89-1792 WHITE - C�TV CLERK COUIICII (//��//�f
PINK - FINANCE G I TY F SA I NT PA IT L j�j�
BLUERy - MAYORTMENT File NO. ,�/���
Coun il Resolu ion �` -
_ r ���
Presented By _
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application ID #88188) for a Massage Therapist License
by Deborah Johnso DBA Grand Tan at 80 No. Snelling Avenue,
be and the same i hereby approved.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
i.ong n Favor ;
Gosw;tz
Rettman D B
Scheibel gai n s t Y
Sonnen
Wilson
��T 5 1989 Form Approved by City Attorney
Adopted by Council: Date .
Cerlified Pass d b Cou il Se etar BY � �� ��
gy,
� ' Approved by Mayor for Submission to Council
6lppro e Mavor. Date —
By By
pI1�IS� 0 C 14 1989
s . ���_ 0 7'_��'
DEPARTM[NT/OFFlCE/COUNGL D TE 1 IATED
Finance/l.icense GREE�I SHEET No. �J02'�
OONTACT PERSOW 8 PHONE �T�V�T� INITIAUDATE
DEPARTMENT aRECTOR �CITY COUNpI
K1^1 S VanHorn/298-5056 � g cmr�rroRr�v 0 cm cxeRK
MUBT 8E ON COUNdL AOENDA BY(DAT� �BUDOET DIRECTOR �FIN.d MpT.8ERVICE3 DIR.
❑�voR�oR�ssisr�wn n2 �C:i 1 R
TOTAL#�OF SKiNATURE PAQE8 ( IP LOCATION�B FOR SIGNATUFtE)
ACTION REQUEBTED:
Application for a Massage T e pist License.
Notification Date: � c� Hearin Date• 10 " $
�co�NOn„o�s:�vv�•c�«�«c�n a��r o�now►�
_PLANNIN(i OO�M�AI8810N _qVIL SERVICE OOMMIS�ON Y PF�ONE NO.
_CIB COMMITTEE _
_$TAFF _ M .
-����� - 251�
8UPPORTB NMICH COUNqL OBJECTIVE? �'�
i ��'�
,�a
n�rru►nNa�.�.oP�nurmr�wno,wn.t,wh.n,wnsre,
Deborah Johnson DBA Grand T n equests Council approval of her
application for a Massage T e pist License at 80 No. Snelling Avenue.
All fees and applications h v been submitted. All required departments
have reviewed and approved hi application.
ADVANTA(iE81F APPROVED:
Dt8ADVANTAOEB IF APPROVED:
C�ur�cE! Research Center,
SCP 21 �989
DISADVANTAOES IF NOT APPROVEO:
TOTAL AMQUNT OF TRANSACTION : COST/NEVENUE SI�ETED(�E ON� YES NO
FUNDING SOURCE ACTIVITY NUMSER
�wwa���awAtiu►norr:��wr�
- � . o , C���=�7��
DiVISION OF LICENSE AND P�:RMIT ADM NISTRATION DATE I3 1�l / b I..3!�/
INTERDF.PARThTFI�'TAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant �/ � `'ly� ' Home Acldress �C.��� �2Y�g��, v�
Rusiness Name �jryM Home Phone �,_Q�,(� ' �'�o��
Business Address � ' (,� Type of License(s) ��,�,���� �,�,u,�
. Q T—���
Business Phone ��1 - �S (� J
Public Hearing Date �O�S (�6�1 License I.D. 4i ��j �S a
at 9:00 a.m. in the Council Chambe s,
3rd floor City Hall and Courthouse State Tax I.D. �� � I�}
llate l�utice Sent; Dealer �� ��}
to Applicant
rederal I'irearms �� �{�f}
Public He�.iring
DATE I SPECTIUN
REVIEW VERFIED, (GOMPUTER) COMMENTS
A proved Not A roved
Bldg I & D `l,�)a +
� �
Health Divn. �/ � ,
� a�i
,
Fire Dept. � � ,
i � I _
! �
� �
Police Dept.
�) a�� � ��
;
License Divn. '
� — ' I
� a-� �
City Attorney �/a� �
1 �
Date Received•
Site Plan � �/
To Council Research l�2���
Lease or Letter Date
from Landlord
. . ,. _ ..
• , ITY OF S'i. PAUL C�� �7��
� DEPARTMENT OF INANCE AND MANAGEMENT SERVICES
LICEN E AND PERMIT DIVISION
Please answer a11 questions fully and completely. This application is thoroughly checked.
Any falsification will be cause for d ial.
Date ��t�t �' 19 Q q
1. Application for i�'�.� �5���,r � � u�� �License)�Permit)
2. Name of applicant '�� �'�� ��� �� ����`
3. If applicant is/has been a maxried female, list maiden name � >,.� �� � �
• � r
4. Date of birth �'- '- ,� � Age �S lace of birth S r � �,� �
5. Are you a citizen of the United St tes `�<: � Native �� Naturalized
� � �;
6. Are you a registered voter V� � W ere �.�a� �a�i�1 ' !� � �+��--��~
-r---- , .
l �,� _�
7. Home Address ) �` � ��?;;C z��z,ti �fi�--�- �� � '�t Ul /ji 1�� Home Telephone e YG - r%� =
8. Present business address ' �r.y>��1.� �r?� ,� ��a-i� �'� Business Telephone
9. Including your present business/em loyment, what business/employment have you
followed for the past five yeaxs. �
Business/employment. � Address
� � � �
- � ._,�.- ��/�' � ��(�,� ��'V L ��- �.�., l
�y� ;7 r"lC.v✓�i �t�f ��.t L.i � r y i �J'�'l
� � �• y . . . , . .
10. Married ��� if answer is "yes", 1 st name and address of spouse
11. If this application is for a Massa e Therapist License, list time so occupied.
'� Years Months.
12. Have you ever been arrested��� f answer is "yes", list dates of axrests, where,
chaxges convictions and sentences.
Date of axrest 19 Whe e
Charge
Conviction Sentence
Date of arrest 19 Where _
Charge
Conviction Sentence
- � � . , � �. , . -�� � ���1�79�
13. Give names and addresses of two p sons, residents of St. Paul, Minnesota who can
give information concerning you.
NANIE ADDRESS
Na � wcvl; lL . oi;, � � _ e.� ls; ��r� zs'� N�az�� sf. Sf. P.��i .���ie2
�" _ 1 `� ( � � �„ � f Y� .� �a y.�rd /��� �i� �.wl sS'//�
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J
State of �Iinnesota )
) �
County of/Ra.nsey )!
�� ' � /'
L�``(t�4L �C ' ��iiuG� •�� b 'ng Qirst duly sworn, deposes and says upon oath
that he '�as read the f ing stateme bearir_g his signature and knows the contents
thereof, and that tt�ane is true of 's oWn knowledge except as to those matters
therein stated upon �nformation and be 'ef a.nd as to those matters he believes them
to be true.
Subs ibed and sworn before me `✓(,
� Sig ture of Applica.nt
thi � , 'day � 19� r
�� � ° � � . .
Not' y Public, Ramsey County, Mi sot
My Commi.ssion expire ::-°�••.. � LLA G. SCHILLINGER
���:�'� NOTARY PUBL► —N��NNESOTA
` RAMSEY COUNTY
`��jt;}r
� My Commission E pires Mar•21.1991