS B y�— Notary Publfc be currer�taAd.Gi o( Notary Pubiic Sea� mus� a� 200� on back) C V council File��S Ordinance # ORIGINAL Presented By Referred To Committee: Date RESOLt/ED: 1 That application (ID #19980000439) for a Gambling Manager License(s) 2 by ROGER CHELBERG DBA ANDERSON NELSON VFW POST 1635 at 648 LAWSON 3 AVE E be and the same ie hereby approved. Yeas Navs Absent Requested by Department of: Adoption Certified by Council Secretary By: App� By: RESOLUTION CITY OF SA{NT PAUL, MINNESOTA �s Office of License, Inspections and Environmental Protection L:< /�1.� ��% Form Approv d by City Attorney �iG� J' - �S-g'� ved by Mayor for Submission to il Green Sheet � LP60022 Adopted by Council: Date �� q � DEPARTMENT/OFFICE/CWNCIL DATE W�TWTED " GREEN SHEET No. LP60022 � � � �� ONTACT PERSON & PHONE i�wvoom m�muoaro UNTHER WILLIAM (BILL) (672)266-9732 � CityAttomey UST BE ON C011NCIL AGENDA BY (DA'fE) �� r"+es-- 3—\� x�rae �z c«,�,R��u, ROUTING OROHt TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: Cou�l approval of fhe fdbwing Gcerse application: License # t9980000439, for ROGER CHELBERG, Doing Business As ANDERSON NELSON VFW POST 7635, ffi 648 LAWSON AVE E, i�xluding the following business type(s): Gambiing Manager. RECOMMENDATIONS:AppfoVe(A)RejeCt(R) ERSONALSERVICECONTRACTSMUSTANSWERTHEFOLLOWINGQUESTIONS: 1. Nas ihis persoNfirm ever worked under a coMrad fa this departmeM? PLANNING COMMISSION yES NO -- CIB COMMITTEE 2. Has this perso�rm ever been a cily empioyee? CML SVC CINN, YES NO 3. Does Nis perso�rm possess a slall not nortnaly possessed by any curte�rt ciry empbyeel YES NO 4. Is ihis persoMrtn a targeteA vendoR YES NO EzpWin all yes answers on separate sheet anA attach W green sheet INITIATING PROBLEM, ISSUE, OPPORTUNITY (Who, What, When, Where, Why): Requesting Council approval for a new gambling managers ficense by Roger Chelberg at 648 Lawson Ave. E./JL �QLt£?�S8 �??��2"c�?rh a,:R^tpt' ADVANTAGESIFAPPROVED: {� ��4b � �� ;.,, . DISADVANTAGES iF APPROVED; DISADVANTAGES IF NOT APPROVED: TOTAL AMOUNT OF TR4NSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDING SOURCE ACTIVITY NUMBER FINANCIAL INFORMATION: (EXPLAIN) �4�,de�o�, - /t/2/ss Minnesota Lawfut Gambling � �_�•___. 11R..«i.rre� �'ec�.+ Cb.e� �l e��s�e . `� �'s= �,c� �g -�g5 Annlinatleri or misleading application information may result in denial of a license. O�Pco�C LG2 �� ares � Page 1 oi Gambling Manager Information � f � Fint Name� — Full Middle NamP ��f _Lesl Name�:� / Maiden Name .� Date ot Binh�l�J� �h� �°} �° b°xea: � ❑� SocialSeWrityNUmber 73 � '�' � S� Diselosunot _ . Soeial3�cudtY Numb�r DeyGme z— 8'3 � � I became an active member of this organization on: 1 sttsndad tha hvo-day gambiing manager seminar on: You are required to p� Y�r sadal secu- riry number on Mb form. Your soeial secv- rity number will be used lo determine your oompliance with lhe tax laws of � AulM�izationfor reVUidngyou �ity pumber ia found a142 U.S.C.405(c)(i). Bond Information A$�0,000 fidelity bond in favor of the organization has been obtained as required by Minnesota Sialutes, section 349.167, subdivision t. Insurance Company Name: , f�AhJdVER IN��-'E Bond Number: }sK ►�s-�yuy (DO NOT USE THE AGENCY NAME) Gambling ManagerChange Emergency Change - nuow uP to ave days ror processing The chief executive officer, by signing below, affirms that the emergency appiication is due to the following reason (check one and fill in date): ❑ Death of gambling manager on �_�� ❑ Disabiiity of gambling manager on / / � ❑ Tertnination of employment of gambiing manager on —� �--.—= NOTE: The new gambling manager may not assume duties until helshe has received the gambling managers ficense from the Gambting Control Board. manager. Other Change - Allow up to ten weeks for procesain9 The new gamblin8 mana9e�s license should become effective (check one): • � 1`./ The �ay after the eurten� gambeng manager's license expires (for example, if the curtent gambling manager's license expires 7/31196, the new gambling managers license becomes eNective on 8/1/86, provided that all appiication infortnation is complete). When the application has been prxeased by the Gam- bling Co�trol Board–the etfe date will be the first day ot the month. I Hfl�t � qR g NOTE: 7he new gambling manager may not assume duties until helshe has received a gambling managers license from the Gambiing Control Board. 