90-504 0 R1 G 1 N A L � �ouncil File # � � ,�
Green Sheet � 7762 _
RESOLUTION ,---=�
CITY OF SAINT PAUL, MINNESOTA 3���
'a A /
Presented By �/���'%� ,
Referred To Committee: Date
RESOLVED: That application ID��54612 for a Massage Therapist license
by Carol M. Sturgeleski DBA Sister Rosalind Gefres
Professional Massage Center at 1999 Ford Parkway, be
and the same is hereby approved.
Yeas a s Absent Requested by Department of:
imon
o w
on � License and Permit Division
acca ee
e ma T
une -- �`
i son --�— BY�
Adopted by Council: Date
��� �% y ��g4 Form Approved by City Attorney
Adoption Certified by Council Secretary By: �Z7.1��
By' Q'�'�' �'�='�� Approved by Mayor for Submission to
Approved by Mayor: Date R � 1g�� Council
By: �i�,'���..� By'
IN18i.ISHED AP R 7 1990
� _ _ �. . ��a_5o�
�PARTM[NT/OFFlCFJCOUNCIL DATEINITUITED �REEN SHEET No. 77�2
Finance and Ma.na ement INI7IAU DATE INITiAUDATE
CONTACT PEA80W 8 PFIONE �pEpqRTMENT DIRECTOR �CITY COUNpL
Kris Van Horn - 298-5056 ��� [�j]cm nrroRr�v 0 cm c�ea�c
MUBT BE ON OOUNpL AOENDA BY(DATE) ROUTINO �BUDOET OIRECTOR �FIN.d MOT.SERVICES DIR.
March 29 1990 ❑�Y�R����� � Council Re
TOTAL�OF SIGNATURE PAGES (CLIP ALL LOCATION8 FOR SIQNATUi�
ACTION RC�JESTED:
Application ID�1�54612 for a Massage Therapist License.
REOOMM�wmo�s:Mv►ow W u►�y.ct(p) COUNCN. REPORT O�TIONAL
_PIANNINO f�BSION _qVIL SERVI�OOMMISSION ANALY8T PFIOPIE NO.
_GB COMMIT7EE —
—STAFF _ OO�AMEPITB:
_OIBTRICT WURT _
SUPPORT8 WNIC;Ii CWNpI OBJECTIVE9
INITIATINO PR061FM�ISSUE�OPPORTUNflY(Who.WA�t�WINn.Whs►�,Why):
Carol M. Sturgeleski request council approval of her application
for a Ma.ssage Therapist License at 1999 Ford Parkway DBA Sister
Rosalind Gefres Professional Massage Center. All applications
and fees have been submittted. All required departments have
reviewed and approved this application.
�uva,rvu�s��c:
DISADVANTA(iES IF APPROVED:
DISADVANTA(iES IF NOT APPROVED:
R�CEfVED `
(;ouncil Research Center.
�i 5��� MAR 131990
C1TY Cl.ERK -
TOTAL AMOUNT OF TRANSACTION = COST/REVENUE etlD0BTE0(qRCLE ONE) YES NO
FUNDINO 80llRCE ACTMTY NUMOER
FlNANdAL INFORMATION:(EXPIAII�
��
� . � - �yo5o�
UIVISION OF LICENSE AND PERMIT ADMINISTRATION DATE r' �� /
INTERDF.PARTMFNTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant '(� �, � Home Address �y� �j, � �,,,�,-�-p,���w�r
J
Rusiness Name �'}' -;"`� Home Phone � �(� ' (� � �
Business Addres � r ���� Type of License(s)
Business Phone �� - G ��j
Public Hearing Date "��� acj L�� License I.D. 4� 3"��, (a
at 9:00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �� p�,l.l [137
llate Nutice Sent; Dealer 4� n. 'P�
to Applicant
rederal Firearms 4� � ��
Public Hearing
DATE INSPECTIUN
REVIEW VERFIED ,(COMPUTER) CUMMENTS
A roved Not A roved
�
Bldg I & D al aJ �
t ' O ,`
�"l
Health Divn. '
a �a�
�
Fire Dept. � �
i '
i 11'`� � � ,
I
Police Dept. I
3 I �'�' Rect�►-�
License Divn. ,�-�, �
�a � i
o�
City Attorney �/ �
a� � ��
Date Received:
Site Plan 1 L `a
To Council P.esearch
Lease or Letter � � � Date
from Landlord
CURRENT INFORMATION NEW INFOKMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
�
,' . � �`CI'� 'p�� 'rl�L,c.�� �� m�A� l!�A�r�'�1'
' � L+��� CITY OF S'i'. PAUL � �� �
DEPARTMENT N CE AND iNANAGEMENT SERVICES
LICENSE AND PERMIT D � ' o�•SG
� �t� `f'EI�
�-P rnfu SsiaZ -}��,.p 8�.5U
Please answer a11 questions f'ully a.ad completely. Th s application is thorough� checked.
