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88-644 WHITE - CITY CLERK COUflC1I (/y' / PiNK - FINANCE /`/y BLUERr - MAYORTMENT GITY OF S INT PAUL File NO. ��✓ �`a,� Council esolution ... - ��, ��_��, Presented By _ � Y/ � ��=�i� � Referred To Committee: Date Out of Committee By Date RESOLVED: That Application (I.D. #5406 ) for a Massage Therapist License applied for by Julie K. Alle DBA Delores' Whirlpool at 781 Pelham Boulevard be and he same is hereby approved. COUNCIL MEMBERS Requested by Department of: Yeas Nays � Dimond t.o� In Favor Goswitz Rettman � �__ Against BY Sonnen Wilson MAY �� � Form Approved by Cit Att ey Adopted by Council: Date � Certified Pa s y uncil S eta By— � � � gy. � Approved by avor: Date _ F�� m � � Approved by Mayor for Submission to Council By �� BY P���.l3��U I;i1�5�1 L `._ �JVV i ,�r ���� ��� ��-�7'{ . ,� � F. c�x�u t�f���`���`1" No.0 016 6 9 COIRACT n�r„�r:dn�eron , �uro�R?���: ICr' �],I11P.Y`-V8t11'IiO�'i1. � �.o � �a►uw►c:er�rr�onECron �«rr a.�c . No: F' ' & �t. 298-5056 c� �°�`o� . �:Coaa�cil ��rh — orrr ArroaaEr I licati�:for a Massage �'�xapist Ia. s�� SH�s 4J�2/88 F��R.'GNG I]A��: �4?2t'i"� :fMwas W or�(R)) CAIN�EM. REPORT: - - COAI�&ON CML.89iVICE WMIAI8610N- DA7E N� DATE OUT . 11W1LY8t � � PFIOIE N0. .- . . .- COI�NMBBION . . IBD!26 SCIIOOL BOQMD . �' '� / I �� . � . . . � . - - ST . . . . .ClIARTEH COMI�&ON � . ..COMPLETE AS . -AO�t MJFO:ADO�* �_��/IDOL�.'�' - .__F��. - � . � . *EXPIANATION: � � �_� . . � . . 9UPPORIS fSOUNCM.OBJECTIVE4 � . . . . - . . � . . . ' �. �. . . . . ,- . . . . :� � ����I. � . � . .- ' . � . . . , . . . � . . . � . � . � . . . . . . . . . . . . . �. . - . . . . . Nf�A1r19 N{IF,OMOl1'i1MfY(Who.WhM.YVIIBfI.VYhere.WhY)r ,, .. Jul e K. Alle� D�A Delores' [�irlppol`at 781 elhanl Eauleva�d �reqt�sts C'�xinc�.l �val. o� , hppr M�ssage T�e�ra�:st Lic�ense.. . , �c+i �.�.�.�rar. _ � _ . A31 fees and �plicati.or�.s ha�.been suk�nl.ttjed �f Ca��cxl apPre�val. is giv�n, Ms. Allen will ..be � a].lawed to practioe M�,ssage Th�rapy at 7 Pe�i�a�ri Hoiil.eva�i. �� • i QNhu,MRiM�.�nt!To.wl�oen}: . If '.1 apprava]. is r�t rec�ived, NIs. will n�t be allc�aecl. tc> p�actic�e A3assage - at 781 P�lh�m Boulevard: . - . ' .i ' : " , �.�u► : . . was : cor�s , ; i _ ; �sraRr . i I , �� . , I _ � i . . ��� �� � DIVISION OF LICENSE AND PERMIT A.DMINISTRAT ON DATE � (U 'b�6 / � /S[ b° INTERDF.PARTMFNTAL REVIEW CHECKLIST Appn Processed/Received by Lic Enf Aud Applicant � T1 • ��n� Home Address �j3 0�� ��� .�. �,av Rusiness Name �o_�m o„� �,� ��,(}�� Home Phone �p�� � � � a1 C.� Business Address �.�j � �,v�. Type of License(s) �(`� � �_5-� Business Phone (�� -�o `�,a.d Public Hearing Date � �n t a(�� �� License I.D. �{ ��Q(.B� at 9:00 a.m. in the Council Chambers, � 3rd floor City Hall and Courthouse State Tax I.D. �� ��J��C� �� llate Notice Sent• J� � Dealer 41 1/� �(� to Applicant � rederal Fixearms 4� � IQ� Public Hearing DATE INSPECTIO REVIEW VERFIED (COMPUT R) COMMEENTS A roved Not A roved Bldg I & D 3 I a d � o I�j , Health Divn. ' 3 � -z� ! o � � Fire Dept. � � 3�vd � p 1� I Police Dept. I ��3 M O k � (l�c-C O r'cQ. License Divn. � `�� 3 l � e�� City Attorney � I ���� Date Received: Site Plan �_ To Council Research �� /S���S` Lease or Letter Date from Landlord �$ , � �.,_.