90-1323 0 R!G!N A L - Council File # �- 3
Green Sheet � 622
RESOLUTION
ITY OF SAINT PAUL, MINNESOTA ��
Presented By
Referred To � Committee: Date
RESOLVED: That application (I.D. 4�97914) for a Massage Therapist License applied for
by Cynthia A. LeRoy DBA Sister Rosalind Gefre's Professional Massage
Center at 1999 Ford Parkway be and the same is hereby approved.
__` ea� Navs Absent Requested by Department of:
n 4
wi z �— License & Permit DivisTOn
on �
acca ee �
�ma �
u e _� By:
z son
u
Adopted by Council: Date AUG 2 ��g� Form Approved by City Attorney
Adoptio Certified by Council Secretary gy: ry-�•9a
By� Approved by Mayor for Submission to
PP Y Y �'��,l9oAUG 2199�un�il
A roved b Ma or: Date
By: By�
PUBLtSNED AU G 1 11990
. � . � * _ ,dr-�p-/3� 3 �'�j1�'
�-
DEPARTMENT/OFFICE/COUNCIL DATE INITIATED G R E E N S H E ET �0 -10 6 2 2
Finance/License
CONTACT PERSON&PHONE INITIAVDATE INITIAUDATE
�DEPARTMENT DIRECTOR �CITY COUNCII
Kris Van Horn/298-5056 ASS�aN �CITYATfORNEY �CITYCLERK
MUST BE ON COUNCIL AGENDA BY(DATE) NUMBER FOR ❑BUDGET DIRECTOR �FIN.&MaT.SERVICES DIR.
ROUTINO
ORDER �MAYOR(OR ASSISTANn ��
� � �
TOTAL#OF SIGNATURE PAG S (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTED:
Application (I.D. 4�97914) for a Massage Therapist License
RECOMMENDATIONS:Approve(A)or Reject(R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING GUESTIONS:
_PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �• Has this persoNfirm ever worked under e contrect for this department?
_CIB COMMITTEE _ YES NO
2. Has this person/firm ever been a city employee?
_STAFF - YES NO
_DIS7RIC7 CouRT _ 3. Does this person/firm ssess a skill not normall
po y possesaed by any current city employee?
3UPPORTS WHICH COUNCIL OBJECTIVE7 YES NO
Explain all yes answers on separate shast and attach to gnsn shaat
INITIATINCi PROBLEM,ISSUE,OPPORTUNITY(Who,What,When,Where,Why):
Cynthia A. LeRoy requests Council approval of here application for a Massage Therapist
License at 1999 Ford Parkway doing business as Sister Rosalind Gefre's Professional
Massage Center. All applications and fees of $83.50 have been submitted. All required
departments have reviewed and approved this application.
ADVANTAGES IF APPROVED:
DISADVANTAGES IFAPPROVED:
DISADVANTAGES IF NOT APPROVED:
RECEIVED
Cat�r�c�V [t�� ��
�Ul.251�,90 ��� 2��g�a
CITY CLERK -- - -
TOTAL AMOUNT OF TRANSACTION S COST/REVENUE BUD6ETE0(CIRCLE ONE) YES NO
FUNDING SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION:(EXPLAIN) d w
- `'' � . ,
NOTE:' COMPLETE DIRECTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIONAL
MANUA�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 suthorized budget exists) COUNCIL RESOLUTtON(Amend Budgets/Accept.Grants)
i. Outside Agency 1. Department Director
2. Department Director 2. City 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. City 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. Cfty 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 paperclip or flag
each 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 project/request 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 citys 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 your 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 City 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 i5 not
approved? Inabiliry 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?
,. . �-yo_,3�3
.
UtVISION OF LICENSE AND PERMIT ADMINISTRATION DATE ��LC.� / �j(j
INTERDF.PARTMENTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant n� � L _ Home Address ����yP,�,�,-�A�r-U I�.,M,) .
��,,. m f�
r .
