90-2107 0 � i � � � � L Council File � —
Green Sheet � L2339
RESOLUTION `
CITY OF SAINT PAUL, MINNESOTA '� "; }
� �;.
Presented By �
Referred To ' Committee: Date
,
RESOLVED: That Application (I.D. ��10730) for a Massage Therapist License
a�plied for by Margarita Treskunova DBA Sister Rosalind Gefre's
Professional Massage Center at 1999 Ford Parkway be and the
same i� hereby approved.
Yeas Navs Absent Requeated by Department of:
i zon '�"
o w z ��
on ��"" License & Permit Division
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acc ee �
et msn ��
une �"�
i son � BY�
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Adopted by Council,: Da�e NOV 2 7 1990 Form Approved by City Attorney
, .
Adoption Certified by Council Secretary
sy: /Cl �/7-96
By' Approved by Mayor for Submission to
Approved by Mayor: Daite / -�` �'�� Council
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By: ///_/.�,/%�.ic�<<,-.�%C.-Cl�� By�
pUBtiSNFD ��� � 1990_
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DIVISION OF LI�ENSE�AND PERMIT ADMINISTRATION DATE � /��c�
INTERDEPARTMEN'�AL R�VIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant � ' � � �,,�• Home Address 'n
{.�..1►�U� �5�.o� � �� _+�-o��� �
Business Name ; � �j�o�Home Phone (��j X- �2vr'(LY
, ''''i(:�-5` �
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Business Addre$s '��j(,1�G� �GQ�� Type of License(s) (�5�,�('�����
� � cJ/
Business Phone ( Q ��— � ( ��
Public Hearing 'Date I �►`-z� I q�> License I.D. � 1 C�"� �O
at 9:00 a.m. i� the �Council Chambers,
3rd floor City IHall '�,and Courthouse State Tax I.D. 4� � p�-,� �,a�
Date Notice Se�t; , Dealer � �I�
to Applicant ' i
Federal Firearms � � 1,p�
Public Hearing '
' �I
i
� DATE INSPECTION
REVIEW VERFIED (COMPUTER) COMMENTS
' A roved Not A roved
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Bldg I & D II �
'� I , 6
Health Divn. l I �
� tv�� �
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0
Fire Dept. , � .
, �
, �
Police Dept. ,
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License Divn.' f
, ���,b I o K
City Attorneyi �
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�C�I �-I i �
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I�ate Received:
Site Plan � I` :
To Council Research
Lease or Letter��, � Date
from Landlord
,,
. . �-�o-�r��
' CITY OF S'i. PAUL
DEPARTMENT OF FINANCE AND iKANAGEMENT SERVICES ' ,
LICENSE AND PERMIT DIVISION
Please a.nswer all questians f�lly a.nd completely. This applicatioa is thorough� checked.
Any falsification vill be cause for denial.
Date 19
l. Application for� M �A SS A G E T H C R A P f Sr L i C F_/0/C�(License)(Permit)
2. Name of applicant 7i�r- s i< u N Q VA ! ` 1 f} (Z G/4 R I r/-�
3. If applicant is/has been a married female, list maiden name �
4. Date of birth �� 7 � Age 5 7 Place of birth (� .S.S Q
�4-`� �-z3�o-I 3 `i
5. Are you a citizejn of �he United States�vNative Naturalized wn�1� �'i= 2 M ,
6. Are you a registered yoter�Where _
7. Home Address �S E S �S't. I�G v L. fFVQ G l�� ' :/ �"fi�(u�'F�ome Telephone �+9� �!'�����
�.P�� Z
8. Present business address � 9 5 9 F O R� PN R k W�� Business Telephone 6,� �� �
9. Including yovr presenit business/emploqment, what business/employment have you
folloWed for the past five yeaxs. � ;
Business/employment, - � .. .'�.� ` Address
�1/OT �►� ��i ��! �A L -
�
10. Married�if a�nsWer is "yes", list name and adc3ress oP spouse
11. If this application is �or a Massage Therapist License, list time so occupied.
r
F I 1� � Years p iV C.� S S � Months.