-� . , � ��-��� CTPY OF ST PAUL DEPARI'1�11'1' OF FIBI4NCE . MAIiAC�' S�tYICP:S LIGEliSE ARD DNLSIOl/ These ststement forms nre issued in duglica . Please ansner all qnestio�ss ltiit�}► aad compleLely. This applicstion ia thorough�y becked. •Any lalailicatioa nill be csuse for denial. �+� 3 ''� i9 s-r� 1. Application tor -� (License) (Permit� 2. Aa�ee of appli csnt � ,� � 3. If applicant is/haa been a mnrried femal , list maidea n�e S ?cal S a '-�. L. Dste of birth �-�S-,��� Age� place o! birtti _�ijp/ S' —�r 5. Are you s citizea of the United States Ratire _ Aaturalized __ 6. Are yau a registered voter �, ,, —�--�— ?. Hove a�ddreas 3�g �j �� �(/. �✓I $� ��� �y-o/�S/ �. Preaent business sddreaa �,y, �� �; � Bn�i�ss ��� �O_��ZO 9. Including your present busir�ess/empl , w6at basiness/�leysent ha� yon follo�+�ed for the past live years. Buainess�F�aPl�� Address ./ ��.� .i. L� r/ �- � � / �� Te'/i' �-i/�` �(� 1� l��G �/. � '`� ��- - 10. Married� IP ans�+er is "yea", liat n e and address a! spause �, � /-�� 3 g a� �/ �,� /s, � s's-�� �- 11. �iave you ever been arrested tor an o!lens that has resulted in a convictionly� It ans�+�er is "yes", list dates of arrests rr6ere, chargea, comrictioos and sentenees. Dste o! arrest 19 CAAF.CE COPVZCZ'ION g� Date of arnst I9 Where CHARGr C�NV ICTIOiI S�� . . . ��'l0�`�' 12. List the names and addresses (if marri d,�ame o�Z��s�ich in suy��+a�Y�ve: corporations, partnerships, associ r 8 g, p mcrtgage interest in the ].icena premise, b. A serurity interest in the licens d premises, license, o� it�rnishings of the licensed premis�, c. A prvmissory note tor funds loar�e for the operation o! the licensed prm�ise or the pnrchase ot 'the license, d. Financislly contributed to the chase oY the premise or the license it- self e. pr�y other interest eithe� direct r indirect, either financisl or other�rise in the licensed premise or the li enae itselP, � � ` �"�' / O. �i� ho , � � � �D �_(,�� ���P� `, Attach a copy hereto of suy at►d all docume ts referred to in this alYidavit. 1?.. Give names and addresses of two pers , resideata of 3t. Pavl, 1�liimesv�ta, who can give information concerning you. . �s FAI� � � � 2���S a�a� �6/�<�l�� S�,d'��/ / � � / S � �-�� /5��� �cGi��� � �i����� ,.5� �-�� 14. Addreas of premises tor Which Licens or Permit is mecle Address � � .�� ?� �� � kz � �� classificatian_,_ 15• Bet�een s+hat croas streets � �rr► � �d� �rr� �rt Whi_b aide of atreet__ 16. Ra�e under Which thia buaineas rrill e condurted �-v��IPS ���'/��l�G�'e`� ��'�� � � 17. ,.Bnainess Lelephoae n�nber � �/�Z Z b 1¢. Attach to thia application, a detai d deacription of the design, locstion, aaa aquare footage of the premises to b licensed � t business �'►�S��C� H� long1� 19. ?re premises no�+ occupied � / �. j � _ , ����� � . �.