89-660 Whi1TE - CITV CLERK COl1I1C11 �9 �La
PINK - FINANCE G I TY O� SA I NT PAU L �+
CANARV - DEPARTMENT �
Bl_UE - MAVOR � (']le NO•
-C un i Resolution ; ;-;;�
��� '�� �°�
Presented By --
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application ( D 90914) for a Massage Therapist License
by Johnathan E. Wa ne at 255 No. Smith Avenue DBA ExerCare
Service (a service of United Hospital ) , be and the same is
hereby approved.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
�ng In Fa or
Goswitz
Rettman 0
�he1�� _ A gai n t BY
Sonnen
Wilson
APR 1 J � Form Appr ved by City Att ney
Adopted by Council: Date -
Certified Passe ouncil Se ar By 3 L 3 �
sy-
A►ppro d by iNavor. Date _ Approved by Mayor for Submission to Council
By BY
PUBtIS�E1f AP R � 1 89
1 � . . I . � �� ..
«�►,�„ : �,,� ..� �,�� . �'iR�� �v�EE1' r�o: 0 02�515
. . . . . � . DEPAR7MEM OMECTOR ; . . - . MAYqt(Ofi AB818TAN'i)� .
Kris VanNo�rn p� — �.��� �«,�«�
�. — ;
� ��*� ; . � CounciT Research
' �inance 8 .M t. 98-5056 , l,.��� , _ . , _ ,; _
�,
Applicatian fo.� a Massage Therapi t icense. ;
Notification D�te: 3-29-89 Hearing Date; 4-'13=89
i � �
nor�s:uion�we u+>«►� ) aEPO�rr:. :
r��ww�c oow�asioN cm4 b�nce c�aeiasioN o���+ oaTS arr u�uvsr �No.
aa�a oo�asioi+ �eo�es acrroo�eo� ,
. -- �-�SMFF . . . � � . . CIN�I7ER COANMS8�71(��. AS IS � -ADDL MFO.� . ��RE7U TO OGIlCA�T - .Cqi�IAtIB1T - .
. _POR.ADD'l M�O. ,_f�ACK MDED• .
OIBTRIC�CCUNCIL � � � *IX � . . _ .. . .� - . .
� � 9UPPOA78�YNYCN OOINCIC OBJEC7NE7 � I �. .� . . � . . . .. �. � .. . .� . . . �� � . . � . .
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. . . . � � i � � . . � � � i . . . � . . . . . .. . � : �
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... _ . . ... . . . ,� . - - . � . .. . . , . . .
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.. . � � . . . . � . . -. . . t . ' � � � � � ' ... �. . ' . � .. . � . , . . � . . . � . .
RIik1M10'*IIO�I.EM,I�MIE, {
EMrt�.N�►bt.WINn.VNrro.1MrYY _
�
Johnathan f: �gner requests Coun i1 approva1 of his ap�lication for a
Massage Therap st .License at 255 0. Smith [�1 ExerCareiSerYice .(a Se�vice ,
af Ur�ited Naspital ). . . _
�
,
�
.�rwc�e„oN�i�. ; �, . ,; .
,I _
All applicatio�ts and fees have be n ut�itted. A11 req ired departments
have,.reviewed alnd �approved tt�is a pi. cation. � "
�
GON�iOAI�t(1MMR iM�a'fndTo Wlwink : ,, .:. : ° � • : , ° . ,
I ,
If Council .appnoval is not receiv d, Johnathan Wagner wi�ll not �ae allo�ed-
to practice ma�sage therapy at th s ocation.
. , . ; i
�u.r�nvES: _ : ' ca�s
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. _ ;
I
Co ncil Research Center
�►�: ; MAR 2 9 i989
_ , I � _
, �
,
`�'��12.02 Thi s fa.ci l i ty i s 1 i censed nd r N�l. Statues 144.�0 througfi 144.7�3 and
does not require a Ptaysical- Cultu a1 Health .Services Clujb L�cense.
