98-815Council File � � 0 � �� S
ORLGfNAL
�
Presented By
Referred To
RESOLUT{ON
GITY OF SAINT PAUL, MlNNESOTA
Committee: Date
��]
RESOLVED:
1
2
3
4
5
6
7
8
9
lo
11
12
13
14
15
16
1't
18
19
20
That application (ID #19980000328} for a Recycling Processing
Center License(s) by DAL INC DBA LAD AUTO at 2A0 SYCAMORE ST
W be and the same is hereby approved with the foliowing conditions:
1.Pursuant to the Special Use Permit #98-131, granted by the
St Paul Planning Commission, the site shall be paved with asphalt
in accordance with the site plan approved by the Zoning Administrator.
This area shall include the temporary holding area, main entry
way to the yard and employee parking/maneuvering area . The
employee parking area shall accommodate (6}six vehicles and shall
be striped in accordance with City parking standards.
2.The remaining yard area shouid be paved with a crushed aggregate.
3.7he drainage of fluids from the vehicle shali occur within
the building designated on the site plan. All extracted fluids
shall 6e stored and disposed of in accordance with applicable
local and federal regulations.
4.Any sediment tracked on to the street shall be removed on a
daily basis. The licensee shall take all necessary precautions
to prevent sediment or other pollutants, on the site, from entering
the storm sewer catch basin in the street at the driveway entrance.
Requested by Department of:
Office of License, Inspections and
Environmental Protection
By:�' �'�G `�-��/
BY: �-- -
Approved by ay r: Date 1(�
By:
Ordinance =.`
Green Sheet � LP60066
Adopted by Council : Date �'�_�.� � �'
Adoption Certified by Council Secretary
Form Approved by City Attorney
41EP/Licensing
tlACT PERSON 8 PHONE
�onn �a.nnes �s+M�
!) 2669073
iT BE ON COUNCIL AGENDA BY
,s� {�tcblt� �arin
TOTAL �f OF S�GNATURE PAGES
)ATE INITIATED
GREEN SHEET
�nivaWate
❑i Ciry Attomey
ASSIfiN
�FpQ ❑2 CountilResearch
No, LP 60066 t �'" �
(CUP ALL LOCATIONS FOR SIGNATURE)
Council approval of the following license appiication: License # 19980000328, for �AL INC, Doing Business !LS LAD AUTO, at 240 SYCAMORE ST W,
inGUding fhe following business type(s): Recyding Processing Center.
RECOMMENDATfONS: Approve(A) Reject(R)
1. HasNiSpersoNfirtneverworkeduntlera contractforthisdepartment�
. PLANNING COMMISSION vES NO
_ CIB COMMITTEE 2. Has this person/firm ever beeo a ciry empbyee�
CIVII SVC CINN, vES NO
Dces this pereonJfirtn possess a skill not normaily passessed by any arrent city employee?
YES NO
. Is this pe5onlfirm a targeted ventlo(!
- YES NO
�&�plain all yes answers on separate sheet and attach to green sheet
JG PROBLEM, tSSUE, OPPORTUNITY (Wtro, What, When, Where, Why):
Council approval for DAL, Inc. DBA (.ad Auto for a Recycling Processing Center at 240 Sypmore St. W.
IF
Counci! Fiese�rc� € �e��
. � . �7,;
'OTAL AMOUNT OF TRANSACTION $
UNDING SOURCE_
!NANG.�L INFORMATION:
XPLAIN)
COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
ACTNITY NUMBER
5 �
��� F `'� #6
Type of License(s) emg applied #6r:
CLASS IIT
LICENS� APPLICATION
THIS APPLICATION iS SLBJECT TO REVIEW BY THE PUBLIC
S
n/ � S
CompanyNazne: !�. R• L. ��
Corporation! Parinaahip / Solc Aoprinonhip
If business is incorporated, give date
Doing Business �s: L A � �y u /v Business Phonc:
ayo w. SrcAnoRf S> PAv� �,n�
St�eet Addresc Ciry State Zip
Business Address:
J q$ l
Between what cross streets is the business located?
