88-1594 WMITE - CITY CLEpK COIIIICII �//�G
PINK - FINANCE G I TY O F SA I NT PAU L /��(
BLUERV - MAYORTMENT File NO. �+(• //��
.._.._,...�
�
o nci Reso ution �, �
Presented By
Referred o Committee: Date
Out of Committee By Date
RESOLVED: That application (ID # 45522) for a massage therapist license
by Patricia Wallace DBA Harmony Health Care Ctr, at 135 E.
Geranium be and the same is hereby approved.
COUNCIL MEMBERS Requested by Department of:
Yeas Nays �
Dimond
Lo� In Favor
�
xettman
�be;�� �_ Against BY
Sonnen
Wilson
SEP 2 91988 Form App ved by Ci Att ey
Adopted by Council: Date � �, �
Certified Pa s d Counc.il r y BY �
Bl � � 1 Approved by Mayor for Submission to Council
Approv Mav
By � By
Ptl�.ISHf�I �'%� " 31988
��-����
� DIVISION OF LICENSE AND PERMIT ADMINISTRATIQN DATE ��gL� / � d
INT�,RDF.PARTMFNTAL KEVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant ��,�ri�,(ti 1A��IC.�CSL.. _ Home Address �� ('_'(C�.Q,�, �J �6•
1/�U- S-E.,
Rusiness Name ���. Home Phone '�I'1 U— �5(�1 `�
�3 s �.. G " �-
fiusiness Address �Y���,�.� Type of License(s) �aS��,Q � ��,��a�.;�..
Business Phone /��- (�ps�
Public Hearing Date � � License I.D. 4� �5�ala
at 9:00 a.m. in the �ouicil Chambers,
3rd floor City Ha11 and Courthouse State Tax I.D. 4� �'�
llate Notice Sent; ^ ` � � Dealer 1� � ( /�-
to Applicant `� �_
Federal Firearms 4� �{-
Public Hearing
DATE INSPECTIUN
REVIEW VERFIED (CQMPUTER) COMMENTS
A proved Not A roved
�
Bldg I & D � � a �
, �
Health Divn. '
; � �a ,
� �
�
Fire Dept. i � �a �
� I � �
�
Police Dept. I
g�3c� o
License Divn. '
q Z � �K..
City Attorney �
� � , o �
Date Received:
Site Plan '1/�1FT � � � (�f
To Council Research a�
Lease or Letter c Da e
f rom Landlord �, (� � ��
. ���
. � City of Saint Paul , ,
��` ' • Department of Finance and Management Services
; . _ Ltcense and Permit Division . �'�"�/.���
� �c�ty Hau
St.Paul,Mtnnesota 55102•29&5056
� . APPLiCAT10N FOR LICENSE
CASH CHECK CLASS NO. _� New Renew • �
i r.. a _ - ° ...
1 :a � ' ., ah . �;� � � `l .:.. � .. . , - .
, _ . _ - � . . . Oate �o� t�
. � Code Na : ' Title cf Llcense . . F�am ��'o� 19Qd To 8��-3 19�
. � .. , , r
'o?� / . ,—� . ' �
, ' • AppllCanUCompany Nams
�'� . , . 100 �� ���Z�C,IQ�Jj
100 eusintss Nam
• �r� .
100 ��J �'
; . /3.5'.� � f� ����'
�• Business Address Phon�Na
I 100 �03�� .��C�r`Z��C;�G[�iyyt/
� 100 Mail toAddress - Phone No.
,� ��-u,�:. �,���� �
.+f ManaperlOwnet•Name .
i 100
I oC �// X�'/Z.w`'�, I/`�"`� ' �'
� 100 AlanaqeHGwnN•Hant Addnss PhoM No.
j 1098 Appltcation Fee 2. sp ���,
�ved the Sum ot • �� , l �pp , ��G�,� •L,°� 'I?�D� 0�9�
� � -�.�-r�Pi Q�d/ 7�' ., .�
. anaqsNOwner•City.State d IIp Cod�
f �� - .. :>.,00 --;.-:. . . . raeai ,00 �. : . _ : .
( ,,� « � . . _
� . i, n Ina • r , e . _ � „tun ot ieant
� . L ce se pecto y S�s MW
� r. � _
, � ' ` ..' � '. ,
' Bond• ' -.
' -- '
.._ •.; ._ . Company Name . . :.. . .. . . Polfcy No. . . � , Expfndon�at� ., •
1 . . . . . . . ' 4
` I�urance• - :. . -
' Compa�y Narr� Policy No. Expintion Oat�
� Mfnnesota State Identificatlon No � � Social Security No
Vehicle Informatlon• �
. S�rial NumWr ab umb�r
� Other . —
�`° THIS IS A RECElPT FOR APPLICATION
( ;, THIS IS NOT A LICENSE TO OPERATE.Yow applicatfon for license wiil either be granted or rejected subject to the provisions ot the zoning .
( l ordl�ance and complstlon of ths inspectio�a by the Health, Fire,Zoninp and/or Licens� Inspectors. -
�[ :�. -
I _:�
I . $15.00 CHARGE FOR ALL RETURNED CHECKS
; . � � _
t �
I -
i
I�
i .Y �
j wi _ '
,:
i Y�� � � �,�,� �
i =� ��
; ; J����.� 8a�-��
� � CITY OF S'i. PAUL ./�'j���'/�p�
� DEPARTMENT OF FINANCE AND MANAGEMENT SERVICES `�'
� LICENSE AND PERMIT DIVISION
Please answer a11 questions l�lly aad completely. This application is thoroughly checked.
Any falsification will be cause for denial.