3i�gna �of CEO �a ' gnalureo( hre Exe� ` � c )elQ:,�, � � ^ 1 � y� �ECc�JS B y�— Notary Publfc be currer�taAd.Gi o( Notary Pubiic Sea� mus� a� 200� on back) C V council File��S Ordinance # ORIGINAL Presented By Referred To Committee: Date RESOLt/ED: 1 That application (ID #19980000439) for a Gambling Manager License(s) 2 by ROGER CHELBERG DBA ANDERSON NELSON VFW POST 1635 at 648 LAWSON 3 AVE E be and the same ie hereby approved. Yeas Navs Absent Requested by Department of: Adoption Certified by Council Secretary By: App� By: RESOLUTION CITY OF SA{NT PAUL, MINNESOTA �s Office of License, Inspections and Environmental Protection L:< /�1.� ��% Form Approv d by City Attorney �iG� J' - �S-g'� ved by Mayor for Submission to il Green Sheet � LP60022 Adopted by Council: Date �� q � DEPARTMENT/OFFICE/CWNCIL DATE W�TWTED " GREEN SHEET No. LP60022 � � � �� ONTACT PERSON & PHONE i�wvoom m�muoaro UNTHER WILLIAM (BILL) (672)266-9732 � CityAttomey UST BE ON C011NCIL AGENDA BY (DA'fE) �� r"+es-- 3—\� x�rae �z c«,�,R��u, ROUTING OROHt TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: Cou�l approval of fhe fdbwing Gcerse application: License # t9980000439, for ROGER CHELBERG, Doing Business As ANDERSON NELSON VFW POST 7635, ffi 648 LAWSON AVE E, i�xluding the following business type(s): Gambiing Manager. RECOMMENDATIONS:AppfoVe(A)RejeCt(R) ERSONALSERVICECONTRACTSMUSTANSWERTHEFOLLOWINGQUESTIONS: 1. Nas ihis persoNfirm ever worked under a coMrad fa this departmeM? PLANNING COMMISSION yES NO -- CIB COMMITTEE 2. Has this perso�rm ever been a cily empioyee? CML SVC CINN, YES NO 3. Does Nis perso�rm possess a slall not nortnaly possessed by any curte�rt ciry empbyeel YES NO 4. Is ihis persoMrtn a targeteA vendoR YES NO EzpWin all yes answers on separate sheet anA attach W green sheet INITIATING PROBLEM, ISSUE, OPPORTUNITY (Who, What, When, Where, Why): Requesting Council approval for a new gambling managers ficense by Roger Chelberg at 648 Lawson Ave. E./JL �QLt£?�S8 �??��2"c�?rh a,:R^tpt' ADVANTAGESIFAPPROVED: {� ��4b � �� ;.,, . DISADVANTAGES iF APPROVED; DISADVANTAGES IF NOT APPROVED: TOTAL AMOUNT OF TR4NSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDING SOURCE ACTIVITY NUMBER FINANCIAL INFORMATION: (EXPLAIN) �4�,de�o�, - /t/2/ss Minnesota Lawfut Gambling � �_�•___. 11R..«i.rre� �'ec�.+ Cb.e� �l e��s�e . `� �'s= �,c� �g -�g5 Annlinatleri or misleading application information may result in denial of a license. O�Pco�C LG2 �� ares � Page 1 oi Gambling Manager Information � f � Fint Name� — Full Middle NamP ��f _Lesl Name�:� / Maiden Name .� Date ot Binh�l�J� �h� �°} �° b°xea: � ❑� SocialSeWrityNUmber 73 � '�' � S� Diselosunot _ . Soeial3�cudtY Numb�r DeyGme z— 8'3 � � I became an active member of this organization on: 1 sttsndad tha hvo-day gambiing manager seminar on: You are required to p� Y�r sadal secu- riry number on Mb form. Your soeial secv- rity number will be used lo determine your oompliance with lhe tax laws of � AulM�izationfor reVUidngyou �ity pumber ia found a142 U.S.C.405(c)(i). Bond Information A$�0,000 fidelity bond in favor of the organization has been obtained as required by Minnesota Sialutes, section 349.167, subdivision t. Insurance Company Name: , f�AhJdVER IN��-'E Bond Number: }sK ►�s-�yuy (DO NOT USE THE AGENCY NAME) Gambling ManagerChange Emergency Change - nuow uP to ave days ror processing The chief executive officer, by signing below, affirms that the emergency appiication is due to the following reason (check one and fill in date): ❑ Death of gambling manager on �_�� ❑ Disabiiity of gambling manager on / / � ❑ Tertnination of employment of gambiing manager on —� �--.—= NOTE: The new gambling manager may not assume duties until helshe has received the gambling managers ficense from the Gambting Control Board. manager. Other Change - Allow up to ten weeks for procesain9 The new gamblin8 mana9e�s license should become effective (check one): • � 1`./ The �ay after the eurten� gambeng manager's license expires (for example, if the curtent gambling manager's license expires 7/31196, the new gambling managers license becomes eNective on 8/1/86, provided that all appiication infortnation is complete). When the application has been prxeased by the Gam- bling Co�trol Board–the etfe date will be the first day ot the month. I Hfl�t � qR g NOTE: 7he new gambling manager may not assume duties until helshe has received a gambling managers license from the Gambiing Control Board. 3i�gna �of CEO �a ' gnalureo( hre Exe� ` � c )elQ:,�, � � ^ 1 � y� �ECc�JS B y�— Notary Publfc be currer�taAd.Gi o( Notary Pubiic Sea� mus� a� 200� on back) C V