Are the premises now occupied7 C.S What
Mail To Address: a�/d w SYLf1 h0/J
r M
ofa,���s� �(E L f G t ,
Which side of the street? s�Y �/7�
CTTY OF SAINT PAI3L '��
os« atL;�, t��tt�� �
and Enviramnrntal Prote�tion/�
350sceatasisete)ao i/f
SentAu�.4.imiaoa SSitll
(b13)166-9090 tns(b1I)36F9I]f -
� ��`� � o �
�
Svxet Addrces CiTy Stam Zip
�
Applicant Information: / (j `
Natne and Title: �A L G L� �{g�• s P�` s
Firot \'liddlc (Maidm) Last Tide
HomeAddress: S$ zOOf QsGEOC� �/� ,��{0�0
scteec naa,�ns c;ry s�ne z;p
DateofBir(h: ����g�Y�I PlaceofBirth: �nCl�r �✓• HomePhone:?fs Z�Y g��'Z
Have you ever bern corrvicted of azry felot�+, crime or violation of any city ordinance othet than Vaffic? YES NO /1
Date of arrest:
Charge: _
Conviction:
Where?
Srntence:
List the names and residrnces of three persons of good moral character, living within the Twin Cities Metro Area, not related to [he app2icant
or financially interested in the premises or business, who may be referred to as to the applicanYs character:
: �A
Go
Ci
sT
io S
List licenses which }'ou currently hold, formerly held, or may have an intetest in:
Have any of the above named Iicenses ever been revoked? YES
ADDI2fiSS
s3 w zowR sr
►G E HY�►G:Mitr S
PHONE
Yg9-o3?S
Z GG-93o3
�?8-�yrb
NO If yes, list ihe dates and reasons for revocation:
?778/97
PLEASE TYPE OR PRI?�rt' I_N INK
Are you going to operate this business personally? � YLS
FirztNnmo
Middle 3nS�iei (]3aidrn)
Home Addrw: SVttt \eme
Are you going to ha�•e a manager or zssist2nt in this business? YES
please complete tl:e following irSormatioa:
NO If not, who wil] operate it? qU ' V ��
Lest Datc of Binh
State Zip PhaxNumber
� hT0 If the manager is not the same as the operator,
First Name .Viiddle Initisl (�lsidrn) Last Date of Birth
Addreeg: Sirce[ Neme City Stam Zip Phone
Please list your emplo}aient history for Lhe previous five (5) yezr period:
$usinesslEmplovment Address
��Q l�} U/�o .S�$a — Zo0 �ST Of�C6GA Iti.� SY0�2�
List all other officers of the corporation:
OFFICER TITLE HOME HOME BUSINESS DATE OF
N1�ME (08'ice Held) ADDRESS PHONE PHONE BIIZTA
NANGYt,!(AR,f tF4-TREA Sfro-�oe�> otGEecn N: ?lS-268.4G�� x2�`G2�o y-2?-YS
If business is a partnership, please include the following infoimation for each partner (use additional pages if necessary):
FintName Middklnitial (Maidrn) Lert DateofBi�th
Fiome Addtesa: $trcet Name
Fintlhame
Middie Initial
City
(Maidrn)
State
�
Homc AdcLxss: Street Name City Stnte Zip Phone Numba
MINNESOTA TAX IDENTIFICATION NUMBER - Pwsuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72)
(Tax Clearance; Issuance of Licensesj, licensing authorities aze required to provide to the State of Minnesota Commissioner of Revenue, the
Minnesota business taY idrnt�cation number and the social security number of each license applicant.
Under ttte Minnesota Government Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the following
regarding the use of the Minnesota Tax Idrntification Number:
- This information may be used to derry the issuance or renewal of your license in the event you owe Minnesota sales, employer's
withholding or motor vehicle �cise taxes;
- Upon receiving this infortnation, the licensing auzhoriry wilt supply it only to the Miimesota Department of Revenue. Howevet,
under the Federal Exchange of Information Agreement, ihe Departmrnt of Revenue may supply ttais infonnation to the Internal
Revenue Service.
Mmnesota Tax Idenrification Numbets (Sales & Use Tax Niunber) may be obtained from ttm State of Minnesota, Business Records Department,
10 Ri��er Park Piaza (612-296-6181).
Social Security Numbes- 39 - ro - 9 8$ 3 ��esota Tax Idem'sfication Number:
_ If a Minnesota Tax Identification Nwnber is not required for ihe business being operated, indicate so by placing an "X" in the box.