�; , 20. Liat license xhich yau currently hold or former�y held, or m�apr have an intere in ` � 21. Have arxy of the licenses listed by y in No. 20 ever been revoked. Yes ,NO �. If anarer is "yl�S"� 13st, 8te8 8Dd 2'eaao�: 22. Do you have an intereet oY at�r type i any o�ur businesa or businesa_ premises. ' I.' anewer is "yes", list business, b iness address aad telepho�e rnimber.�� 23. If business is incorporated, giw da� ot incorQoration _ J1i1,'�19_ and attach capy of Articles of Incarp rstion a� minutes of first meetiag. , 24. List all officers of the corporation iving their nsares, oftice held, home address, and home and buaineea teleph ne numbers: /- , y �P �'�z I o� -l� S7, ,� v r-s �i9 -`' '73 _ ICO��n � t° l�cs-� 77 -D � � � .SO �'!� P .l.�D� �J '_ y y5� �,,,�;� �l� 3�?� /e ��-o/� _. 25. If buainess is partnership, list part er(s) addresa e.nd telephoe�e ntabera: � 7/,<� v�f _ Ad rees Tel.Ao. . —� — 26. Is there arXyone else who will have an iutereat in thia bnsiaees o� premisesY It ar�swer is "yes", give nsme, home dreas, telepho�e rn�bers and in xhat manner is t8eir intereat: � � 2T. Are you goinR to operate this busines" personal]y �,�Q i! not, xho xill vperste it: J"'— R� ome addresa 1�e1.Ao. ' , � �a -!O`�`"y . . � � . , . t Are y�u going to ha.ve a Manager or ass stant in this business? If ana�rer is "yes", give name and ho;ae address and �e telephone number: Name /L� H address Te1.No. 29. Has anyone you have named in questioas 22 through 26 ever been arrested? If answer is "yes", list name of person, ates ot arrest, where, cha.-�ges, comric- tions aad sentence 30. I ���(��� ���t.� understand this premise mey be in- spected by the police, Pire, health an other city officials at a� and all times when the business is in aperatio . State oF Mirmesota) )SS ou.-�ty of Ramsey ) • �_%�� being Y st du�q sworn d oses and says on s .cP �P th that he has read the Poregoing �tateme t bearing his si�ature and lmo�rs the ontents thereoP, aad that the aeme is true oP his oWn la�m�rledge excrpt a: to those matters therein stated upon information and elief and as to those matters he be- lieves them to be true. Subsc ibed and svorn to oxe me ,�` Sigaature of Applicsat th �� day 1? U� � P'AF�ELi_A G. SCHILLIRCER :"��::�^.,. ��_E�� r41�iNESOTA Notary Public, Ramaey County, Min ota � .�,l;,.,�^, �,,�-rar��-,��.•�- � � ;,�s��,� �iAivla��r COUaaTY '�jr co�ission !'Xp�2'C3 ''•''�A�,•..r�:' My Com�"i�sion Expirss Msr.21.1991 7 (�,�'—0 0 lo T� ________________�______________= AGENDA ITEMS = ______________________________ G.S.#: 001669 ID#: 88-[467 ] DATE REC: 04/18/88� AGENDA ATE: [00/00/00] ITEM #: [ ] SUBJECT: [APP MASSAGE THER LIC/DELORES' WHIRLPO L/ALLEN/781 PELHAM BLVD ] C.R. STAFF: [SWENSON ] SIG:[SONNEN ] OUT-[ ] CLERK [00/00/00] ORIGINATOR: [J. CARCHEDI ] CON ACT: [K. VAN HORN, 5056 ] ACTION: [ ] [ l C.F.# [ ] ORD.# [ ] G.S. RETURN D [00/00/00] FILE CLOSED [ ] * * * * * * * * * * * * FILE INFO: [RESOLUTION/CHECK LIST/APPLICATION ] � � =x===ox=�====oa=saas=mx====mmamms=s=xm=aza=ams== oosm=msmes==xx==xa===a=====__