89-1798 WHITE - CiTV CIERK CO�IRCII � /A� [J
PINK - FINANCE
CANARV - DEPARTMENT G I TY O SA I NT PALTL � �f
BLUE - MAVOR File NO.
Coun il Resolution (�� �
�.__
Presented By __ __
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application ID #24130) for a Massage Therapist License
by Mary Jane Heim 1 DBA Sister Rosalind's Professional Massage
Center at 1999 Fo d Parkway, be and the same is hereby approved.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
�� [n Favor
Goswitz
Rettman -D
Scheibel A gai n s t BY
Sonnen
Wilson
OCT 5 1989 Form Ap oved by Cit Att tney
Adopted hy Council: Date • G
Certified Ya.s d Coun ' ecre y BY � �6
Bl,
C
A►p rov y Mavor: Date — Approved by Mayor for Submission to Council
By.
p�� C T 14198�
� s • ��'�r—�7��'
DEPARTM[Nt/OFFICEICOUNCIL D INITIATED
Finance/�icense GREEN SHEET No. �J02S
OONTACT PERSON 3 PNONE ��T�w�TE INITIAUDATE
�DEPARTMENT DIRECTOR �CRY OOUNpL
Kri s VanHorn/298-5056 � �CITY AITORNEY �qTV CLERK
MUST BE ON COUNCIL AOENDA BY(DAl'� �BUDOET DIRECTOR �FIN.8 MaT.SERVICES DIR.
�MAYOR(OR A8818TANT)
TOTAL#►OF 81ONATURE PAOES ( ALL LOCATIONS FOR 81pNATURE'
ACTION REGUEBTED:
Application for a Massag erapist License.
Notification Sent:
Fl�con��rron�s:Mw�w a�cR) NCIL
_PUINNINO COMMIS�ON _qVIL 8ERV1�COMM Y� PHONE NO.
_q8 COMMITTEE
_�� _ M��: r�CE1V�D
—��� —
���,�,����E��,�� SEP 2�19�
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Mary Jane Heimel DBA Sis e Rosalind'.s Professional Massage Center requests
Council approval of her p ication for a Massage Therapi.st License at
1999 Ford Parkway. All e and applications have been submitted. All
required departments hav viewed and approved this application.
ADVANTAQES IF APPROVED:
DISADVANTA(iE81F APPRONED:
Counci! Research Center
SEP 21 i9�9
d3ADVANTAQE8IF NOT APPROVED:
TOTAL AMOUNT OF TRANSACTION = COST/REVENU�BUDOETED(CIRCLE ONE) YES NO
FUNDINQ SOURCE ACTMTr NUM9ER
FlNANCIAL INFORAAI►TION:(EXPLAIN)
. . � ��.�7��'
DIVISION OF LICENSE AND P�:RMIT AD NISTRATION DATE �I �1.� / � �
INTF,RDF.PARTMFNTAL REVIEW CHECKLIS Appn Processed/Received by
Lic Enf Aud
Applicant I I� � Home Address �1U � - '��l�r�rm � -
Lt.�-S`� •
Rusiness Iv'ame 5; �.rV(C��ome Phone �� _ /j-cjl S�
`�o
Business Address ��lq � Type of License(s) � AS�-��- ����-
Business Phone �-
Public Hearing Date � �j License I.D. 4{ a ��3U
at 9:00 a.m. in the Council Cham, ers,
3rd floor City Hall and Courthou e State Tax I.D. �t �{ �, 3�?S��J
llate Notice Sent; Dealer 4f � ��
to Applicant
rederal Pirearms �� n �q
--�
Public Nearing
�
DAT INSPECTIUN
REVIEW VERF ED (COMPUTER) CUMMENTS
A rov d Not A roved
�
Bldg I & D �
�I �I
Health Divn. '
�
� �2 ' a
Fire Dept. � . •
i
j � �A-c�
I (
Police Dept. �� I
� G�
License Divn. ,
� � ' � �
, �
City Attorney �Ia �
i Q�
Date Rec� ved:
Site Plan
To Council P.esearch ylao��
Lease or Letter Date
from Landlord n �'
. . : . � ��-�-����'
CITY OF S'i. PAUL
DEPARTMENT 0 FINA�ICE A13T MANAGEMENT SERVICES
LIC NSE AND PERMIT DIVISION
Please a.asver a11 questions ftiilly d completely. This application is thorough� checked.
Any falsification will be cause For denial.
� 7.����,�� Date 7 19�
r � t" �'ft y
1. Application for icense)(Permit)
2. Name of applicant
3. If applicant is/t� t�aa a marr ed female, list maiden name � �l1/
4, Date of birth / Age -� Place of birth �—
. i
5. Are you a citizen of the Unite States d�Native � Naturali2ed
6. Are you a registered voter Where �//" � �'�"'�'�' ��
7. Home Address D Home Telephone �
8. Present business address Business Telephone�9�z-3
9. Including your present busines /employment, what business/employmeat have you
followed for the past five ye s.
Business/emplo,/ment, Address
� . . (°J�°fYD 1�' h���� ,/
' ��C��u�� ���
� � � � ��� ���
L ` ` ` l449 �� ��� ���T
10. Married�if answer is "ye ", list name and address of spouse
. , �� ' ,,
. �
;-�/o
11. If this application is for a assage Therapist License, list time so occupied.
--Years Months.
12. Have you ever been arrested if answer is "yes" , list dates of arrests, vhere,
charges convictions and sent nces.
Date of axrest_ 19 Where
Chaxge
Conviction Sentence
Date of arrest 19 �ere
Charge
Conviction Sentence
� � �� ~ ������9d
. .
13. Give r.ames a.nd addresses of �WO ersons, residents of St. Paul, Minnesota �rho ca.n
give infor�atien concerning you.
NAI� ADDRESS
/'�L�G[i �0�9�/�%�e��l� • �/dZQ.� ..5��/D�S"
, � - —�
State of ;?inn sota )
� jj
County of 3a�asey )
,( , � +t {�,1�, , ! being first 3uly suorn, 3eposes and says upon oath
that :e "_as ��ead t?:e �o�egoing state ent beaxing his sigaat�;re and �snows �he contents
thereof, and that t;:e same is true o his own knowledge except as to those na.tters
therein stated upor. informatior. and elief and as to t:�cse matters he believes �hea
to be �rue.
Subscribe3 ar.3 sworn to beIO2'� me '
gnat�.�r of Applicant
thi.s � �ay of 19 �
11 an;-v.�,�n:t�.�._,.-.nn.n,�,ti,,�:.;:,�.,-,, . .. .. ...
. " - � 5�,�'ti (Ri�'l�1a . v„N i,'F. �
i
"1ot19.rJ ruol�c, y, County, t�finne ota � �NQTARY �Uc"UC htINNES;:i� �
' .-��� � DAKOTA COUNTY • '
��� � t ,� My Comm�on Exp�res 1an.2, 1992 �
`-1;� Ccnmiss:on expires l 1 .p I 1 �v��nNwwww r