2J78J97
Q�' ��
CERTTFICATIOA� OF WORKERS' COMI'ENSATSON COVERAGE PURSUANT TO MINNESOTA STATUTE 176182
I hzrebti� certify thzt I, or my company, am in compiiance nith ihe workers' compensation insurance coverage requirements of A/unnesota Statute
176.182, subdivision 2. I also understand that provision of fzlse informaGon an this certification constitutes sufficient �ounds for adverse action
against all licenses hzld, including revoc2tion end suspension of said licrnses.
i�Tame of Insura��ce Company: S��' V RA ZAS
Po?icyNumber: a��/G30�.SZ�S Coveragefromq'/' to 9 '�` 98
::al e no emplo}'ees covered under ti•o:kers' compensation insurance (I2��ITIALS)
.A?VY FALSffICATIO\ OF Ai\*SWERS GNEN OR hiATERIAL SUBMI'ITED
�VILL RESULT IN DEiVIAL OF TJItS APPLICATION
I hereby state i�:at I have answered all of the preceding questions, and that the information contained herein is true and coirect to the best of
my lmowledge and belief. I hereby state fiuther that I have received no money or other consideratioq by way of loan, gift, contribution, or
othenuise, other than aUeady disclosed in the application which I herewith submitted I also understand this premise may be inspected by police,
fire, health and other ciry oflicials at any and aii times when the business is in operation.
t-Z9-R$
Signature (REQUIRED for ali applications) Date
We will accept payment by cash, check (made payable to City of Saint Paun or credit card (M/C or Visa).
IFPAYINCBYCREDITGIRDPLEASECOMPLETETHEFOLLOIf'INGINFOItMATION: � MasterCazd � Visa
EXPII2ATION DATE: ACCOUNT NtJMBER:
❑oiC]❑ ❑oo❑ 000❑ ❑oo❑ ❑oo❑
for all char¢es) Date
**Note: If llvs application is FoodlLiquor related, pleasc contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review
plans.
1f any substantial changes to sWcture are anticipated, please contact a City of Saint Paul Plan Exanuner at 266-9007 to apply for
building pemuts.
If there are any changes to the parking lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at
266-9008.
All applications require the following documents. Please attach these documents N�hen submitting your appiication:
I. A detailed description of the de�ign, location and square footage of the premises to be licensed (site p3an).
The following data should be on the site plan (preferably on an 8 1!Z" x I I" or 81/2" x 14" paper):
- Name, address, and phone number.
- The sca3e should be stated such as 1" = 20'. ^N should be indicated toward the top.
- Placement of all pertinent feamres of the interior of the licensed facility such as seating sreas, kitchens, offices, repair area,
parking, rest rooms, etc.
- If a request is for an addition or e�cpansion of the licensed facility, indica[e both the cutrrnt area and the ptoposed expansion.
2. A copy of your lease agreement or proof of oumership of the property.
SPECIFIC LICENSE APPLICATIOl�'S REQUII2E ADDTTIONAL IlVFORMATION.
PLEASE SEE REVERSE FOR DETAILS >>>>
2l18/97
Council File � � 0 � �� S
ORLGfNAL
�
Presented By
Referred To
RESOLUT{ON
GITY OF SAINT PAUL, MlNNESOTA
Committee: Date
��]
RESOLVED:
1
2
3
4
5
6
7
8
9
lo
11
12
13
14
15
16
1't
18
19
20
That application (ID #19980000328} for a Recycling Processing
Center License(s) by DAL INC DBA LAD AUTO at 2A0 SYCAMORE ST
W be and the same is hereby approved with the foliowing conditions:
1.Pursuant to the Special Use Permit #98-131, granted by the
St Paul Planning Commission, the site shall be paved with asphalt
in accordance with the site plan approved by the Zoning Administrator.
This area shall include the temporary holding area, main entry
way to the yard and employee parking/maneuvering area . The
employee parking area shall accommodate (6}six vehicles and shall
be striped in accordance with City parking standards.
2.The remaining yard area shouid be paved with a crushed aggregate.
3.7he drainage of fluids from the vehicle shali occur within
the building designated on the site plan. All extracted fluids
shall 6e stored and disposed of in accordance with applicable
local and federal regulations.
4.Any sediment tracked on to the street shall be removed on a
daily basis. The licensee shall take all necessary precautions
to prevent sediment or other pollutants, on the site, from entering
the storm sewer catch basin in the street at the driveway entrance.