� D te —O v,.� 195��1
l. Application for 'cense)(Permit)
� .
2. Name of applican
�
3. If applicant is/has been a married female, list maiden nam • �
, /� �`
4. Date of bi:th "" ge�_�Place of birttl��.'�c.I� �^ � )
5. Are you a citizen oP the United States V Native Naturalized
6. Are you a registered voter��here� � s �l ` ���/f �
/ � ' /� 1 Home Tele hone � �O �]
7. Home Addres�� / � ��f'�� (i(.( � /�/ • P J
8. Present business address�'�^�(,I�•.�� G(�t�E' Business Telephone - '��
9. Including your present business/employment, what business/employment have you
followed for the past five yeaxs.
Business/employment. Address �
t , y�--�- ��L6�/� -
_ �
- l� ����e� �� �1 �-
10. Married/VV if answer is "yes", list name and address of spouse
11. IF this ap�lication is for a M assage ?'herapist License, list time so occupied. �
. ,�� e Mor,ths.
12. Ha�re you ever bee arrestedf�Ii a.nswer is "yes", list dates of axrests, w�.ere,
charges convictions and sentences.
Date of axrest 19 Where
Chaxge
Conviction � __ Sentence
Date of axrest 19 �ere —
Charge
Conviction _ Sentence
13. Give names and addresses of two persons, residents of St. Paul, i�tinnesota who can ' "
give information concerning you.
NANIE � ADDRESS
� �
- _ �'�9�/
�
State of nnesota } ��?S �� C�C(J
) ss �1��
County of Ramsey ) J �i
being first duly sworn, deposes and says upon oath
th�,t he has read the foregoin� statement beaxing his signature and knows the contents
thereof, and that the same is true of his own knowledge except as to those matters
therein stated upon information and belief and as to those matters he believes �hem
to be true. � ---�
��. � �
Subscribefl a.nd s�orn to be£ore me ��
Signature of Applicant
th' .G day of 19 ��
Lo ary blic, , Minnesota �Jy�,�zy � Bueye
� NpiAR�PUBLIC—MINNESOTA
Pdy Comnission expires � ' _ WASHINGTON COUNTY
N1�• comm�ssion expires 7,30-93�
. � � ��-i���
� � � � HARMONY HEALTH
���- ��'^�����=�. �::,
GARE GENT�� � :� ..f.
Progressi ve • In vol ved • Caring L �'� 2� 53
July 27, 1988
To Whom It May Concern:
This is to verify that we are aware that Patricia Wallace will be
comi.ng to Harmony Health Care Center to administer therapeutic
massage to residents in their rooms.
Sincerely, �
Y'd�r�Ot �d
Tamara Murr/Y�K�� �
Y.
Director of Nursing
13S EAST GERANIUM, ST. PAUL. MINNESOTA SS1 17
(612)488-6658
' • C1"'� ��T
mn . • o�t�»nru�,� e�,e�tet� ..> .
Mr. J. Carch di
�iR��l+�I� �►��T �wc,: f�0 2�(3 2
e:vt�r�cr o��� �von�i�sr�n
t � r- n' �F� T �.��� 3«r«�
°�*� . . nounr,a ��� 2 Caunci 1 Resear�c#� `
` _ ORDER: " _" -
' CRY ATTORNEV � . - � � � -
. . . . . ..,...... . . . .. .. . ..._... . .
REQ :
Application for a Flassage Therapist Lic�r�se.
" Notification Date: 9-8-88 Hearing Date: 9-29-88
7IOpi:(APfi►ov1(�)d Wjecx(R)) COIlFIFit.RESEAAp!1l�CRT:
. GU1PM'�ING OOIAM8810N � . . CIVIL 9ERVICE COM�AIBSION . DATE W� �.DA1E OlR . �ANN.YBT . . PIIOIIE N0.� �. , � .
. . 20NIN0�ANA�810N . ISD 826�� � � . � . .. � � .
� � . 87AFF � � . � .pUWTER COMMB�ON. . . COMPLfiTE AS I$ . . A�t WFO.ADOED* RETD-TO iANTA�T � � CGllBiffll@ff -
. ' � � � _ � �_FOR ADD'l IPIFO. .. ' _FEEDBAGC IWOED• .
� ��� � � *EXPIANAT�ON: . .� � .. � . . . .
. .&1PPOiiTB MM1NCII COINiC!091ECTIVE? .. . � �. � �. . . � . ' - � �. . � . - . .
M1IA7MB MOiL�.bNIB OMkl1171MMTY(Who�What.1N11M,WIIMr.VNy)c
PatriEia Wallace request Councit approval of her appiication for a '
Nk�s�age Therapist License. at 135 E. Geranium, Harmany Hea1th Care ` �
-
, _ ,Cente�^.- : �
�ur,�+ca►�ow w�•ue•�.�ia�ar�.r��:. _ . _
A]7 applications and: fees have been submitted. All required departrnents
have rev.iewed and appraved_this application.
ca�ouaMC�fl�a.wiw►.�e ra v�am>: .
.
If Councii approval is not received, patricia Wa1lace will not be allor�d
to pr.actice massage therapy. -
- - - - - __ ---__ ----
�►t�u►vnes: c�s
Cour►c I Research Center
�� EP 121988
_ ,
Msromrmn�c�rrs: � �'�C'L���
. , ' _ _
I`
, _ . , , _ ..
��� Chap. 41 . 2 exc u es �esta is ments a are cerrs un er . a . ec. .
through 144.703 from obta3ning a Physical Cultural Health C1ub License. Harmony
Care Center is licerrsed by the state.