90-812 o K ��r I n��'I . Council File �` ��0��
v 1 Y�1 L
Green Sheet # 5683
RESOLUTiON �'�,
CI OF SAINT PAUL, MINNESOTA �
Presented By
Referred To Committee: Date
RESOLVED: That application ID4�38511 for a Massage TherapisC License
by Karla N. Stromgren DBA Sister Rosalind Gefre's Professional
• Massage Center.at 1999 Ford Parkway, :be and the same is
hereby approved.
�eas Navs Absent Requested by Department of:
� w --� License and Permit Division
o �,_
acc
e �
—3' un —�
so �— By:
�
Adopted by Council: Date
MAY .1 n �gga Form Approved by City Attorney
Adoption Certified by Council Secretary gy: • • � �-��'.{►
BY� Approved by Mayor for Submission to
Approved by Mayor: Da
� 4 �f"IAY � p lgf�unci�
l By:
By: �
Pt1��SHED r�AY 1 9 1990
. �9o-��i� �
DEPARTM[NT/OFFICEICOUNGL DATE INITIATED �
Finacne and Ma.na ement GREEN SHEET NO. 5683
CONTACT PERSON&PHONE INITIAU DATE INiTIAVDATE
�DEPARTMENT DIRECTOfi �CITY COUNCIL
Kris Van Horn - 298-5056 N�� C]! anr�rroaN�r �cm c�RK
MUBT BE ON COUNqL AOENDA BY(DAT� ROUTINp �BUDQET DIRECTOR �PIN.8 MOT.SERVICEB DIR.
�,�.( 1 �Ct�O �MAYOR(OR A861STAN�T OCouncil Research
TOTAL#OF SIGNAT RE PA ES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTED:
Application ID��38511 for a Massage Therapist License, ..
RECOMMENOATIONS:APP��(N o►�1�(R1 COUNGL COMMITTEE/RESEARCH REPORT OPTtONAL
_PLAWNINO COMMISSION _pVll SERVI�COMMISSION ��YBT PHONE NO. .
_CIB OOMMITTEE _
_STAFF _ OOAAMENTS:
_DISTRICT COURT _
BUPPORT8 WHICFI OOUNCIL OBJECTIVE?
INITIATINO PR�IEM,188UE.OPPORTUNITY(Wfro.Nfhet.When.Wh�ro.Wh�:
Ka.rla N. Stromgren requests Council approval of her application
. for a Massage Therapist License at 1999 Ford Parkway DBA Sister
Rosalind Ge£re's Professional Mas�age Center. All mpplications
and fees of $83.50 have been submitted. All required departments '
have reivewed and approved this application.
ADVANTAQES IF APPROVED:
DISADVANTA(iE3 IF APPROVED:
D18ADVANTAOES IF NOT APPROVED:
RECEIVED
��251�p �ouncU Research Genter
. APR 2 319�1
CITY CLERK ._. •"".
TOTAL AMOUNT OF TRANSACTION a CAST/REVENUE BUDOETED(CIRCLE ONE� YES NO
FUNDINO SOURCE ACTIVITY NUMOER
Flwwc��iNFO�u►norc�x�uN�
�W
� ��,��z
UIVISION OF LICENSE AND P�;RMIT ADMINISTRATION DATE �� � / �
INTERDF.PARTMFNTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant �;U��U n .�Y���Y(�_ Home Address �(�') �j_ ���
,�_�
IrV1,�ls -
Rusiness Name �, Home Phone �'aa, •Cj/o(ya,
Business Addre"s� ��j ��Q�j�/ . Type of License(s) � ,�;<-;rA����,,�, 5-�
Business Phone �Ct u�_T ���
Public Hearing Date �p C,�,.^ (d��� License I.D. 41`���� �
at 9:00 a.m. in the Council hambers,
3rd floor City Hall and Courthouse State Tax I.D. It �(p�q7 �
llate Notice Sent; Dealer �� '� �
to Applicant
Federal F�rearms 4� � f
Pub.lic He��ring
DATE INSPECTIUN
REVIEW VEKFIED (COMPUTER) COMMENTS
A roved Not A roved
�
Bldg I & D �
. 1 `� o �
Health Divn. ' � '
�� � U
� �
Fire Dept. �
� lw
I
i I
Police Dept. ' I
�Na o
License Divn.