;
. . Cl "J�^ �� C7
DIVISION OF LICENSE AND PERMIT ADMI IS RATION llATE �J 'i I� / � ( I �S�I
INT�;RDF.PARTMFNTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant �py����N �, � Home Address '?���j�C3Y�C�C� 1�-cx _��
Rusiness Name � �r� `jEr Home Phone '13� 'v��C(�j
Business Address p�`j 5 �v Srn� Type of License(s) �����qy���,-����-
Business Phone ��o"� -S-S�l�
Public Hearing Date � License I.D. 4{ C(Q���
at 9:00 a.m. in the Council C amber ,
3rd floor City Hall and Courthouse State Tax I.D. 46 �� o��t`1
llate Notice Sent; � Z� �� #ID Dealer �f �Iq
to Applicant
rederal Pi.rearms 46 ���
Public He�.iring
DATE TNS EC IUN
REVtEW VERFIED ( 0 UTF.R) CUMMENTS
Approved ot A roved
�
Bldg I & D 3I ZU �
Q '�j
Health Divn. 3 I ' �
Zd ' d
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Fire Dept. �
; � �a-� i 6�i
� I
Police Dept. 3�� I
G k. ►�t� .12s�c-e�,,�
�
License Divn. '
� �
a� ' ��,
City Attorney 31 a 3 � Q �
Date Received:
Site Plan
To Council RPSearch 3 � Z.�( l �
Lease or Letter Date
from Landlord � �
CURRENT INFORMATION NEW INFOftMATION
Current Corporation Name: New Corporation Name:
Current DBA: New DBA:
Current Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
Stockholders:
� • • C Y F S'i. PAUL
DEPARTMENT OF F A E AND MANAGEI�NT SERVICy'S
LICENS A PERMIT DIVISION
Please answer a11 questions fully and c mp etely. This application is thoroughly checked.
Any falsification will be cause for den al
� Date 2 Z� 19 �
l. Application Por �'l� �.u- ` �(sL icense �Permit)
2. Name of app
lica.nt � 61... � �
3. If applicant is/has been a married em e, list maiden name �
4. Date of birth 2 (� Age 2. ""� ac of birth ('� b ��--
5, Are you a citizen of the United St es �Native Naturalized
6. Are you a registered voter� e�' v" �
7. Home Address 7� J� �Z�D Home Tele hone —� �
Lk�.��,yZ� 2��5-g2SD
S. Present business address � 02, S�y,.v� Business Telephone
9. Including your present business/em lo ent, vhat business/employment have you
followed for. the past five yeaxs.
Business/employment, Address
l�.o� � � �� ,. 3�3 ��--��.�� ����w
���� ��J�� i ,_:::�...�, ��6 1 .
(N�u.�LJ ee��e� �� � t��eT�... �.-,�� ` �
��a�
U.Vl,ii � �
10. Married ✓l, iP answer is "yes", ist name and address of spouse
��� �� -�(,
11. If this application is for a M a s e Therapist License, list t�me so 0
r /l/�c-J�''� �'��� ��5 Months.
S rS u ,�
12. Have you ever been axrested � If answer is "yes", list dates of arrests, where,
chaxges convictions and sentences
Date of axrest 19 Wh re
Chaxge
Conviction Sentence
Date of arrest 19 ere
Charge
Conviction
Sentence
13. Give names and addresses of two per on , residents of St. Paul, Minnesota Who can
give information concerning you.
N� ADDRESS
��J � `� � _ �� ���v�l�-� �� . ��-;��
_3�� �-c�� ��.���..
State of �Iinnesota �
) SS
County of Ra.msey )
� S�hc�,�w✓� l , .
C - �.V bei 'rst duly sworn, deposes and says upon oath
that he has read tY:e forego ng statement e ing his signature and knows the contents
th�reof, and that the sa,me is true of his' o knowled�e except as to +hose matters
therein stated upon information and beli d as to those matters he believes them
to be true.
Subscribed an�3 sworn to before me - �. � �
ignature of App 'can+
thi s ,�_day o f `�� 19 ��
���. -��J . ,
No a.r;� Public, � County, Minnesota � KRISTINA L.VAN HORN
�, ���NOTARY PUBLIC—MINNESOTA
�R.y OAKOTA COUNTY
t�y Co�ission expires o� � My Commission Expues Jan.2. 1992
u v��n+vwwvv�n '
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.«•••. � CITY OF SAINT PAUL
"� ' DEPARTMENT OF COMMUNITY SERVICES
.
� i�� e .
' DIYISION OF PUBIIC HEALTH
���� 555 Cedar Street,Saint Paul,Min�usoa 55101
George latimer (612)292-7741
Mayor
Octaber 2, 1987
- Mr. Jonatl��n Wac�er
. 1816 St.evens Ave. (#26)
Miru�ea1�olis, Nh. 55403
j Dear Mr. Wacg�er: .
I a¢n ha�y to infortn yau that ha passed the m�.ssage therapist
w�'itteri alxl p�iCdj Pxamina� . Ycu msy rryw m3ke a�lication for a
license at the Liaen.ge Ins�pec.vtor s fice, Roaii 203 City Hall, 15 W.
Kellogg Blvd., St. Paul, Mn. 551 2.
Bring thi.s letter with yrxz when a�.plicati,on. .
. %=
�`f�' Yw�rs tavly.
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p � ;;;: ;:� ��.:� ....:�.w,�a�s �
�'�r• ; �; ,F'tr s a� ►
�`'`���;���� ��,��°'� ~
Frank A. Staff
. ._ ._ �nriro�nental . , Direct�,or
� � FAS/ac
c: Joseph Camhad.i,
Lioen.9e Divisi�
� ,