Any falsification will be cause Por denial. e� tl
Date f S 19 ` �"�d J�a7
1. Applicativn for �1��,,,�a�X �a.t.a.c�-�rx � o•+ � V��cens��(Permit)
2. Name oP applica.nt a r�1 ,�e r i�e. �.�f u v'�/e �k I
3. If applicant is/has been a married female, list maiden name •_ .�a � Ie r
�+. Date of birth /� -a• 35/ Age ,�,� Place of birth f U-a c�� ��v� v� .
5. Are you a citizen of the United States�Native�Naturalized
6. Are you a registered voter�Where �i„^�n U� u���-�— r-� •-�,_���.�c,
7, Home Address 7�� �J o L �.1C� St.��ome Telephone )e 9� -D�O �7
r ,
8. Present business address,.f 999' Fn�-cQ ;�^ L/_t �/ S't. ��.�.Q Business Telephone '�'- / 3
/
9. Including your present business/employment, what business/employment have you
followed for the past five yeaxs.
�, �
� `�-.
Business/employment. Address � '--
�'�' Vi�v�e Q H fo�e �a u _�L � 1� �7X. �f .�2 7 - /�.2 ,=*;
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...S�.L���/{��_.vs-�� _ �S�G d2�, � "
�r
r :
�
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co �
10. Married�if ansver is "yes", list name and adc2ress of spouse �
l�'�/' Qe r n, r� .� �'�r a�,��!,._�S�' �.�'e 1� t r��c''o t� �k,,,v .!'f.�a u�,, ;�t h SS//�
r
11. IF this application is for a M assage Therapist License, list time so occupied.
Yefsrs ,S'� Months.
12. �ave you ever been axrested��IP answer is "yes", list dates of arrests, where,
charges convictions aad sentences.
Date of arrest_ 19 Where
Charge
Conviction Sentence
Date of arrest 19 �ere
Chaxge
Conviction Sentence
�
- • ��d�`J�7
13• Give names and addresses of two persons, residents of St. Paul, Minnesota who can
give information concerning you.
NAME . ADDRESS
.1fr� (�',e;�h�e e Ma�uska �I�' Tuho �ve. �'t. �aul_ J'�ihh . SS/o�
,�r_ �� e s a ��.� c� �e�t'Q ��i Fa r c� !'a r���/ .�'f (1 a t��+ �' SS'/t�
iNn.
State of Minnesota )
) SS
County of Ramsey )
- _ �
�/J�s>�,c `�' -�-� �' � being first duly sworn, deposes and says upon oath
that he has�•�r-�ea� the f e ng statement beaxing his signature and knows the contents
thereof, and that the e is tz-ue of his own kr.owledge eucept as to those matters
therein stated upon information and belief and as to those matters he believes them
to be true.
Subscribed and s��rorn to before me . . `
-�,/ �, Signature of plicant
this — day of �; � �?i 19�_
- �
- .G'���� .
Notarx. Public, Ramsey o ty, Minnesota
D'�y Commission expire !�-� r '
� . •
�JV(ona 1'. `�Cze�e�6ez9
t NOTA0.V ►UAL�C-MINNESOTA
R:.MSEY CCUNTY
g pAy commission expir�s Sept.26,1990 —