87-643 WHITE - GTV CLERK COURCII / /
PINK - FINANCE GITY OF SAINT PALTL
CANARV -�DEPARTMENT ��� /� �
BLUE - MAVOR File NO. �0
Coun il esol 'o -----������.
Presented By
a�-�
Referred To ommittee: Date
Out of Committee By Date
RESOLVED: That Application (I.D.#52703) for a Physical Cultural Health 5ervice
License applied for by Irene Grufman DBA Irene's Hair Gallery at
2105 Ford Parkway be and the same is hereby approved.
COUNCILMEN
Yeas Nays Requested by Department of:
Drew
Maea� /�E77�,.n� [n Favor
hlicos�a �
scr,e+be! _ b __ Against BY —
Sonnen
7�ti�cn
Wdypn — M�Y r _ '�g$7 Form Appro e by City Attorne
Adopted by Council: Date
Certified Y•:- b Co '1 Se ry BY
By
Ap o d by Mayor. Date t � {��f Approved Mayor for Submission to Council
B BY
ng� y
�(S i s!�6"�a: _, � ',.r:!
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,/ CIT'Y OF ST, PAUL
DEPAR'1'N�NT OF FIl�I4NCE AND MARAGH�'r S�VICES
LICENSE AND PERNQT DIVISIOA
I
' pl�e�se ansrrer all queatio�cs ltiill3► aad
- These stateaient forms are iaaued in d4glicstc�cked. Any talaificstion �►ill be �s�e
�omplet�ly� This applicstion ia thorougti3J►
- for denial. �� 19
...__ `_ ,� � �;• . '�i '� � , ' , (License) �Permmit)
_ , a- , .. � - ': .
1. ppplication for -
licant �-�-���'f"/��� �� ��" '-�� �'7�� � ��
2. Name of spp __ -_.
3. If applicsnt is/haa been a mss'ried remsl�. list msidea name 1 �> r- � '" � '
,.. .
� - �_ � e 7'� Place of birth ;_� ��E�� ,, i; � � \�-..
4, Date of birth �� - ' 1 � -( � +---
5. pre yo�u s citizen of the United Ststes �_ �ti� ���iZeB ��
(, pre you a registered voter _ �r°
— - � � ' c ( � l ic� �iame t°7'°pho°e �� '� I
_ ;
; �_
.
' 1a � :� � .
7, gome e+ddreas 1 r _ .
,
�- : �:'111
� t businees a�ddress . �,�) _ c-�� -ic ,;, � � ,�-�r �,_`•_;` �- Buainass t�ls'pbeae ��, .� .
4t R. Preaen `' � ht� y�
ece o�. pnsent business/emploJ►��t� '�t �iaess�e�ployoe
g, Including y
— f ollo�+ed f or the psst live yes='a•
--- N�ddress '
Busineas/EmploYment .
_ , ��� -� - - � �� :a : t
• • � > < '�.• ic
,
wens r i �,� �_`�� � l �� I1 � _ � ���"1 (k� l-�) �' (� � 'i` �: _ ( 1 ;
�nd:_
sura�
" " list name aad sddress oi spaise j`. '�_ � l
nnes 10• �rried = If answer i� Yea ,
;<_ c (t•
; r c __ �� .- �_ �_1 �� � �a �: � _ 1 � .
hicle � ) '' 1 'I -
l, s,{81Ve ou ever been arrested for nn offense that has resulted�i��i�i�n!�
her._ 1 y
I! answer is "yes��, list dates of arrests, where, c B ,
.�H; sentences.
o�a 19_ wtiere
Date of arrest
Cf1AF.GE
S�TENCE
COPiVIL'PION
- Date �f arrest _ 19 Flhere
CHARG�'
SENTF.NCE
CONV IGTIOtI
4
-� r--- �••�+o•.j�a, asaociat�ona or organizationa Wtrfchvin a+ �ra��
4Y �+ay hav�
, , a. A mortgage interest in the licensed premise, ,
�� �� �����3 �
b• A serurity interest in tbe licensed premises, license, or 2'urnishi s of
A8 the '
licensed premise, I
c. A prvmissory note for funds loaried for the o�pera�tion o! the licenaed remi
1 P se
or the purchase o! 'the license,
d. Finaacially contributed to the purchase of the premise or the license it-
self
e. Ar�y other interest either direct or indirect, I,ither financial or other�,rise
�
in the licensed premise or the licenae itaE�f, �
\,�;
Attach a copy hereto of any and all documents referred to in this affidavit.
1?. Give names and addrea8es oP two persons, reaidertts of St. psul, Iyi�eBOta� W�
�� 6i� inrormatton concerning you.
I�AME
-- � 1�::� ��1 (_:,���f �3
� -��� t��C, � �(� . �_
- � 1;�, >>�� -r�l � ��� ����� � � �
� , _ �-�, � � � k"���� �� �� �� �� � 1�, ��
` � }
--- ���.� �� � � ��L �� �> ( � � ��� - , i �t �,Jf�i
�_f�.