�
12. Have you ever been asrested /C/�. If answer is "yes", list dates of arrests, vrhere,
charges convictions a.ad sentences.
Date of arrest�� 19 where
Chaxge
Conviction Sentence
Date oY ar:est 19 �ere
Charge
Conviction Sentence _
' • � � �'q�o?/�7
�
. .
13. Give names a.nd addresses of two persons, residents of St. Pai.;l, Minzesota �rho can
give information cpncerning you.
iVpldE . ADDRESS
�2 o � r_ RT u�,ENS1� i N ��rou �cFC � woofli 5-�- ���
� � _ AiVi� ,Jhaai2 � � 4 �C �� F_ � iv�RA /�vr_ � Sfi• P�.u �
State of Minnesota ) '
) SS
County of Ramsey ) ,
T� E S 1<U N O✓;A M,�l�(ZG�4 R f tA being Pirst duly sworn, deposes a.nd says �:�on o�th
that he has read tl:e fo�egoing statement bearing his signature and knows the contenta
thereof, a.nd that the s�e is true of his own knowledge escept as to those matters
therein stated upom infclrmat�on and belie� and as to t�ose matters he believes the�
to be true.
f
Subscribed and s*�orn to before ae �2.v3K-t�'rl-o 'VQ �1Q2 '�''�v �,' .
Signature of Appiicant
this ,� dajy of CG`}OP��19 �O +
� ��'�`-��'y� '!i'�' �� NOT�PUBGC—MI NESOTA
Notaxy Public, Ran�ey County, Minnesota WASWINGTON COUMY
�A'Cortmas�on Ezpres NdV 6.1995
A1y Commission expixes �fl U �' 1 c1� �
- P��� �
DEPARTMENT/OFFICE/COUNCIL DATE INITIATED
F�nan�e�Li�en$e GREEN SHEET N° _ 12139
CONTACT PERSON&PHONE INITIAVDATE INITIAUDATE
�DEPARTMENT DIRECTOR �CITY COUNCIL
Kris Van Horn/29 5056 ASSIGN Q CITYATTORNEY �CITYCLERK
NUMBEH FOR
MUST BE ON COUNCIL AOEN A BY DATE) ROUTING �BUDGET DIRECTOR �FIN.&M�T.SERVICES DIR.
1''OY' Hearing: ��Pa"4 �� ORDER �MAYOR(ORASSISTANT) � (!rn�nri 1
• i a (ao
TOTAL#OF SIGNATURE AGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTED:
Application (I.D. ��107 0) for a Massage Therapist License
RECOMMENDATIONS:Approve(A)or eject(R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING GUESTIONS:
_ PLANNING COMMISSION CIVIL ERVICE COMMISSION �• Has this person/firm ever wOrked under a contfact for this department?
_CIB COMMITTEE YES NO
2. Has this person/firm ever been a city employee?
_STAFF
YES NO
_DISTRIC7 COURT 3. Does this person/firm possess a skill not normaliy possessed by any current cfty employee?
SUPPORTS WHICH COUNCIL OBJE IVE7 YES NO
Explain all yes anawers on separate sheet and attach to green sheet
INITIATINO PROBLEM,ISSUE,OPPO TUNITY( ho,What,When,Where,Why):
Ma.rgarita Treskun va r quests Council approval of her application for a Ma.ssage Therapist
License at 1999 F rd P kway (Sister Rosalind Gefre's Professional Massage Center). All
applications and ees o $83.50 have been submitted. All required departments have reviewed
and approved this appli ation.
ADVANTAGES IF APPROVED:
DISADVANTAOES IF APPROVED:
DISADVANTAGES IF NOT APPROVED:
aEC��v�o -�, .� .,
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NQV191g9p . � - ., �.���,���-
Nu`�! 1 � ;�;�0
�:r� e�ERK
TOTAL AMOUNT OF TRANSACTI S COST/REVENUE BUDGETEp(CiRCLE ONE) YES NO
FUNDING SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION:(EXPIAIN) ,�(�
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