89-1800 WHITE - CITV CLERK COI1flC1I
PINK - FINANCE G I TY O SA I NT PA U L ��I�DI)
CANARV - DEPARTMENT
BLUE - MAVOF File �0•
� Counc l Resolution �� �
�
Presented By �
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That Application (I. . 4�77800) for a Ma.ssage Therapist License
applied for by Siste Mary 0'Brien DBA Sister Rosalind's
Professional Massage Center at 1999 Ford Parkway be and the
same is hereby appro ed.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays
Dimond
�� n Favor
Goswitz
Rettman t7 B
s�he;n�� gai nst Y
Sonnen
�Ison
�CT 5 ��$9 Form Approved by City Attorney
Adopted by Council: Date •
Certified Pas•e Counci cre BY " �,� '�
B}�
t�p rove � avor: D - �_ Approved by Mayor for Submission to Council
By' - BY
�� Q C 14 1989
� i
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DEPARTMENTIOFFlCE/�UNqL DATE pN D
Finance/License GREEN SHEET NO. 5 3 8 4
CONTACT PERSON�PHONE INtT1AU DATE INITIAUDATE
�DEPARTMENT DIRECTOR �GTY COUNqL
Kris Van Horn/298-5056 � �CIT1f AITORNEY �CIT1f CLERK
MUBT BE ON COUNqL AOENDA BY(DAT� BUOOET DIHECTOR �PIN.3 MOT.SERVICE8 DIR.
�MAYOR(OR ASSISTANn � COUIICil R
TOTAL N OF SIGNATURE PAOE8 (CL LOCATION8 FOR SKiNATUR�
ACTION RECUE8TED: '
Application for a Ma.ssage Therapi� License
NOTIFICATION DATE: a � ; j �EARING DATE: i(�► �+c�
RECOMMENDATION8:MProve(lu a Rs�eCt(I� COMMI7TEE/RE8EARCM i�PORT OPTIONAL
y PHONE NO.
_PUWNINO COMMISSION _CIVIL BERVICE COMMI8810N
_qB OOMMITTEE _ i
_DISTRICT COURT _ i '���EIVd�
SUPPORT8 WHICH COUNqL 08JECTIVE7 I ��^���
r
INI'MTINQ PROBLEM,iSSUE,OPPORTUNITY(Who,Whet,Whsn,Whsro, ):
�, -� r , �..r.
t l�. , . .
Sister Mary 0'Brien requests Counc�l i pproval of her application for a Massage Therapist
License at 1999 Ford Parkway DBA Sist� r Rosalind's Professional Massage Center. All
applications and fees have been sulpm�. ted. Al1 required departments have reviewed and
approved this application. �
ADVANTA(�ES IF APPROVED:
DISADVANTAOES IF APPROVED:
Courc�i �esea�•ch Center
S�I' 21 ���9
�
DISADVANTA(iES IF NOT APPROVED:
i
I
TOTAL AMOUNT OF TRANSACTION COST/REVENUE BUDOETED(CIRCLE ONE) YES NO
FUNDINO SOURCE ACTIVITY NUMBER
FlNANGAL INFORMATION:(IXPWN) I
. . . - �c'�rl�ed
UIVISION OF I.ICENSE AND PERMIT ADMINI TRATION DATE �3v �`1 / ( c�! 9
INTE,RDFPARTMFNTAL REVIEW CHECKLIST A.ppn Processed/Received by
Lic Enf Aud
Applicant � i5�f I t lu i V�f�n Home Address � n . �. �. , `�l� ,
��
Business Name S� Home Phone 333—��,(na
Business Address �_ � � Type of License(s) rnCi�,�c�..�xnc.,yp��
Business Phone �g�l�, (o� 3
Public Hearing Date b License I.D. 4i `�`1���
at 9:00 a.m. in the Council Chambez' ,
3rd floor City Hall and Courthouse State Tax I.D. �t � (p� o1�a�
llate Notice Sent; Dealer �� (� i �-
to Applicant
Pederal Firearms �� �/� f Gj
Public Hearing
DATE I 'SPECTIUN
REVZ�;W VERFIE (COMPUTER} CUMMENTS
A proved Not A roved
�
Bldg I & D � I �
� � � v �
Health Divn. � I a '
!
V�
�
Fire Dept. � �
i .
I � �
I I
Police Dept. I
°� � � C�
License Divn. G ,
f� i
�
City Attorney �f ( � O�
� ,
Date Rece ved:
Site Plan p` �"
To Council Research ���� ��j
Lease or Letter Datg
from Landlord � 1A
� - - . . ���_��a�
` ' ` ^ CI OF S'i. PAUL
DEPARTMENT OF FI NCE AND MANAGEMENT SERVICES
LICENSE AND PERMIT DIVISION
Please answer all questions fully and c pletely. This application is thorough?y checked.
Any.Palsification will be cause Por den a.l.
Date . 19�
1. Application for � �License)(Permit)
2. Name of applicant
3. If applicant is/has been a married aiale, list maiden name �
4. Date of birth -.,3- Age-�� lace of birth ��„r�-�/ -
. 5. Are you a citizen of the United St tes�Ne.tive Naturalized
6. Are you a registered voter`�� ere
7. Home Address
� � l'`-"� Home Telephone��___���
8. Present business address � Business Telephone
9. Including your present business/ ployment, what business/employ�eat have you
followed for the past five yeaxs
Business/employment, Address
»�
� 7 � � ,�r�� -�
�� �� � �
10. Married if answer is "yes' , list name and address of spouse
11. IF this application is for a M ssage Therapist License, list time so occupied.
. ,,� � Years Months.
12. Have you ever been arrested if ansver is "yes", list dates of arrests, where,
chaxges convictions a.nd sente ces.
Date of arrest 19 ere
Chaxge
Conviction Sentence
Date of arrest 9 Where
Charge
Conviction Sent ce
. �
�
. _ _ � � ���=i��
13• Give r.ames a.nd addresses of �wo pers ns, residents of St. Paul, Minnesota who ca.n
give in*or�ation concerning you.
NAME ADDRESS
�
T �.� ,�r �.� .Q.� /t��
� � � /� �/�11�.����
State of Minnesota )
) S3
Count;� of °a�sey )
�, �(Q / bei g first 3uly sworn, 3eposes a.nd says upon oath
t:�at ^e ::as read t_.e �o:egving statemer.t beaxing �is signatl:se and knovs the contents
trereof, and that tY:e same �s t:ue of hi own knowledge except as to those matters
therein stated upor. information and bel' f and as to those matters he believes thea
to be �rue.
Subsc�ibe3 ar.3 sworn to befor� �e
Signat� e of Applicant
this : � cay of 19��
■
r1 f �lit7Z_C� ,l� ., � .
Da Ko E JqNET A.ODA EN
�-'�r Cc�miss:on expires ` NOTARYPUTAC�OUN'�A
"'� MY COMM.EXP� ,1991
Y