14. Addreas ot premises for Which License or Permit ia made
Addreas �� , ' 1��;l� � �-�,� �� ��__%,�;< < < /
� Zone claaaificstion �
(—,.�i,
15. BetWeen srhat croes streets ( y•�.� ,
' �' �r���<� Whi�h aide oP street ��: ,
1 6. Re�e u n d e r x h i c h t h i s bus iness will be conducted .��'f ,� '
- ��,s �-��)i ��' �T ti�//c ��:
17. Buainess telephone number (�- � , i � ��
�' ) / �
1". Attach to this application, a detailed description oP the design, location ar�d
$Qua2'e Pootaga of the premises to be licensed �
'-9. ?re premises now occupied �-� �% What business
N�� long
r
. . - . � ��7- ���
. �.
20. List license which you currently hold, or former�y held, or mqy have an intere
in ,
��.� � �-�--
21. Have a�+ of the licenses listed by you in No. 20 ever been revoked. Yes
N� . If arisr+er is "yes", list dates and reaaona:
?_2. Do you have an interest of ar�y type in aqy o�er businesa or business premiaes.
I.° answer is "yes", list business, businees address and telephoae number.
_ � /7!�/S .
). � � �
, � �7 - , I
i
j �) ,,�� �� k' � .� � � �� I )< ���� �) C� `� � �r J�, ��: �'�����(_ �� . � �( �< <� J -� �,�
_
23. If business is incorporated, give date of incorporation 19
and attach copy of Articles of Incorporstion and minutes of firat meeting.
24. List all oYficers of the corporation giving their names, office held� hame
address, and home end business telephone numbers:
I� , t,\ �
�' 25. If business is psstnership, list partner(s) address a� telephone rnanbera:
Na� ;�� � �� Address �e1.Fo._
Bc
��
In:
26. Is there ar�yone else who will have an interest in thia buainess or premises?
M�' If answer is "yes", give name, home e�ddrese, telephone n�bers aad in wi�st
manner is their interest: 7��_ � ( '
UC.�ri - -
�t�}�
27. Are yo�u goin�t to operate this business peraonally-,�� if not, �rho rill aperate
it:
R� Ho�ne address Te1.Ro.
- , " ��''l-la�(� `�` -n
Are you going to have a Mans�er or assistant in this businesa? If aasWer is
��yes", give name and ho:ne address and home telephoae number:
Name Home address Te1.No.
29. Has anyone yau have named in questions 22 through 26 ever been arrested? If
answer is '�yes", list name of person, dates of arrest, where, charges, comic-
tions and sentence
30. I �_i��� �: ;- �,-'��� '/, _-- understand tt�is premise mey be in-
spected by the police, fire, health and other city officials at anp► and sll
times when the business is in aperation.
State of Minnesota) '
)SS
County of Ramsey )
.;-- ( 1
� �- �,F� l_� - , � �„ �a , being first duly sworn, deposes and says upon
oath that he has re the foregoing statement bearing his sigaature and lmo�s the
contents thereof, and that the same is true of his own knoWledge exce�pt as to those
matters therein stated upon information and belieP and as to those matters he be-
lirves them to be true.
Subscribed and svorn to bePo�e me - ;�",%'�c�_ ,�`�, 1-r--�-------
`�" Signature of�Applicant
this <�, day of �f Y��,;_,,� �, 19 �� 1
� hlnn„�.±�4^ .
-� -�-. �' . �"I�,�L.,,�, -....__i_.� �� i� KRIS'fINA L SCHINEINLER �
N�ta Public, xa�ssy C�unty, Minne,sota �� NOTAPY FUBLIC-MINNES07A
\��.�,--=,��.. � _._. DAKOTA COUN7Y
MY COMM. EXPIHES JAN.2, 1992
My commission expirea � _ -� � '1� �Y�,,..r:,.,.,r..,.wti-,�.�_•,, , -
I . i vlr�yyVyvY\n!r
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r�, � tr, s t � �-� �;.. �. rr � EV � t� a � i �,. '�-
City Clerk ,� .
�' � � P � i C.,, �� � t C3 f��
386 City Hall ��-
' F � I E N (}. L52703 �I
. � �
Dear Property owner; . P Q r E 1
,
._._.._.r- - ------.
. - - �
� �� � O S� Application for a Physical Cultural Health Services License ,
�
�
(
�
,
. • __________. .___._____.!
"""""""" _ __. .__.��.--�
f`�� �
�PPI.�ICAt��� �
Irene Grufman DBA Irene's Hair Gallery �
� �
� . ` _ �.�_ .� ��
,_
L� C�� � � � 2105 Ford Parkway �
i
�. - ------ .�_�—_--------------------
• May 6, .1987 10:00 n.M. - --.'�+i
R '� � �City Counci:� Chambers, 3rd Floor City Nall - Court^iiouse ,
H E� ;`---.�..__ _ --
- - --- ;
IIy License and Perrnit Division, Geparrment of Finance anu �f
�(�-�-� �� ,�� N-r-� �tanagement Serviccs Room 203 Citv I-iall-Court }iouse I
S;iint Pau: ,htinnesota ,
298-5056 �
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