89-1236 WHITE - CiTV CLERK
PINK - FINANCE GITY O AINT PAUL Council /�
CANARY - DEPARTMENT ����/3�
BLUE - MAVOR File NO. �� � -
Co n 'l Resolution ,, ��
. � .
Presented By
Referred To Committee: Date
Out of Committee By Date .
RESOLVED: That application (ID 52 5) for a Massage Therapist License by
Randy Wo1ff DBA Siste R alind's Professional Massage Center at
, be d he same is hereby approved.
j Y y� ��� P�cKW�-�
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
Long �fl F8 Ot
�•6eswiia�
Rettman �,? B
sche;n�� _ A gai n t Y
Sonnen
Wilson
SEP 2 8 g Form Approved by Ci A orney
Adopted by Council: Date � ' �
Cert�fied Passe cil Se By � �/� '�y
By
Approv b �Vlav r. Date Approved by Mayor for Submission to Council
By BY
�t181.i�ED �C T '7 1 9
- • � - . �d�I/�3G
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DEPARTMENT/OFFlCEICOUNCIL DATE INI TED
' Fi nance/�i cense GREEN SHEET No. 4����
CONTACT PER80N R PHONE DEPARTMENT OIRECTOR �CITY OOUNqL
KY'1 S VanHorn/298-5056 Nu� � GTY AITORNEY �CITY CLERK
MUST BE ON COUNqL AOENDA BY(DA7� ROU71N BUDOET DIRECTOR �FIN.3 MQT.BERVICE8 DIR.
MAYOR(OR ASSIBTANn ��,,QLLCiG]-� R
TOTAL#OF SI(iNATURE PAGES (CLIP A L ATIONS FOR SIGNATURE)
ACTION REOUESTED:
Application for a Massage Therapi t icense.
NCl►I'�F'TCATICIJ DA'1'F: 6-21-89 I�,RUVG DAZ�: 7-11-89�
RECOMMENDATION3:Approve pu a Rs�sct(i� COUNCIL OM ITTEE/RESEARCH i�PORT OPTIONAL
_PLANNING COMMISSION _dVIL SERVICE COMM18810N A��YST PFIONE NO.
_pB CO�AMITTEE _
COMMEN :
_3TAFF _
_DISTRICT COURT
SUPPORTS WHICH COUNCIL OBJECTIVE?
INITIATINQ PROBLEM.ISSUE.OPPORTUNITY(Who.What.When,Whero,Wh»:
Randy Wolff requests Council appr va of his application for a Massage Therapist
License at 734 Grand Avenue DBA S st r Rosalind's Professional Massage Center.
All required applications and fee h ve been submitted. All required departments
have reviewed and approved this a pl cation.
ADVANTAOES IF APPROVED:
DISADVANTAQES IF APPROVED:
a8ADVANTAQES IF NOT APPROVED:
Counci! Research Center
J UN 2 7 �989
TOTAL AMOUNT OF TRANSACTION = COST/REVENUE BUDOETED(qRCLE ON� YES NO
FUNDINO SOURCE ACTIVITY NUMBER
FlNANCIAI INFORMATION:(EXPWN)
� � � � . . ��-y-,a3 4
DIVISION OF LICENSE AND PERMIT ADMIN ST TION DATE �1 L1 / (.Q (p
INTERPF.PARTMF.NTAL REVIEW CHECKLIST A.ppn Processed/Received by
Lic Enf Aud
Applicant�j�(,tv ��j���_ Home Address � � �`� �� �ts•�, ���
-�
Rus ine s a Iv'ame �V�� � ome Phone �3� - �9�JOv�j
�
Business Addre�ss Type of License(s) �r ��
�
Business Phone a�� - �� �
Public Hearing Date � License I.D. �6 C/,�a"'j,-�
at 9:OQ a.m. in the Council ambers
3rd floor City Hall and Courthouse State Tax I.D. �t �,�,-5�j �'(d5�j
llate Notice Sent; � . � �n Dealer �� I! I/�-
to Applicant � "1
I'ederal Pisearms �� y� �
Public Ne�.�ring
DATE INS 'C UN
REVtEW VEKFIED ( TER) COMMENTS
A proved t roved
�
Bldg I & D (o/ �
� �� ! o
�5
Health Divn. � �
, t� � C5 �
;
� ,
,
Fire Dept. �
i
� �1 ��, � O[�
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Police Dept. (p�� f
� D�i �<c:�--�
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License Divn. '
��a �
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City Attorney �
(� �r�., , 6 .�
Date Received:
Site Plan �
To Council P.esearch
Lease or Letter Date
f rom Landlord � I�-
-�
� � . ' ' ' C Y F S'�. PAUF, ��'f,"'I���
• � DEPARTMENT OF F 'A E A2�T MANAGEMENT SERVICES
LICENS A1 PERMIT DIVISION
Please answer a11 questions fully and c mp etely. This application is thoroughly checked.
