87-537 WHITE - C�TV CLERK
PINK - FINANCE COUI�CII
C4NARV - DEPARTMENT G I TY OF SA I NT PAIT L File NO. ����� �
BLUE - MAVOR
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Presented By '�/ ��
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,
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That application (ID# 19592) for a New On Sale Wine, On Sale
3.2 Ma.lt Beverage (Menu Item Only) , Restaurant,
and Class A Catering License expiring 2/2/88 by Ma.done, Inc.
dba Caravan Serai Restaurant at 2046 Pinehurst Avenue
(Nancy J. Kayoum, Pres) be and the same is hereby approved,
COUNCILMEIV Requested by Department of:
Yeas Drew Nays �
Nicosia ln Favor
Rettman
Scheibel �
Sonne� __ Ag8iI1St BY
Tedesco
Wilson �p
��� 2 � 1�� Form Approve y City At rney
Adopted by Council: Date
Certified Pa.s ouncil S BY
gS.
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Approve y Mavor: Date � ���Y+ r i ��� Approved Mayor for Submission to Council
By _ _ By
p��,_����D , ::,�,� �? ]98�'
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Application No. �ate Received By
CITY OF ST. PAUL, MINNESOTA ,
APPI.ICATION FOR ON SALE IMTOXICATING LIQUOR LICEiVSE
SUNDAY ON SALE INTOXICATING LIQUOR LICENSE .
PRIVATE CLUB INTOXICATI�VG LIQUOR LICENSE
OFF SALE INTOXICATING LIQUOR LICENSE
ON SALE MALT BEVERAGE LICENSE
ON SALE WINE LICENSE
Directions : This form must be filled out with typewriter or by printing in ink by the sole
owner, by each partner, by each person who has interest in excess of 5% in the
corporation and/or association in which the name of t,he license will be issued.
THIS APPLICATION IS SUBJECT TO REVIEW BY THE PUBLIC
1. Application for (name of license) Madone znc. _
2. LoCated at (dddre55) 2046 Pinehurst Ave. , St. Paul, Mn. 55116
3. Name under which business will be operated Caravan Serai Restaurant,
690-1935
4. True Plame Nancy Jane Ka oum Phone 698-5919
First Middle Maiden Last
5. Date of Birth 5-22-1960 Place of Birth Salt Lake City, Utah ���
Month, Day, Year
o. Are you a citizen of the Unit2d States? Y eS Na�ive Naturalized
7. Home Address 1635 Scheffer Av. , St. Paul Home Telephone 698-5919
8. Including your present business/employment, what business/employment have you followed
for the past five years?
Business/Employment Address
9. Married? N� If answer is "yes" , list the name and address of spouse.
. . � Pj�c- �Z- 5.3 7
10. Have you ever been convicted of any felony,, ��ime or violation of any city ordinance,
other than traffic? Yes _ �Vo \/
Date of arrest 19 tdhere �
Cnarge
Conviction Sentence
Date of arrest 19 Where �
Charge
Conviction Sentence
1:. Retail Beer Federal Tax Stamp Retail Liquor Federal Tax Stamp will be used.
12. Closest 3.2 Place Church School
13. Closest intoxicatinq iiquor place. On Sale Off Sale
i�. List the names and residenc�s of three persons of Ramsey County of qood moral character,
not related to the applicant or financially interested in the premises or business , �Nho
��nay be rererred to as to the applicant' s character.
Name Address
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I5. Address oT premises for which application is made �'_c' i-�(,, ; i} ".�_ , � �It,,,�Y ;:,I- (,,(';��}{�
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Zone Classification ��;. �i, i"���-,,% t �� ( � �-,� 1 t'i�I %1 Phone �;;�1 (. 1�1 �'�1
,
16. Between what cross streets? ( � �t �:';'� •���..i�� �;��i � r �,��1�� >!;'t:�'.` ;I� �rlhi ch s i de of Street j' �; jv� ;��
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17. Are premises now occupied? \;��' � , What Business? � (�'` �, + 1 1 ✓�� j�i-�- �
How Long? ` `_f / ; ,-,-
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'_3. List licen5es which you c�rrentiy ho1d, or fo rnerly he1d, or may have an interest in. i
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19. Have any of the licenses listed by �ou in No. 18 ever been r�voked? Yes �'Vo �_ i
If answer is "yes" , l �st the dates and r�asons i
I
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I
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. If business is incorporated, give date of incorporation ��� � `� 19 ��,;
_ and attach copy of Articles of Incorporation and minutes of first meeting.
21. List all officers� of the corporation, gi,Ying their names, offi.ce held, home�ddress. andq
home and business telephone numbers. IV/�(�i(' �.� �/-��(�'� ��-�(�( %(,lY�`l � � t E��i�('Y�-1 �
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22. If business is partnership, list partner(s) , address and telephone numbers.
:Vame � V/ /--t Address Phone
23. Is there anyone else who will have an interest in this business or premises? ��
24. Are you going to operate this business personally? _ `� If not, who will operate
it? Name Home Address Phone
25. are you going to have a manager or assistant in this business? � If answer is
"yes", give name, home address, and home telephone number. '
Name Home Address Phone
ANY FALISFICATION OF .du'VSWERS GIVEN OR hIATERIAL SL'BMITTED WILL RESULT I�I DENI?,L, OF THIS
APPLIC?�TION.
I hereby state under oath that I have answered all of the above questions, and that the
information contained therein is true and correct to the best of my knowledge and belief. I
hereby state further under oath that I have received no money or other consideration, directly,
or indirectly, in connection with the transfer of this license, from any person by way of loan,
gift, contribution or otherwise, other than already disclosed in the application which I have
herewith submitted.
State of :�innesota� f } •
County oE Ramsey )
(�(�.r�:t,� __�Gt�1� l��"��[�(��.1'r�l
(Signat re or apalican )
Subscribed and sworn to before me this
� � day ot 4. • 19 � !
t?nnnn�f�... ,
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;Iotary Public, Ramsey County, Minnesota `:�,r„'.: '
Ky Commission e:c�ires `, .� `�°
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P%�r = L19593 l
PROPERTY OWI�JERS
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� � � � 0 �� Application for an On Sale Wine, On Sale 3.2 Beer, Restaurant
,
Entertainment and Catering License
�`� P P L t C A i� � MADONE, INC dba/ CARAVAN SERAI RESTAURANT
Nancy J Kayoum, President
�._o c,�� � o �
2046 Pinehurst Avenue I
����
CAPRIL, 22, 1987 lO:OG :a.*�.
�-1 E ,� R f P� G � �Y Council Chamners, 3rd i-loor City 'r.s1: - Court Nouse
Ey License and Permit Division , D�partr�e�: o` �;nance zn�
N OTt CE SE NT �'T�nagement Services Roo� �C� City Ha1i-:,our� tiot:��
Saint Paul ,'•linnesota
2�)S-5056
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