Rusiness 1V'ame ; � �� �;� ��� Home Phone _ �� y — ��c��Y,
� �
Business Address _�C'c� . � � TYPe of License(s) `�}'�C.��.�Ci�-� � �t`Lt.L�S�
Business Phone ��- �I�?, _
Public Hearing Date �� ' License I.D. �{ ��� (�
at 9:00 a.m. in the Counci Chambers,
3rd floor City Hall and Courthouse State Tax I.D. 4� ;�/n �,�a 1
llate Nutice Sent; Dealer 4� � � �
to Applicant "
rederal Firearms �� Yl �q
Public Hearing
DATE II�SPECTIUN
REVIEW VERFIED (COMPUTER) COMMENTS
A roved Not A roved
�
Bldg I & D +
� y
Health Divn. '
�i� � � ' o� l .
�
Fire Dept. � _
i f .
A
I I
Yolice Dept. I I
� a b� +� �-�-o
License Divn. �
� ( ,� � ��
City Attorney �
�, [ � , o-.�
Date Received:
Site Plan � l�
To Council Research
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:
. . . . ��.�0'/.3,�3
CITY OF S'i. PAUL '
�EPARTMENT OF FIV�,NCE AND �tANAGII�NT SERVICLS �
LICENSE AND PERMIT DIVISION
Plesse aaswer a.l.l questions f�lly a.ad completely. This application is thoroughly checked.
Any falsification �rill be cause for denial.
Date �� Q �a 192�
I. Applicaticn for M A 5 sa� � TN-E�An f s % �� c�N s ,.d�� (License)(Permit)
2. Name of applicant Cvn� rr� ,/a A.�.vc L�°�c:y -
3. Zf applicant is/has been a married female, list maiden name � /vQ -FL _
�. Date of birth /� .-�.a /-; Age�_Place of birth ,Sq s�rr 5-.= /���.F h�t� �c�^'
5. Are you a citizen of the United States y�� Native � Natvralized
6. Are you a registered voter yES w�ere kA-Gf+.�
7. Home Address 7/'{ j���,,, r, �n�.n .�,.; �, � c�nn h /�l� Hame Telephone 'S!S y- 7��i,�
s,�;-�� r_�s«.r,•�r � �,?s—,
8. Present business address lqn 4 �_•.) a,;x, .p v Sr.rA��c. Business Telephone�,�1!�-`'/.C�3
9. Including your present business/employment, What business/employment have you
followed for the past five years.
Business/employment. Address
7cN'i R L I-�Y G i E�/S�/�'�S. C,rU�f Dn�.1�117.�S. C/'a.r�, 7y C T --
�
r ��-
l�.�n,r�i l�v l-�c r�s,�/ 1�, �E4 Tr t�, !�M,7
10. Maxried�if ansWer is "yes", list name and adc2ress of spouse.�Ah t� P. L.e.��y
� � � �lLc r.�T 1,., rc�� F.Prn,� �/�C fl� ��.v fS'/ 3 �
11. IY this application is for a Me.ssage 'I'herapist License, list time so occupied.
- Years � Moaths.
I2. �ave you ever been arrested �0 • If aasver is "yes", list dates of arrests, Where,
charges convictions and sentences.
Date of arrest 19 Where
Chaxge
Conviction Sentence
Date of arrest 19 �ere
C:�axge
Conviction Sentence
� - _ . �yQ -�.3�3
� 13• Cive na�es a.�3 addresses of two persons, :esidents oP �t. Pai.;I., Ms.n3esota �rho csn
give information conceraiag �ou.
iYAME . ADDR�SS
State of i�innesota )
) SS
County of Ra.msey )
being first duly sworn, denoses ?nd says t�pon o�th
that he .as read t�:e �oregoing statement bearing his signature and kno*.�s �he content�
ther=of, and that the same is true of his own knowledge except as to ±hose matters
therein stated u�on informat?on a.nd 'oelief and as to those matters he believes then
to be true.
Subscribed �.nd s•Norn to before ne C`�" '`'ti� � ` �E`"`
Signature of Appl�nt
this �� day of ����,Q 19 Cl(�
�_�.�__.J:?- Y`Cc��J i�CR,,�
Nctarf ?ublic, � „ County, Minnesota ■ ,
� 1'i�� KRISTINA L.VAN HORN
�1 Commission e i,��NOTARYPUBLIG—MINNESOTA
_ y xpires �i � 1� �
OAKOTA COUNTY
�Vly Commiss�on Expues Jan.2, 1992
��v�nnnMnM�n
•