91-2128 �l��NA� - ✓
���Council File #
� Green Sheet # 16368
RESOL N
OF IN AUL, MINNESOTA
Presented By
Referred To Committee: Date
RESOLVED: That application (ID #B-02848-012) for the renewal of a State
Class B Gambling Premise Permit by Children's Heart Fund at
Triviski's, 173 So. Robert Street, be and the same is hereby
approved.
Y_ eas Navs Absent Requested by Department of:
imon �
oswi z
on� �— License & Permit Division
�ca eb e �
ettman � fJ �/
une /�i son BY� _,
D
Adopted by Council: Date �(� 2 � �qQ� Form Approved by City Attorney
Adoption Certified by Council Secretary �
By: -l�!�/
By: �, �j.DL / ���/
`Z, J Approved by Mayor for Submission to
App oved y Mayor: Date � " Council
B �����.��-�
Y= � Ey:
PUBLISlIE9 r�� 7 '91
_ �'yra���
DEPARTMENT/OFFICE/C NCIL DATE INITIATED
Finan�e�Ll�ense GREEN SHEET N° 16368
CONTACT PERSON�PHONE INITIAUDATE INITIAUDATE
�OEPARTMENT DIRECTOR �CITY COUNCIL
Christine Rozek-298-5056 ASSIGN �CITYATTORNEY �CITYCLEFiK
NUAABER FOR
MUST BE ON COUNCIL A�NDA BY(DATE) City Clerk ROUTING �BUD(3ET DIRECTOR �FIN.&MGT.SERVICES DIR.
Hearin � �� �I B / � � ORDER �MAYOR(ORASSISTAN� � (!n�inri 1 R
TOTAL#OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTED:
Approval of an application for renewal of a State Class B Gambling Premise Permit.
�f
Notification/ Hearin / /i �'j
RECOMMENDA710NS:Approve(A)or Reject(R) pERSONAL SERVICE CONTRACTS MUS ANS ER TME FOLLOWING QUESTION3:
_PLANNING COMMISSION _ CIVIL SERVICE COMMISSION 1• Has this person/firm ever worked under a contract for this department?
_CIB COMMITfEE _ YES NO
2. Has this person/firm ever been a city employee?
_STAFF
— YES NO
_DISTRiCT COURr _ 3. Does this personRirm possess a skill not normally possessed by any current city employee?
SUPPORTS WHICH COUNCIL OBJECTIVE? YES NO
Explain all yss answers on separate sheet and attach to gresn sheet
INITIATING PROBLEM,ISSUE,OPPORTUNITY(Who,What,When,Where,Why):
Mark Farnam on behalf of Children's Heart Fund requests Council approval of
their application for renewal of a State Class B Gambling Premise Permit at
Triviski's, 173 So. Robert Street. Proceeds from the pulltab sales are used
for children's heart surgeries.
ADVANTACiES IF APPROVED:
If Council approval is given, Children's Heart Fund will continue to operate
a pulltab booth at Triviski's, 173 So. Robert Street.
DISADVANTAGES IFAPPROVED:
DISADVANTAOES IF NOTAPPROVED:
C��:����
_ ;`4` �,;€ �`,"����r
RECEIVED
Nov 131991 NOV 0 8 1991
CITY CLERK
TOTAL AMOUNT OF TRANSACTION s COST/REVENUE BUDGETEp(CIRCLE ONE) YES NO
FUNDINQ SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION:(EXPLAIN) ��
NOTE: COMPLETE DIRfCTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIONAL
MANUAL AVAILABLE IN THE PURCHASING OFFICE(PHONE NO.298-4225).
ROUTING ORDER:
Below are correct routings for the five most frequent types of documents:
CONTRACTS(assumes authorized budget exists) COUNCIL RESOLUTION(Amend Budgets/Accept. Grants)
1. Outside Agency 1. Department Director
2. Department Director 2. Ciry Attorney
3. City Attorney 3. Budget Director
4. Mayor(for contracts over$15,000) 4. Mayor/Assistant •
5. Human Rights(for contracts over$50,000) 5. Ciry Council
6. Finance and Management Services Director 6. Chief Accountant, Finance and Management Services
7. Finance Accounting
ADMINISTRATIVE ORDERS(Budget Revision) COUNCIL RESOLUTION (all others, and Ordinances)
1. Activity Manager 1. Department Director
2. Department Accountant 2. City Attorney
3. Department Director 3. Mayor Assistant
4. Budget Director 4. Ciry Council
5. City Clerk
6. Chief Accountant, Finance and Management Services
ADMINISTRATIVE ORDERS(all others)
1. Department Director
2. City Attorney
3. Finance and Management Services Director
4. City Clerk
TOTAL NUMBER OF SIGNATURE PAGES
Indicate the#of pages on which signatures are required and papercHpvr flag
eech of these pages.
