89-1804 WMITE - CITV CLERK COI1flC11
PINK - FINANCE
CANARV - DEPARTMENT G I Y OF SA I NT PAU L D
BLUE - MAVOR File NO. �� /
C uncil Resolution �-� �
�3�;,
Presented By
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That applicat on (ID #66335) for a Massage Therapist License
by Barbara J. Zawislak DBA Sister Rosalind's Professional
Massage Cente at 1999 Ford Parkway, be and the same is hereby
dpproved.
COUNCIL MEMBERS
Yeas Nays Requested by Department of:
Dimond
�ng In Favor
coswitz
Rettman BY
scne;n�� _ A gai n s t
Sonnen
Wilson
G+'1' _ � '1989 Form Appr ved by City Attorn
Adopted by Council: Date - �
Certified Pa. y Council retar BY '
� f�
By
A►pprove Ylavor: Date �6 �u� Approved by Mayor for Submission to Council
By
p�� 0 C 141989
� � . � . � �����a�
DEPARTMENTlOFFICE/COUNqL DATE INITIATED
Finance/i.icense GRE�N SHEET No. 50Q9 '
WNTACT PERSON 8 PMONE �NRIAU DATE INITIAUDATE
�DEPARTMEWT DIRECTOR �CITV COUNCIL
Kri S VanHorn 298-5056 �� m��n�� �cm c�e�uc
MUSI'8E ON WUNGL AOENDA BY(DATE) R01171N0 �BUDOET GiiECTOR flN.3 MOT.SERVICE8�R,
�MAYpi(OR A8818TANn 4 •�
TOTAL t�OF SIGiNATURE PAQES (CLIP ALL LOCATIONS FOR SIONATUF�
ACTbN REQUESTED:
Application for a Mas ag Therapist License.
PJotification Sent: � �-..����'�. - -A
RECO�IENDAT :Mp'�W a►�le�IRl COUNCIL FlPORT OI�TIONAL
_PLANNINO OOMMI8810N _CIVIL BERVIC�OOMM ANALYST PHONE N0.
_qB()OMMITTEE _
_8TAFF _ COMMENTS:
—���� — $Ep 251�8g
�����������
T'.� R �
xrm�nNa waoe�M,issue.oPaoRruNrnr Mrno.wn.t,wn.r�. wny�. . ..
Barbara J. Zawis1ak DB ster Rosa1ind's Professional Massage Center
requests Counci1 appro a of her app1ication for a Massage Therapist
License at 1999 Ford P r ay. A11 fees. and app1ications have been
submitted. All requir d epartments have reviewed and approved this
application.
ADVMITA(iES IF APPROVED:
d8ADVANTAOEB IF APPROYED:
Council Research Centet'
SEP 21 i989
DIBADVANTA(iE3 If NOT APPROVED:
TOTAL AMOUNT OF TRANSACTION ' OOdT/l1EYENUE BUDOETED(qRd.E ON� YES NO
FUNDING SOURCE ACTIVITY NUM�ER
FlNANCIAL INFORMATION:(EXPLAII� �
_ . .. . ����o�
DiVISION OF LICENSE AND PERMI A.DMINISTRATION DATE �S�_� / '�
INTERPFPARTMENTAL KEVIEW CHEC LIST A.ppn Processed/Received by
Lic Enf Aud
Applicant � � � Home Address '����j��,����y0.6�.�,
Rusiness Iv'ame ' � .��cc�, Home Phone � aZ 1 C�� a
rI C�r �
Business Address "1�,�( ���/ Type of License(s) mqS ���y��i�
Business Phone g� (a � �
� � ��-
Public Hearing Date �O�S�� , License I.D. 41 �,Q��3J
at 9:00 a.m. in the Council C uibers,
3rd floor City Hall and Court use State Tax I.D. �� �3��s ��
llate Notice Sent; Dealer 41 �1Q�
to Applicant �
rederal I'irearms �� �
Pub.lic Hearing
D[A E IrSPECTIUN
REVIEW VEIt IED (COMPUTER) CUMMENTS
A ro ed Not A roved
�
Bldg I & D ,f� �
.b ' �
Health Divn. '
' �� � C�
-- ,
�
Fire Dept. �� � � n •
, � � `�""_ 1 /�e.
�
! �
Police Dept. �I � I
O i�� S1�C�:�Q
License Divn. �
�'la � a
City F,ttorney � �
� �s � o
Date Recei d:
Site Plan
To Council P.esearch ��aO��j
Lea�e or Letter Date
from Landlord
_ ' s � ��j�(���/a O�
` CITY OF S'i. PAUL i.
DEPARTME OF FIIVANCE ATJD MANAGEMENT SERVICES
ZCENSE AND PERMIT DIVISION
Please ansWer a11 questions Pv].ly and completely. This application is thoroughly checked.
Any falsification will be cause f r denial. �
Date 19 4�
1. Application for r'�3 �:.r i'S-"t C .vxwrL License)(Permit)
2. Name of applicant 13 ��a.i-��- � �
3• If applicant is/has been a m ried female, list maiden name �
4, Date of birth ���Y/3'1 Age " �fi Place of birth {�'�'t,�lS 1�'� �`� ' —
5. Are you a citizen of the Unit d States � Native Naturalized
o. Are you a regi stered voter �dhere�,�,v�,K.�— C �� c: ��-1
"' .- - j���'�,q_�, /U.�_ Iiome Telephone �7 1��`�g
7. Home Addre s s �e' "��C� �.��
8. Present business address �j -f-c;r� ,a 1��-�+� Business Telephone C�r - .�3
Sf �?�
9. Including your present busin ss/employment, �rhat business/employment have you
followed for the past five y ars.
Business/emplo�ent, Address
, � , �� ._ 1959'-�.�b ,��-�'��«�, .. S7_r?,��, n'"�'�.
S cs ��<Q �;e FP,s�S i�r � ess. �
; �...� .
�M.rS g/ � �.r.v�-.�� � .. ,,. ,.._ ..
;..
10. Married if answer is "y s", list na.me and address of spouse
11. If this application is for a Massage Therapist License, list time so occupied.
QU u5 (� � �� �
Years Months.
12. Have you ever been arrested N �% If answer is "yes", list dates of arrests, where,
charges convictions and sent nces.
Date of asrest_ 19 Where
Chaxge
Conviction Sentence
Date of axrest 9 �1'�ere
Charge
Conviction Sentence
. � • � � ���y.��o�
13. Give r.ames a.�d addresses of � o persons, residents of St. Paul, Minnesota who ca.n
give in_'or�atien conceraing y u.
NAME ADDRESS
�^+.�z - ?.��..z 19 y�— �-q�o�•�► �,��_ S.� _/�t.��� �s'ii.�
^ a �
.� � �i c.�i� 7�e�►�c� ti . �_�T_�'�� S'.571�
State of P4innesota )
� J�7
Count;� o i Ra.,ms ey )
being first 3uly sworn, deposes a.nd says upon oath
that :!e :=as r�ad t'.:e `oregoing sta e�ent bearing �is signattzz�= and knoWS the contents
thereof, and that the same is t.ue of his own know2edge except as to those matters
therein stated upor. informatior. an belief and as to thcse matters he believes thea
to be true.
Subscribe3 ar_3 sworn to befor° �e �y'� � \
' �y Signa re At�plicant
this `� �� cay of �'�<�-�.c 19 /
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_•totar�f �ubl:c, �a�sey Eountf, _�iinn scta
r�1y Conmiss:on expires -- s r.
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