Requested by Department of:
Office of License, Inspections and
Environmental Protection
By:�' �'�G `�-��/
BY: �-- -
Approved by ay r: Date 1(�
By:
Ordinance =.`
Green Sheet � LP60066
Adopted by Council : Date �'�_�.� � �'
Adoption Certified by Council Secretary
Form Approved by City Attorney
41EP/Licensing
tlACT PERSON 8 PHONE
�onn �a.nnes �s+M�
!) 2669073
iT BE ON COUNCIL AGENDA BY
,s� {�tcblt� �arin
TOTAL �f OF S�GNATURE PAGES
)ATE INITIATED
GREEN SHEET
�nivaWate
❑i Ciry Attomey
ASSIfiN
�FpQ ❑2 CountilResearch
No, LP 60066 t �'" �
(CUP ALL LOCATIONS FOR SIGNATURE)
Council approval of the following license appiication: License # 19980000328, for �AL INC, Doing Business !LS LAD AUTO, at 240 SYCAMORE ST W,
inGUding fhe following business type(s): Recyding Processing Center.
RECOMMENDATfONS: Approve(A) Reject(R)
1. HasNiSpersoNfirtneverworkeduntlera contractforthisdepartment�
. PLANNING COMMISSION vES NO
_ CIB COMMITTEE 2. Has this person/firm ever beeo a ciry empbyee�
CIVII SVC CINN, vES NO
Dces this pereonJfirtn possess a skill not normaily passessed by any arrent city employee?
YES NO
. Is this pe5onlfirm a targeted ventlo(!
- YES NO
�&�plain all yes answers on separate sheet and attach to green sheet
JG PROBLEM, tSSUE, OPPORTUNITY (Wtro, What, When, Where, Why):
Council approval for DAL, Inc. DBA (.ad Auto for a Recycling Processing Center at 240 Sypmore St. W.
IF
Counci! Fiese�rc� € �e��
. � . �7,;
'OTAL AMOUNT OF TRANSACTION $
UNDING SOURCE_
!NANG.�L INFORMATION:
XPLAIN)
COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
ACTNITY NUMBER
5 �
��� F `'� #6
Type of License(s) emg applied #6r:
CLASS IIT
LICENS� APPLICATION
THIS APPLICATION iS SLBJECT TO REVIEW BY THE PUBLIC
S
n/ � S
CompanyNazne: !�. R• L. ��
Corporation! Parinaahip / Solc Aoprinonhip
If business is incorporated, give date
Doing Business �s: L A � �y u /v Business Phonc:
ayo w. SrcAnoRf S> PAv� �,n�
St�eet Addresc Ciry State Zip
Business Address:
J q$ l
Between what cross streets is the business located?
Are the premises now occupied7 C.S What
Mail To Address: a�/d w SYLf1 h0/J
r M
ofa,���s� �(E L f G t ,
Which side of the street? s�Y �/7�
CTTY OF SAINT PAI3L '��
os« atL;�, t��tt�� �
and Enviramnrntal Prote�tion/�
350sceatasisete)ao i/f
SentAu�.4.imiaoa SSitll
(b13)166-9090 tns(b1I)36F9I]f -
� ��`� � o �
�
Svxet Addrces CiTy Stam Zip
�
Applicant Information: / (j `
Natne and Title: �A L G L� �{g�• s P�` s
Firot \'liddlc (Maidm) Last Tide
HomeAddress: S$ zOOf QsGEOC� �/� ,��{0�0
scteec naa,�ns c;ry s�ne z;p
DateofBir(h: ����g�Y�I PlaceofBirth: �nCl�r �✓• HomePhone:?fs Z�Y g��'Z
Have you ever bern corrvicted of azry felot�+, crime or violation of any city ordinance othet than Vaffic? YES NO /1
Date of arrest:
Charge: _
Conviction:
Where?
