90-875 0 R I G f N�4 L Council File ,� ����
Green Sheet ,� 5685
RESOLUTION '" �,,
CITY OF SAINT PAUL, MINNESOTA ��
Presented By
Referred To Committee: Date
RESOLVED: That application ID��38338 by Marlieke Van Tyn DBA
Vi's Theraputic Massage Center at 182�University
Avenue, be and the same is hereby approved.
— e s Nava Absent Requested by Department of:
o �
z
License and Permit Division
on �
acca e �
e ma
iune
i son �"_ gY:
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Adopted by Council: Date
MAY 2 2 1990 For►Y► Approved by City Attorney
Adoption Certified by Council Secretary By: �.�
By� � v" ��'�'«�� Approved by Mayor for Submission to
Approved by Mayor: Date �Y 2 3 1994 Council
By:
�. „���.�.�`-��' By:
PUBIISNED J U P� - 2 19�Q_
. .. �20-�s �
DEPARTM[NTIOFFICEICOUNGL DATE INITIATED �
Finance and Management GREEN SHEET NO. 5�g 5
CONTACT PERSON R PHONE INITIAU DATE INITIAlJDATE
�DEPARTMENT DIRECiOR �qTY COUNqL
Kris Van Horn - 298-5056 �R� Q cmr arrro�aEV �c�rr c�e�c
�U3T rBQ ON NCIL AaEN �j ROUTINO �BUDQET DIFiECTOR �FIN.8 MOT.SERVICES DIR.
i18t����ot�ity���f�by 5/15/90 ��YOR(ORA8818TANn �rn�n�il Re
TOTAL�►OF SIGNATURE PAQES (CLIP ALL LOCATlONS FOR 8KiNATURE�
ACTION REQUE87ED:
Application ID�38338 for a Ma.ssage Therapist License.
RECOMMENDATIONB:Approvs pa a Rej�c4(H) (;pV�n, REPORT OPTIONA�
_PLANNINO COMMISSION _qVll BERVIC�OOMMISSION �� - ���
_dB OOMMITTEE _
COMMENTB:
_8TAFF _
_DISTRIC'T COURT _
BUPPOpTB WHICH COUNpL 08JECTIVE?
INITIAT1Nf�PROBLEM.ISBUE.OPPORTUNITY(YVho,Wh�t.When.WMn�M�hy):
Request for Council approval by Marlieke Van Tyn for a Ma.ssage
Therapist License at 1821 Univeristy Avenue DBA Vi's Theraputic
Massage Center. All applications and fees of $83.50 have been
submitted, all required departments have reviewed and approved
this application.
ADVANTAOES IF APPROVED:
018ADVANTA(iE3 IF APPROVED:
DIBADVANTAOEB IF NOT APPROVED:
REC�IVED
�Y14�� c:ourrcu Kesearcn i:enre�
CITY CLERK MAY 09 ,�u
TOTAL AMOUNT OF TRANSACTION = C08T/REVEMUE SUDGETED(CIRCLE ONE) YES NO
F1N�IOINp SOURCE ACTIVITY NUMBER
FlNANCIAI INFORMATION:(EXPUIIN)
l��
. � � ��o �Ts,
DIVISION OF I.ICENSE AND P�RMIT ADMINISTRATION DATE f �? U / '
INTERDF.PARTMENTAL KEVIEW (:HECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant �(A�((,�,�� ��y� _ Home Address �(��'� jC�,p�(� W-�� �s
Rusiness Name � � ` (,I �l G�C� Home Phone da �i - �� a5
J
r
Business Address �a� ��,�,�,`,����i� Type of License(s)
Business Phone ID� - (1('���
Public Hearing Date � License I.D. �� ?jg � � �
at 9:00 a.m. in the Council hambers,
3rd floor City Hall and Courthouse State Tax I.D. 4� �j.��`j���
llate Notice Sent; Dealer �� n�/�-
to Applicant
I'ederal Firearms 4� � ,l�
Public Hearing
DATE II�SPECTIUN
REVIEW VERFIED (COMPUTER) CUMMENTS
A roved Not A roved
�
Bldg I & D +
`-� 1 �3 c� �
Health Divn.