ACTION REQUESTED
Describe what the projecVrequest seeks to accomplish in either chronologi-
cal order or order of importance,whichever is most appropriate for the
issue. Do not write complete sentences.Begin each item in your list with
a verb.
RECOMMENDATIONS
Complete if the issue in question has been presented before any body, public
or private.
SUPPORTS WHICH COUNCIL OBJECTIVE?
Indicate which Council objective(s)your projecUrequest supports by listing
the key word(s)(HOUSING, RECREATION, NEIGHBORHOODS, ECONOMIC DEVELOPMENT,
BUDGET, SEWER SEPARATION). (SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
PERSONAL SERVICE CONTRACTS:
This information will be used to determine the city's liabiliry for workers compensation claims,taxes and proper civil service hiring rules.
INITIATING PROBLEM, ISSUE,OPPORTUNITY
Explain the situation or conditions that created a need for yoar project
or request.
ADVANTAGES IF APPROVED
Indicate whether this is simply an annual budget procedure required by law/
charter or whether there are specific ways in which the Ciry of Saint Paul
and its citizens will benefit from this projecUaction.
DISADVANTAGES IF APPROVED
What negative effects or major changes to existing or past processes might
this projecUrequest produce if it is passed(e.g.,traffic delays, noise,
tax increases or assessments)?To Whom?When? For how long?
DISADVANTAGES IF NOT APPROVED
What will be the negative consequences if the promised action is not
approved?Inability to deliver service?Continued high traffic, noise,
accident rate?Loss of revenue?
FINANCIAL IMPACT
Although you must tailor the information you provide here to the issue you
are addressing, in general you must answer two questions: How much is it
going to cost?Who is going to pay?
. �q������
DIVISION OF LICENSE AND PERMIT ADMINISTRATION DATE l4 18 / /
INTERDEPARTMENTAL REVIEW CHECKLIST Appn Processed/Received by
���� � �i��f Aud
Applicant �j����1,lZo� 7�d/'7 �/Jl�' Home Address �O'� c�� �T � �'-
, .�'""�
Business Name {2� S' /^� �(�10' Home Phone g�-�f�6d
i�ld/S � / Q
Business Address Type of License(s)�� [,�1-�1SS�' ,C,
Business Phone �103��dQ (��j!/�1 7IL��19�(S'rPJ�'yyI/T 't1�-°�'I°�-+G��/
Public Hearing Date _� � � License I.D. � �- ��fL��' ���
at 9:00 a.m. in the Council Ch bers, l
3rd floor City Hall and Courthouse State Tax I.D. 4� �����/
Date Notice Sent; Dealer � ���}"
to Applicant
Federal Firearms #
Public Hearing �;�y�� 1�
�
DATE INSPECTION
REVIEW VERFIED (COMPUTER) COMMENTS
A roved Not A roved
Bldg I & D !
� fl
Health Divn. I
'��A �
Fire Dept. I
�`-�' � I
Police Dept. �� I ����lsi
License Divn. �
il'I�l y� I � �c._..
City Attorney �
/�'a,� �� � �,�
Date Received:
Site Plan /�''� ���'j I
To Council Research Ij�g-ci�
Lease or Letter Date
f rom Landlord t � ( I�l Cj�
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FOR BOARD USE ONLY
LG214 BASE#
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PP#
FEE
Minnesota Lawfui Gambling CHECK
Premises Permit Application - PSI't 1 Of Z DA�S
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� Class of premises permit
Renewal (check one)
� Otganization base license number D�$N� � A($400) Pull-tabs,tipboards,paddlewheels.rafftes,bingo
Premises permit number O 1 a- � B($250) Puli-tabs,tipboards.paddlewheels,raffles
� N� ❑ �($Z00) &ngo only -. _
❑ �($�so� aarnes o�y . _
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Name of Organization . .