Srntence:
List the names and residrnces of three persons of good moral character, living within the Twin Cities Metro Area, not related to [he app2icant
or financially interested in the premises or business, who may be referred to as to the applicanYs character:
: �A
Go
Ci
sT
io S
List licenses which }'ou currently hold, formerly held, or may have an intetest in:
Have any of the above named Iicenses ever been revoked? YES
ADDI2fiSS
s3 w zowR sr
►G E HY�►G:Mitr S
PHONE
Yg9-o3?S
Z GG-93o3
�?8-�yrb
NO If yes, list ihe dates and reasons for revocation:
?778/97
PLEASE TYPE OR PRI?�rt' I_N INK
Are you going to operate this business personally? � YLS
FirztNnmo
Middle 3nS�iei (]3aidrn)
Home Addrw: SVttt \eme
Are you going to ha�•e a manager or zssist2nt in this business? YES
please complete tl:e following irSormatioa:
NO If not, who wil] operate it? qU ' V ��
Lest Datc of Binh
State Zip PhaxNumber
� hT0 If the manager is not the same as the operator,
First Name .Viiddle Initisl (�lsidrn) Last Date of Birth
Addreeg: Sirce[ Neme City Stam Zip Phone
Please list your emplo}aient history for Lhe previous five (5) yezr period:
$usinesslEmplovment Address
��Q l�} U/�o .S�$a — Zo0 �ST Of�C6GA Iti.� SY0�2�
List all other officers of the corporation:
OFFICER TITLE HOME HOME BUSINESS DATE OF
N1�ME (08'ice Held) ADDRESS PHONE PHONE BIIZTA
NANGYt,!(AR,f tF4-TREA Sfro-�oe�> otGEecn N: ?lS-268.4G�� x2�`G2�o y-2?-YS
If business is a partnership, please include the following infoimation for each partner (use additional pages if necessary):
FintName Middklnitial (Maidrn) Lert DateofBi�th
Fiome Addtesa: $trcet Name
Fintlhame
Middie Initial
City
(Maidrn)
State
�
Homc AdcLxss: Street Name City Stnte Zip Phone Numba
MINNESOTA TAX IDENTIFICATION NUMBER - Pwsuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72)
(Tax Clearance; Issuance of Licensesj, licensing authorities aze required to provide to the State of Minnesota Commissioner of Revenue, the
Minnesota business taY idrnt�cation number and the social security number of each license applicant.
Under ttte Minnesota Government Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the following
regarding the use of the Minnesota Tax Idrntification Number:
- This information may be used to derry the issuance or renewal of your license in the event you owe Minnesota sales, employer's
withholding or motor vehicle �cise taxes;
- Upon receiving this infortnation, the licensing auzhoriry wilt supply it only to the Miimesota Department of Revenue. Howevet,
under the Federal Exchange of Information Agreement, ihe Departmrnt of Revenue may supply ttais infonnation to the Internal
Revenue Service.
Mmnesota Tax Idenrification Numbets (Sales & Use Tax Niunber) may be obtained from ttm State of Minnesota, Business Records Department,
10 Ri��er Park Piaza (612-296-6181).
Social Security Numbes- 39 - ro - 9 8$ 3 ��esota Tax Idem'sfication Number:
_ If a Minnesota Tax Identification Nwnber is not required for ihe business being operated, indicate so by placing an "X" in the box.
2J78J97
Q�' ��
CERTTFICATIOA� OF WORKERS' COMI'ENSATSON COVERAGE PURSUANT TO MINNESOTA STATUTE 176182
I hzrebti� certify thzt I, or my company, am in compiiance nith ihe workers' compensation insurance coverage requirements of A/unnesota Statute
176.182, subdivision 2. I also understand that provision of fzlse informaGon an this certification constitutes sufficient �ounds for adverse action
against all licenses hzld, including revoc2tion end suspension of said licrnses.
i�Tame of Insura��ce Company: S��' V RA ZAS
Po?icyNumber: a��/G30�.SZ�S Coveragefromq'/' to 9 '�` 98
::al e no emplo}'ees covered under ti•o:kers' compensation insurance (I2��ITIALS)
.A?VY FALSffICATIO\ OF Ai\*SWERS GNEN OR hiATERIAL SUBMI'ITED
�VILL RESULT IN DEiVIAL OF TJItS APPLICATION
I hereby state i�:at I have answered all of the preceding questions, and that the information contained herein is true and coirect to the best of
my lmowledge and belief. I hereby state fiuther that I have received no money or other consideratioq by way of loan, gift, contribution, or
othenuise, other than aUeady disclosed in the application which I herewith submitted I also understand this premise may be inspected by police,
fire, health and other ciry oflicials at any and aii times when the business is in operation.
t-Z9-R$
Signature (REQUIRED for ali applications) Date
We will accept payment by cash, check (made payable to City of Saint Paun or credit card (M/C or Visa).