�
� I � � �
City Attorney �
°`�� , � , C�L�
Date Received:
Site Plan �I�
To Council Research
Lease or Letter Date
from Landlord � �/�
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
. . . . ; . . . �q�-�,�
ci�c oF s•r. FAUr. "
DEPARTMEpT OF FIHIINCE AND"MANAGEMENT SERVICES , • . .
� LICENSE AND PERMIT DIYISION
. � .
Plesse aas`rer sll questions tull�r sad completely. This applicstioa is Lhoroughly checked.
Aay talsificstion �rill be csuae for denial.
` � Date �n fr�n � 19 R �
1. Applicstioa !or`!IGc55r�c � i5 � � (License)(Permit)
2. Nam� o t appli c aat � t P�vl�
3. It apDlicsat is/has been a married lemale. list maidea name �
4. Date of birth 3 � 7 -� Age ���� Place of birth Y I �,v�c,rn t�'2 �r� , `1�1 i S , � �
��
S. Are you a citizea of Lhe United Statea�_Native Xaturslized ° �
�.� • ('T�
6. � Are you s registered voLer � � Gihere =';
• ,.� _,`_?.
�t ,_:
7. Home ASdreas ��.1 Z �l Z �v � 1� l��,f,�V�ll�H �iome Telephone _ --
� � S- _ ',
8. Preaeat businees sddreaa I�(�1 �-nrd ��r/ uxw ��, u.l Businesa Telephone - _
5S I I C.+ cn .
9. Including your preaeat busiaeas/employment, vhat buainess/employment have qou�
tolloved for the past five yeara.
Business/employmeat, Address
�1,le�e�c�t u�,.e ��cz�__ ��l°( �n r r�e 12c�: ��;��+ �/�1� SS'43S
�:�-.
; �� �� ��u� VY�t�J
� _
1,.= �, .�« , . � t> 1��v'� ir,� !1�lL
�
10. Marri•__i! answer is "yes", list aa� aad address oi spouse
� ( L �rG�n�•,��
il. It thia applicstion is !or a Maasage Therapist License, liat time so occupied.
� Years / Months.
12. Have you ever been arrested�?I! aaaver is "qes", liat dstes ot arrests, srbere, �
chsrges convictions aad aeatences.
D t� o! arrest__9=ere --
c�
r��e�
,Con�tZtioa ---� _ Seatenee
�.:
c— —
`�Aate 6t arreat 19,=ere __
.f,�, ��
Cliargar'' _ ,
Coaviction � Seatence
. �. � . . � - - - � ��-���
. �
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13. Give names and addresses of two persons, residents of St. Paul, Minnesota vho can
�ive informe.tion concerning you.
NAI� _ ADDRESS
�L S � i � . 1�- � Q� �F w V^ �.0 ' V
. 1`r � A 1
�;�c� \,v; �s�-, . 7L2� �u�� /�� s�,e�� , t�i�; �s��y
state or Minnesota ) : _.
) SS
County ot' Ramsey ) ,
being first 3uly svorn, deposes and says upon oath
tnat i:e Las reaa t:�e f�r�going statem�nt ber�iag his signat;;re aad 2:no:rs t�e cor.�en±3
thereof, e.ad that the same is true of his own knowledge except as to those matters
therein stated upon information exid belief sad as to thoae mattera be believes thea
to be true. �
Subscribe3 a.z3 sworn to before ae � ���d
�{�( ignature of App c
thia C� y ' day of 19�� .
, �—,�!��C'�� � .
*lotary Fublic, Ramsey Count;/, Minaesota � . .
!Zy Coamission expires � ��`�_ !�
w
�� KATHLEEN M.A.KEtCIH�R �
��MO1aRY P�BU� MlNNESOtA
R/UY�SEY GO��TY ._ , �.
M►Comm�s,van�x,��res June 14, 1991
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