89-1795 WHITE - GTY CLERK
PINK - FINANCE G I TY O SA I NT PA U L Council ///�
BLUERy - MAVORTMENT File NO. �• -/�� -
Coun il Resolution �q�
Presented By
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application ( D #47298) for a Massage Therapist License
by Mavis Doten DBA Sister Rosalind's Professional Massage
Center at 1999 Fo Parkway, be and the same is hereby approved.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
�� [n Favor
cosw;tz
Reriman ,(� B
Sc6eibel A gai n s t Y
Sonnen
Wilson
�C''r 5 � Form App oved by City Att ney
Adopted by Council: Date •
Certified Pas b Counc.il S tar BY
�/r .-
By
"� � Approved by Mayor for Submission to Council
Ap rove Mavor. Date ��' —
g By
pUgltS�D 0 C T 14 1989
� � � � ���I--/79�'
DIVISION OF LICENSE AND P�RMIT A.I)MI ISTRATION DATE �l� ��I l �S(
INTERDF.PARTMENTAL kEVIEW CHECKLIST A�pn Processed/Received by
Lic Enf Aud
Applicant (�V�S��� Home Address � \ ��w'��c����4h�„
[
Rusines5 IvTame � Home Phone ��n_ 1�� �
���
Business Address �CL Type of License(s) �.-�r.
Business Phone � -� �a 3
Public Hearing Date 3 �� License I.D. 4f �'7ag' �
at 9:00 a.m. in the Council Chauib' s,
3rd floor City Hall and Courthous State Tax I.D. 4t a�� (�O�
llate Notice Sent; Dealer 4� i` ��
to Applicant
rederal Pi.rearms 46 � �.
Public He�.�ring
Dt1TE TNSPECTIUN
REVtEW VERFI D (COMPUTER) CUMMENTS
A rove Not A roved
�
Bldg I & D �I �
�
Health Divn. n' '
�� a , ��
�
Fire Dept. � �
i
j � � �- -
� �
Police Dept. �I� I
0 y1,b
�I �
License Divn. '
a � �
City Attorney �I �
, / � d�
Date Rece ved:
Site Plan /
To Council P.esearch ��ZO(�1
Lease or Letter Date
from Landlord
� �� ����
DEPARTM[NT/OFFlCE/COUNCIL D TE 1 TED
Fi nance/�i cense GREEN SHEET No. 50(�g
CONTACT PERSON 8 PHONE INITIAU DATE INITIAUDATE
DEPARTMENT DIl�CTOR CITY COUNqL
Kri s VanHorn/298-5056 � g c�TV ArroaNev �C1TY CLERK
MUST BE ON COUNCIL AGENDA BY(DAT� �BUDC�IIET DIRECTOR �FIN.8 MOT.SERVICES DIR.
• �MAYOR(OR A38i8TMIT) ��,IILLI��7�
TOTAL#�OF SIGNATURE PAOE8 ( I LL LOCATIONS FOR SIGNATI�R�
ACTION REWEBTED:
Application for a Massage h apist License.
Noti fi cati on Sent: ��[ta tla�:
F�COMMENDATIONS:MP��(N a R�(R) L REP OPTIONAL
_PLANNINO COMMI8810N _qVIL SERVIC�COMM18810N ��E�.
_as�� —
ENTB:
_8TI1FF _
—���o�� — R�CEIVED
SUPPORTS NMIGI OOUNp��JECTIVE�
IWTIATINO PF�BL.EM�188UE�OPPORTUI�ITY(IAlho.Nlh�t,Wlan.Whs►e�
�.��`� (�� �i ':'.
Mavis Doten OBA Sister Ro a nd's Professional Massage Center requests
Council approval of her a p cation for a Pqassage Therapist License at
1999 Ford Parkway. All f e and applications have been submitted. All
required departments have r iewed and approved this application.
ADVMfTA6E3 IF APPROVED:
DIS/0.DVANTAOEB IF APPRGVED:
Council Research Center,
SEP 21 i989
DISADVANTAOES IF NOT APPROVED:
TOTAL AMOUNT OF TRANSACTION C08T/REVENIIE BUDOETED(qRCLE ONE) YES NO
FUNDIN�i SOURCE ACTMTIf NUMBER
fINANGAI INFORMATION:(D(PWN)
• � • " � ' ���1--/��1'S�
�� TY_ OF S'i. PAUL
DEPARTMENT OF NAI�CE A1VD MANAGF,MENT SERVICES
LICEN E AND PERMIT DIVISION
Please answer a11 questions fully and ompletely. This application is thorough� checked.
Any falsification will be cause for d ia1. /�
Date � �T � 19�
1. Application for L e E u S C (License)�Permit)
2. Name of applicant /'1'1 A ✓� 5 d 7 a"'
3. If applicany�is as been a marrie female, list maiden name � /�f}7 T/N G✓"
. �...l� � . 1
b. Date of birth - 30- Age �`J' Place of birth n L.O Q U � 7 � /h N
/9 3t
5. Are you a citizen of the United tates��Native Naturalized
6. Are you a registered voter �5 �ere��j' R.po(LC..`f�./ ��/✓f��
7. Home Address �Da / fj�lJi?�E Iiome Telephone S��'�8/S
8. Present business address m C� Business Telephone�/ 2 3
9. Including your present business employment, �rhat business/employment have you
followed for the pa.st five year .
Business/employme Address
.�� o ' o d s � �� /�00 (,?J. 1►4-�t �. � S, SS�t�B
� �
,,3 �t ' P�Rrg 1-� � � ✓� U L
10. Married if answer is "yes ', list name and address of spouse
� ao Tc� - � E,� � ,� o(c�Y� G'7 M N .
il. If this application is fo: s . essa.g° 'L'here�ist License, Iist time so occupied.
Years Months.
12. Have you ever been arrested � If answer is "yes", list dates of arrests, where,
charges convictions and sente ces.
Date of axrest 19 Where
Chaxge
Conviction Sentence _
Date of arrest 9 Where
Charge
Conviction Sentence _
� ° . . - ���1`�7�5�
,_ _.
13. Give r.ames a.�d 3ddresses of :wo persons, residents of St. Paul, Mi.nnesota �aho can
give infor�ation conceraing you
N� ADDRESS
S.a- �r f r (�.c.v
S r� �o dv .�1 e� oa tJ lo 0 0 �0.�,0
State of ;4innesota )
� Jj
Count;� o f Ra.ms ey )
eing first 3uly svorn, 3enoses and says u�on oath
tnat �e ::as read t:e °o�egoi:!g statem nt beaxing '�is sigaati;re a.nd knows the contents
t�ereof, and that t::e same is true of his own knowledge except as to those matters
therein stated upor. informat�or. and b lief and as to those atters he beli es then
to be t�ue.
4
Subscribe3 and sworn to before �e
Signature of Applican�
th?s�^day of 19�_
�� � •
"To ax'�j =uol:r� : a�asey Count�r, �Iinneso a KRIST(NA L.VAN HORN - �
��,�NOTARY PUBLIC—MINNESOTA '
�� DAKOTA COUNTY �
i4y Conmiss�on expire � A YN���on Expires Jan. 2, i�g? s
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