IFPAYINCBYCREDITGIRDPLEASECOMPLETETHEFOLLOIf'INGINFOItMATION: � MasterCazd � Visa
EXPII2ATION DATE: ACCOUNT NtJMBER:
❑oiC]❑ ❑oo❑ 000❑ ❑oo❑ ❑oo❑
for all char¢es) Date
**Note: If llvs application is FoodlLiquor related, pleasc contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review
plans.
1f any substantial changes to sWcture are anticipated, please contact a City of Saint Paul Plan Exanuner at 266-9007 to apply for
building pemuts.
If there are any changes to the parking lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at
266-9008.
All applications require the following documents. Please attach these documents N�hen submitting your appiication:
I. A detailed description of the de�ign, location and square footage of the premises to be licensed (site p3an).
The following data should be on the site plan (preferably on an 8 1!Z" x I I" or 81/2" x 14" paper):
- Name, address, and phone number.
- The sca3e should be stated such as 1" = 20'. ^N should be indicated toward the top.
- Placement of all pertinent feamres of the interior of the licensed facility such as seating sreas, kitchens, offices, repair area,
parking, rest rooms, etc.
- If a request is for an addition or e�cpansion of the licensed facility, indica[e both the cutrrnt area and the ptoposed expansion.
2. A copy of your lease agreement or proof of oumership of the property.
SPECIFIC LICENSE APPLICATIOl�'S REQUII2E ADDTTIONAL IlVFORMATION.
PLEASE SEE REVERSE FOR DETAILS >>>>
2l18/97
Council File � � 0 � �� S
ORLGfNAL
�
Presented By
Referred To
RESOLUT{ON
GITY OF SAINT PAUL, MlNNESOTA
Committee: Date
��]
RESOLVED:
1
2
3
4
5
6
7
8
9
lo
11
12
13
14
15
16
1't
18
19
20
That application (ID #19980000328} for a Recycling Processing
Center License(s) by DAL INC DBA LAD AUTO at 2A0 SYCAMORE ST
W be and the same is hereby approved with the foliowing conditions:
1.Pursuant to the Special Use Permit #98-131, granted by the
St Paul Planning Commission, the site shall be paved with asphalt
in accordance with the site plan approved by the Zoning Administrator.
This area shall include the temporary holding area, main entry
way to the yard and employee parking/maneuvering area . The
employee parking area shall accommodate (6}six vehicles and shall
be striped in accordance with City parking standards.
2.The remaining yard area shouid be paved with a crushed aggregate.
3.7he drainage of fluids from the vehicle shali occur within
the building designated on the site plan. All extracted fluids
shall 6e stored and disposed of in accordance with applicable
local and federal regulations.
4.Any sediment tracked on to the street shall be removed on a
daily basis. The licensee shall take all necessary precautions
to prevent sediment or other pollutants, on the site, from entering
the storm sewer catch basin in the street at the driveway entrance.
Requested by Department of:
Office of License, Inspections and
Environmental Protection
By:�' �'�G `�-��/
BY: �-- -
Approved by ay r: Date 1(�
By:
Ordinance =.`
Green Sheet � LP60066
Adopted by Council : Date �'�_�.� � �'
Adoption Certified by Council Secretary
Form Approved by City Attorney
41EP/Licensing
tlACT PERSON 8 PHONE
�onn �a.nnes �s+M�
!) 2669073
iT BE ON COUNCIL AGENDA BY
,s� {�tcblt� �arin
TOTAL �f OF S�GNATURE PAGES
)ATE INITIATED
GREEN SHEET
�nivaWate
❑i Ciry Attomey
ASSIfiN
�FpQ ❑2 CountilResearch
No, LP 60066 t �'" �
(CUP ALL LOCATIONS FOR SIGNATURE)
Council approval of the following license appiication: License # 19980000328, for �AL INC, Doing Business !LS LAD AUTO, at 240 SYCAMORE ST W,
inGUding fhe following business type(s): Recyding Processing Center.
RECOMMENDATfONS: Approve(A) Reject(R)
1. HasNiSpersoNfirtneverworkeduntlera contractforthisdepartment�
. PLANNING COMMISSION vES NO
_ CIB COMMITTEE 2. Has this person/firm ever beeo a ciry empbyee�
CIVII SVC CINN, vES NO
Dces this pereonJfirtn possess a skill not normaily passessed by any arrent city employee?
YES NO
. Is this pe5onlfirm a targeted ventlo(!