Ct���v,r<.��S ��-2���- r"Z.t.�. .
Business Address of Organization-Street or P.O Box(Do not use the address of your gambling manager) .
g�C� � <.S-�' c�`g�' .S�'/��-{� _
+ Ciry State Zip Code County Daydme phone number
M�n►-�Pa l � M.rJ 3 5 �l0-7 . Nev�v�e �r. � t�ory 863- !oo
Name of chief execudve oKcer(cannot be your gambli�g managerj Tide . , Daytime phone number
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singo Occasions
If applying for a class A or C permit, flll in days and beginning&ending hours of bingo occasions:
No more than seven bingo occasions may be conducted by your�anization per week.
Day Beginning/Ending Hours Day Beginning/Ending Hours Day Beginning/Endiiig Hours
tn to tA
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to If bingo will aot b�conducted.chec]�here �
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ame o estabTis ment w ere gam ling wi I be conducte Street d�ess( not use a post o �ce box num ) _
T��V�sl�;'s (3��� ��3 So�.�.-I-�- Ra�ier♦- St�e-c�- Sr. Pa,,,.l n�t�1 SS1 a7
Is the premises located within aty limits? �Yes O No If no,is township �organized � unorganized O ���Ded
Ciry and Couny where gambGng premises is located OR Township and Counry where gambGng premises is located if outside of aty 6mits '
ST l��,..I l2ur►�.S-�
I _ _ _ _
Name and address of legal owner of p mises City State Z�p Code
Tc�� pc��IC ��r1 s I(p�l/ �n���( �t�i Ic w c�,,� ST /�u�.l M/J ,�S t I �o
Does your organization own the building where the gambling will be cond ? p YES �. NO
It no,attach the folbwing:
• a copy of the lease(form LG202)with terms for at least one year.
• a copy of a sketch of the floor plan with dimensions,showing what poroon is being leased.
A lease and sketch are not required for Class D applications.
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Minnesota Lawfui Gambiing :
Premise Permit Application - Part 2 of 2
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Gambling Site Au o tion •1 am the chief executive officer of the organization; -
I hereby consent that local law enforcement officers,the •I assume full responsibility for the fair and lawful opera-
board or agents of the board,or the commissioner of tion of all activities to be conduded;
revenue or public safety,or agents oi the commissioners, .�will familiarize myself with the laws of Mir�nesota
may enter the premises to enforce the law. governing law(ul gambling and rules of the board and
Bank Records Informatioa agree,'rf licensed,to abide by those laws and rules,
The board is author�zed to insped the bank records of the including amendments to them; .
gambling acxount whenever necessary to fuifill •any changes in application information will be submiited
requirements of current gambling rules and law. to the board and local unR of govemment within 10 days
Oath of the change;and
I declare that: •I understand that failure to provide required information
•1 have read this appl' ion and all iniormation submitted or providing talse or misleading inionnation may resuh in
to the board is tr e, u`ate and complete; the denial or revocation of the license.
•all other requir d i ormation has been fully disclosed; •
Signatu of chi f e ecuti�e officer ate
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1. The city'must sign this application H the gambling prem• 4. A co�v oi the local unit of Qqvernmerrt's resolution ao- .
ises is located within city limits. iL�L9 this a��lication must be attached to this a�lication.
2. The county••AND township••must sign this application'rf 5. If this appl'�cation is denied by the bcal unft of govemmeM.
the gambling premises is located within a township.
ft should not be submitted to the Gambling ConVol Board.
3. The bcal unit govemment(city or county)must pass a Townshlp• By signature bebw.the township adcnowledges -
resolution specif'ically approving or denying this application. that the organization is applying for a premises permit within -
� __ _ .... . :
township limits.
Clt • or Count '• Townshl •• � � � � - �
Ciry or Counry Name Township Name .
Signature oi person reoeiving appGcation Signature of person reoeiviny application'" �- ' ' -
Tide ( Date Received Title , I Daoe Received _ :
�� �� c!�
Refer to the lnstructjons for required atiachments. ,O1
Mail to: Gambling ConVol Board
Rosewood Plaza South�3rd Floor
1711 W.Counry Road B
Rossvllle,MN 55113 LG214(Part 2)
(R�v7r1�9t)