Any falsification will be cause for den a1
Date � — /— 19 ��1
�
l. Application for �i� �License)�Permit
2. Name of applicant �✓c� L O �
3. If applicant is/has been a married em e, list maiden name �
� ��P ac of birth �G'�/r � �i Fo��'✓,�l
4. Date of birth���.` � Age —
5. Are you a citizen of the United Sta es � � Native�_Naturalized
6. Are you a registered voter�Wh re �<✓
7. Home Address /O �/� Sr SE L Home Telephone �.���%�'�
8. Present business address Business Telephone
9. Including your present business/emp o nt, what business/employ,nent have you
folloWed for the past five years.
Business/employ�ent. Address
' D �
�L�c���i a.-✓ ��r,����=��� �
10. Married/v� if answer is "yes", li t eme and address of spouse
11. If this application is for a M assag erapist License, list time so occupied.
Ye s lO Months.
/
12. Have you ever been arrested /1/(� I swer is "yes", list dates of arrests, where,
chaxges convictions and sentences.
Date of axrest 19 Wher
Charge
Conviction Sentence
Date of axrest 19 Wh re
Charge
Conviction Sentence _
� � � C,���--i.�`�
y3. Give .^.ames a.^.d �.ddresses of �wo perso:�s r s�dents of �t. Paul, Minnesota �ho can
give inTor�a�ion concerning you.
!VAi+fE 4DDRESS
State of t4innesota )
� J�7
Count;� �°•�sey )
r` '
�.i<�l�c � � ' oeing ir t 3uly sworn, 3eposes and says upon oath
t:at =e :=asi" °ad �:e fo.e oi:!g statement be i g '.:is sigaatt:se an3 knows the contents
t?�ereof, and that �"e same is true of his o nowledge except as to those matters
t�erein stated upor. information and belief d as to those matters he believes then
to be �rue. /�
/ �2�2� ,��j/'
Subscribe3 ar.d s�.rorn t eior° me � �
� G ignature o Applicant j�
t _s ��-- cay f !��i�-�___l9 D�
( �-*�.L '/ .:-/ � %/' .
:Totary Fuol=r� �a.�sey Count�r, ylinneset
:-1�r Cenmiss_on expires .:;:w•.. . S HILLINGER
;1�jN-!� '0is NOTARY PUB C— INNESOTA
'��`���� Rarfs� c UNTY
��
��•� My Commission xpir s Mar.21,1991
-- . ��_,,�3�
� .°�••�• � CITY OF SAINT PAUL
�� ` DEPARTMENT OF COMMUNITY SERVICES
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���,�� ^,,, , . ,_ - - t.� DIVISION OF PUBUC HEALTH
,.�. , � 555 Cedar Street,Saint P�ul,Minnesota 55101
Ceorge Latimer (612)292•7747
Mayor
M�j� 19, 1989
Mr. Raric3y lnblff
ll07-4th St. S.E.
Mpls., r�. 55414
Dear Mr. Wblff:
I am happy to i.nfonn you that you hav p3ssed the m�ssage therapist
written and practical eaaminatio . ou m3y naa m3ke a���lication for a
license at the Licer�se Inspe�tor' Of ice, Roan 203 City Hall, 15 W.
E:ellogg Blvd., St. Paul, N�. 5510 .
Bring this letter with you when application.
Yaurs tnzly.
<;,�% �2%��'/�1
Gary . Fech;t3rm ,
Ea�virorniental Health Prograr;� r�na
GJP/tn5g
c: Jos�h ��ecli,
Liaense Division