- YES NO
�&�plain all yes answers on separate sheet and attach to green sheet
JG PROBLEM, tSSUE, OPPORTUNITY (Wtro, What, When, Where, Why):
Council approval for DAL, Inc. DBA (.ad Auto for a Recycling Processing Center at 240 Sypmore St. W.
IF
Counci! Fiese�rc� € �e��
. � . �7,;
'OTAL AMOUNT OF TRANSACTION $
UNDING SOURCE_
!NANG.�L INFORMATION:
XPLAIN)
COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
ACTNITY NUMBER
5 �
��� F `'� #6
Type of License(s) emg applied #6r:
CLASS IIT
LICENS� APPLICATION
THIS APPLICATION iS SLBJECT TO REVIEW BY THE PUBLIC
S
n/ � S
CompanyNazne: !�. R• L. ��
Corporation! Parinaahip / Solc Aoprinonhip
If business is incorporated, give date
Doing Business �s: L A � �y u /v Business Phonc:
ayo w. SrcAnoRf S> PAv� �,n�
St�eet Addresc Ciry State Zip
Business Address:
J q$ l
Between what cross streets is the business located?
Are the premises now occupied7 C.S What
Mail To Address: a�/d w SYLf1 h0/J
r M
ofa,���s� �(E L f G t ,
Which side of the street? s�Y �/7�
CTTY OF SAINT PAI3L '��
os« atL;�, t��tt�� �
and Enviramnrntal Prote�tion/�
350sceatasisete)ao i/f
SentAu�.4.imiaoa SSitll
(b13)166-9090 tns(b1I)36F9I]f -
� ��`� � o �
�
Svxet Addrces CiTy Stam Zip
�
Applicant Information: / (j `
Natne and Title: �A L G L� �{g�• s P�` s
Firot \'liddlc (Maidm) Last Tide
HomeAddress: S$ zOOf QsGEOC� �/� ,��{0�0
scteec naa,�ns c;ry s�ne z;p
DateofBir(h: ����g�Y�I PlaceofBirth: �nCl�r �✓• HomePhone:?fs Z�Y g��'Z
Have you ever bern corrvicted of azry felot�+, crime or violation of any city ordinance othet than Vaffic? YES NO /1
Date of arrest:
Charge: _
Conviction:
Where?
Srntence:
List the names and residrnces of three persons of good moral character, living within the Twin Cities Metro Area, not related to [he app2icant
or financially interested in the premises or business, who may be referred to as to the applicanYs character:
: �A
Go
Ci
sT
io S
List licenses which }'ou currently hold, formerly held, or may have an intetest in:
Have any of the above named Iicenses ever been revoked? YES
ADDI2fiSS
s3 w zowR sr
►G E HY�►G:Mitr S
PHONE
Yg9-o3?S
Z GG-93o3
�?8-�yrb
NO If yes, list ihe dates and reasons for revocation:
?778/97
PLEASE TYPE OR PRI?�rt' I_N INK
Are you going to operate this business personally? � YLS
FirztNnmo
Middle 3nS�iei (]3aidrn)
Home Addrw: SVttt \eme
Are you going to ha�•e a manager or zssist2nt in this business? YES
please complete tl:e following irSormatioa:
NO If not, who wil] operate it? qU ' V ��
Lest Datc of Binh
State Zip PhaxNumber
� hT0 If the manager is not the same as the operator,
First Name .Viiddle Initisl (�lsidrn) Last Date of Birth
Addreeg: Sirce[ Neme City Stam Zip Phone
Please list your emplo}aient history for Lhe previous five (5) yezr period:
$usinesslEmplovment Address
��Q l�} U/�o .S�$a — Zo0 �ST Of�C6GA Iti.� SY0�2�
List all other officers of the corporation:
OFFICER TITLE HOME HOME BUSINESS DATE OF
N1�ME (08'ice Held) ADDRESS PHONE PHONE BIIZTA
NANGYt,!(AR,f tF4-TREA Sfro-�oe�> otGEecn N: ?lS-268.4G�� x2�`G2�o y-2?-YS
If business is a partnership, please include the following infoimation for each partner (use additional pages if necessary):
FintName Middklnitial (Maidrn) Lert DateofBi�th
Fiome Addtesa: $trcet Name
Fintlhame
Middie Initial
City
(Maidrn)
State
�
Homc AdcLxss: Street Name City Stnte Zip Phone Numba
MINNESOTA TAX IDENTIFICATION NUMBER - Pwsuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72)
(Tax Clearance; Issuance of Licensesj, licensing authorities aze required to provide to the State of Minnesota Commissioner of Revenue, the
Minnesota business taY idrnt�cation number and the social security number of each license applicant.