I �� I �� !
i
Fire Dept. �
i •
i I .
I �
Police Dept. �/ /
3 � o �
License Divn. , �
�� �� ' o�i
City Attorney �
�� �� � 0 �
Date Received:
Site Plan ��(�
To Council Research
Lease or Letter Date
f rom Landlord ��/k
CURRENT INFORMATION NEW INFORMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bat�a:
Workers Compensation:
New Officers:
Stockholders:
��� . ��
;��`� �ya �
,rL,.`�� �, ' CITY OF S'i'. PAUL
�`b' ,,�� DEPARTMENT OF FINANCE AND,�MANAGENIENT SERVICF.S
LICENSE AND PF.,,t$ C�3T D�VISION
�� ao3� ���t b4e0
�-P� /►'in� S.SIO�.
Please aaswer a11 questions f�lly and completely. This application is thorough� checked.
Any ialsificatioa �rill be cause for denial.
.. . . _ _ � Dat� 3 -a� �9 9Q
l. � Application Por 1�1 ASSaaa. I ►�v"it�o�/ License (Permit) _
2. Name oP applicant 1Vt a r l i P��. ,�ttt�l�T►r-+
3. If applicant is/has been a married female, Iist maiden name •
4. Date of birth 5 �c2 Age Z-`1_Place of birth 5'}���a� . `� � --
5. Are you a citi2en of the United States Native Naturalized
6. Are you a registered vot�r �f5 �ere S�- (�a.c.�.�
—'T—
7. Home Address i a�� ��S�-ed��- /�'�e{s-f-�au i ���me Telephone �SS'U��-S
8. Preseat business address�$�I uvli'J[VSi� ltv'�- S'�{ ��`� Business Telephone �yS-���
s-�3A�r ss i v y�
9. Including your present business employment, what business/employment have you
followed for the past five years.
Business/employment, Address
� �5 1 �e�o�,�o e�%Ei c_ ��11�G.S Sa� jg a 1 t�l�l i �!t✓S i 1�.�,� S,i�e 14�/ s'� �u� .5'S�I 0�/
� �, � �UtM e� '�vdrr_�� C.evv�c� 6�I U a��SUv� Sf� PQ u I �S fU�
�a[r��a w�Pvr♦ !��rt.t�- Cd . I 9 a`1 5 ,S`�'`" S� 1/����S�!S y
I0. Married NV if answer is "yes", list name and adciz�ess of spouse
11. IP this application is for a Massage Therapist License, list time so occupied.
s'��-j� 31 a s�q v Years Months.
12. Have you ever been arrested �U • If answer is "yes", list dates of arrests, where,
charges convictions a.nd sentences.
Date of arrest__ 19 Where
Chaxge
Conviction Sentence __
Date of arrest 19 Where �
Charge
Conviction Sentence
�.
. . . �-�a,��..�
. �,
13. Give names and addresses of two per'sons, residents of St. Paul, Minnesota who can
give information concerning you.
N� . ADDRESS
���L���F.. Ul�l l v G h t �� 1���a �SG20�� r�`1/G S�' !"Q Lt I ,$�S/dS�
o� �a� I�v� 1�4�5 3'�°{�9-v� S M.�l � �'Sy'v9
State of Minnesota )
) SS �
County of Ramsey )
. J`.
(( t" (2�(� � C1 r� ' U 11 being first duly sworn, deposes and says upon oath
that he has read the foregoin statement bearing his signature and knows the contents
thereof, and that the same is true of his own knowledge except as to those matters
therein stated upon information e.nd belief and as to..those matters he believes them
to be true. ,
�� ���.et��-/ �(�' /�,�,�.�,t ��-�i..,
Subscribed and sworn to before me � �
Signature of Applic�_a.n
this �3%� day of A- Z�'- 19 S�
����..�� � � ,
Notary Public, Ramsey County� Minnesota ���
��-�., r,HR'�T"1E A �?��EK
,
q � / 1���NOTARY P!':LIC—trP•r','::SOTA
A�y Commission expires � 1 �`y" • il�.., R�;J;E"i3OU?:Tv
My Cwnmission txpires Aug. t5. 1994
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