89-1797 WMITE - CiTV CLERK
PINK - FINANCE G I TY O SA I NT PAU L Council /J
CANARV - OEPARTMENT ��/��i
BLUE - MAVOR File NO.
Coun 'l Resolution ��
�
I ��
Presented By
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application ( D #20895) for a Massage Therapist License
by Margaret Hersch 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
Lo� n Favor
Goswitz
Rettman o B
scne;n�� _ gainst Y
sonnen
Wilson
_ �, Form Appr ved by City Attorney
Adopted by Council: Date � •
Certified Yasse y ouncil , By ' � ?� �
gy —
4
A►ppro y �lavor: Date �- Approved by Mayor for Submission to Council
By
14
. � ��-���
DEPARTMENT/OFFICE/COUNCIL DA IN TED
Finance/�icense GREEN SHEET No. 5�74
CONTACT PERSON 3 PHONE �NITIAU DATE INITIAUDATE
�DEPARTMENT DIRECTOp �CiTY COUNpL
Kri s VanHorn 298-5056 � F� ��ATTORNEY �CITY CLERK
MUST BE ON COUNCiI AOENDA BY(OAT� �BUDOET DIRECTOR FIN.8 MQT.SERVICES DIR.
�MAYOR(OR ASSIBTANT)
TOTAL#OF SIGNATURE PAGES ( P L LOCATION8 FOR SIQNATUt�
ACTION REQUESTED:
Application for a Massage T e pist License.
Notification Date: °� 2a
RECOMAAENDATIONB:MP��IN a�1�(Al REPORT OPTIONA�
_PLANNINf3 COMMISSION _CIVIL 8ERVI�OOMMI8SION Y PMONE 1�.
_d8 COMMITTEE _
—��� — M $� �'�CEIVED
—����� —
BUPPORT3 WHICH CalNqL OBJECTIVE7 S�P��,�
tNITIATINO PROBLEM�IS�IE.OPPORTUNITY(Who�WhN.WMn.WMro� YI. \-. :._Y �� ��,,,4
Margaret Hersch DBA Sister Ro lind's Professional Massage Center requests
Council approval of her ap li ation for a Massage Therapist License at
1999 Ford Parkway. All fe s nd applications have been submitted. All
required departments have ev ewed and approved this application.
ADVANTIUiES IF APPROVED:
I
OISADVANTA(iES IF APPROVED:
Catt�ce! �esearch Center.
S�P 21 i989
DI8ApVANTAOES tF NOT APPROVED:
TOTAL AMOUNT OF TRANSACTION S COST/pEVENUE dllDfiETED(qRCLE ONE) YES NO
fUNDINO 80URCE ACTIVITY NUM9ER
FINANGAL INFORMATION:(EXPLAIN)
.^lccrl�t ..t�G�- Z��}ti�7�c7'�.
� � ` ���-��47
DIVISION OF LICENSE ANT) PERMIT ADMIN STRATION DATE ��_1� / 1 3
INTERDF.PARTMF.NTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant ��--_ Home Address ���J� �nc��
Rusiness Name �(�Home Phone (p�-[a- � �l�`j
Business Address �J� � c..a� Type of License(s) �Ct�a-GlR �i'�v���
Business Phone � . /
Public Hearing Date lp - � License I.D. �l G�4��S
at 9:00 a.m, in the Council Chamber ,
3rd floor City Hall and Courthouse State Tax I.D. 4� p� � (�a."j F�6
llate ATUtice Sent; Dealer 4� 1� ��
to Applicant
I'ederal Pirearms 4� ��
Public Hearing
DATE I�'SPECTIUN
REVIEW VERFI� (COMPUTER) CUMMENTS
Ap roved Not A roved
�
Bldg I & D i �
� � �r o
Health Divn. '
' `� IZ� ' �
� ��
�
Fire Dept. � ( _ .
i �
I
�
I I
Police Dept. �'a I
Q�
�
License Divn. '
R� �; ' ��
City Attorney �
��Z ��
,
Date Rece'ved:
Site Plan
To Council P.esearch ��2p f��j
Lease or Letter Date
from Landlord
`� ,:.,
�" >��� �i.:...,�,: ��';� ,��`, �
�� �' �� �,
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-- - " '1 Z 0!" S'i. PAUL /�j� �,9/
��!"''�_W DEPARTMENT OF INANCE AND MANAGEI�PT SERVICES c/�`
LICEN E AND PERMIT DIVISION
Pleaae aasver a11 questions fully and completely. This application is thorough]�y checked.
Any falsification �rill be cause Por d nial.
' Date � v�� 19�
.
1. Application £or -SSa G � (License) Permit)
2. Name of applicant
� � I
3. If applicant is/has been a marri d female, list maiden name � -2V���`
�+. Date of birth�d� Age �° Place of birth��� �'^
5. Are you a citizen of the United tates � Native Naturalized
6. Are you a registered voter Where �i�n�� 2� �"'SU ✓��
1
7. Home Address 3 �,J Home Telephone (o� Z �d� y
8. Present business address � � '�� Business Telephone��l�-�l�Z-3
9. Including your present busines /employment, what business/employment have you
Polloved for the past five ye s.
Business/employment. Address �, �;
� - cti ' v� .2 ,�_S �.�,,,,� 1�ta�t �c� � �-�1 , ..f�r�c�
� �..ic__. �- �G�—
y�,� a-0, � — �Ol�-�� —
� " " list aeme aad address of spouse
10. Married if ansxer is ye ,
11. If this ap lication is for a Masasge Therapiat Licenae, list time so occupied.
` y"/g 7 � z,�- � � ��^�_ Months.
Years
12. Have you ever been arrested :� Zi aaswer is "yes", list dates of arrests, where,
charges convictions aad sen ences.
Dat of arrest 19 Where
Charge
Conviction Sentence
Date of arres 19 �ere -
Char
Conviction Sentence
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e�osauu�ti ay� o� apjnoad o� paiTnbaa a * aaj���o4�ns 8ujsusajt '(sasua�T1 )o a�aans�i :a�ue
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_ __,.. . - ----
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13. Give names a.zd addresses oP `WO pers ns, residents oP St. Paul, Minnesota who can
give infor�ation concerning you.
:vAl� I�'��S. � I� l l� c.� /O SU FAD RESSO�- " ' -Q .
l�Q Gl S �0 (� SO �-�Yv�0•� r I v-�-
�- C c�o v
State oF Minnesota )
� ►S3
Countf of Ra.msey )
bei g first 3uly s�rorn, 3eposes and says upon uath
that 'r.e "as read t'_:e foregoing state�ent bearing �is signati:re �.nd knows the contents
t?:ereof, a,nd tha� �Y:e same is t:-ue of hi own knowledge except as to those matters
therein stated upor. information and beli f and as to those matters he believes thea
to be t:-ue.
Subscribe3 an3 sworn to before �e ' 1V/� v— It"C�� ��-L./
Signature of Applicsnt
this cay of 19
?Totaxy Fub1=c, �s.�sey CountJ, �Iinnesota
�•'� Cc�miss:on expires
Subacribed and ��orn t0
before me thie `S day
BETHANY A.EqV€S '"
o f����19$�� NOTARY PU811G��}fNNESpTA
HENNEPiN�pUN1�,
MY Cemmisswn Expires Feb ]U, 1yg�
•
i�ioZ�r� Puhlia