Under ttte Minnesota Government Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the following
regarding the use of the Minnesota Tax Idrntification Number:
- This information may be used to derry the issuance or renewal of your license in the event you owe Minnesota sales, employer's
withholding or motor vehicle �cise taxes;
- Upon receiving this infortnation, the licensing auzhoriry wilt supply it only to the Miimesota Department of Revenue. Howevet,
under the Federal Exchange of Information Agreement, ihe Departmrnt of Revenue may supply ttais infonnation to the Internal
Revenue Service.
Mmnesota Tax Idenrification Numbets (Sales & Use Tax Niunber) may be obtained from ttm State of Minnesota, Business Records Department,
10 Ri��er Park Piaza (612-296-6181).
Social Security Numbes- 39 - ro - 9 8$ 3 ��esota Tax Idem'sfication Number:
_ If a Minnesota Tax Identification Nwnber is not required for ihe business being operated, indicate so by placing an "X" in the box.
2J78J97
Q�' ��
CERTTFICATIOA� OF WORKERS' COMI'ENSATSON COVERAGE PURSUANT TO MINNESOTA STATUTE 176182
I hzrebti� certify thzt I, or my company, am in compiiance nith ihe workers' compensation insurance coverage requirements of A/unnesota Statute
176.182, subdivision 2. I also understand that provision of fzlse informaGon an this certification constitutes sufficient �ounds for adverse action
against all licenses hzld, including revoc2tion end suspension of said licrnses.
i�Tame of Insura��ce Company: S��' V RA ZAS
Po?icyNumber: a��/G30�.SZ�S Coveragefromq'/' to 9 '�` 98
::al e no emplo}'ees covered under ti•o:kers' compensation insurance (I2��ITIALS)
.A?VY FALSffICATIO\ OF Ai\*SWERS GNEN OR hiATERIAL SUBMI'ITED
�VILL RESULT IN DEiVIAL OF TJItS APPLICATION
I hereby state i�:at I have answered all of the preceding questions, and that the information contained herein is true and coirect to the best of
my lmowledge and belief. I hereby state fiuther that I have received no money or other consideratioq by way of loan, gift, contribution, or
othenuise, other than aUeady disclosed in the application which I herewith submitted I also understand this premise may be inspected by police,
fire, health and other ciry oflicials at any and aii times when the business is in operation.
t-Z9-R$
Signature (REQUIRED for ali applications) Date
We will accept payment by cash, check (made payable to City of Saint Paun or credit card (M/C or Visa).
IFPAYINCBYCREDITGIRDPLEASECOMPLETETHEFOLLOIf'INGINFOItMATION: � MasterCazd � Visa
EXPII2ATION DATE: ACCOUNT NtJMBER:
❑oiC]❑ ❑oo❑ 000❑ ❑oo❑ ❑oo❑
for all char¢es) Date
**Note: If llvs application is FoodlLiquor related, pleasc contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review
plans.
1f any substantial changes to sWcture are anticipated, please contact a City of Saint Paul Plan Exanuner at 266-9007 to apply for
building pemuts.
If there are any changes to the parking lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at
266-9008.
All applications require the following documents. Please attach these documents N�hen submitting your appiication:
I. A detailed description of the de�ign, location and square footage of the premises to be licensed (site p3an).
The following data should be on the site plan (preferably on an 8 1!Z" x I I" or 81/2" x 14" paper):
- Name, address, and phone number.
- The sca3e should be stated such as 1" = 20'. ^N should be indicated toward the top.
- Placement of all pertinent feamres of the interior of the licensed facility such as seating sreas, kitchens, offices, repair area,
parking, rest rooms, etc.
- If a request is for an addition or e�cpansion of the licensed facility, indica[e both the cutrrnt area and the ptoposed expansion.
2. A copy of your lease agreement or proof of oumership of the property.
SPECIFIC LICENSE APPLICATIOl�'S REQUII2E ADDTTIONAL IlVFORMATION.
PLEASE SEE REVERSE FOR DETAILS >>>>
2l18/97