87-1522 WHITE - CITV CLERK
PINK .- FINANCE CO11flC1I G
CANARV - DEPARTMENT GITY OF SAINT PAUL File NO. " � ����
BLUE - MAVOR
1
cil Resolution _ �
Presented By . U
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D.#63704) for a Massage Therapist License by
Violet A. Neuhaus DBA Vi's Therapeutic Massage Center at 1821
University Avenue be and the same is hereby approved.
COU[VCILMEN Requested by Department of:
Yeas Drew Nays �
Nicosia ln Favor
Rettman
���1 �c` L__ Against BY
�Onnen
Weida
�' WilsOn QCT 2 � �p7 Form A ve by 'ty orn
f Adopted by Council: Date �
�
Gertified Pa • b u cil ecr t y BY
By, �
� Approved by Mayor for Submission to Council
A►ppr e y �Vlavor: Dat
By By
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t- DEPARTMENT � - - - - - -
` CONTACT NAME _ ': :
�G g-� c.a PHONE �
DATE .
� r �OR SDUTING ORDER: (See reverse side.)
_ Depar `ent Director Mayor (or Assistant)
_ Finan e and Maaagement Seswices Director � City Clerk
_ Budge Director ,� ('o, ��Q. ,p,.�.,,�,
,� City torney _
. �
P (Clip all locations for signature.)
W Y ? {purpose,/Rationale)
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S B T BU G AND EL C CI
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I G C D UGTACTVI D C I D:
(Mayor's s gnature not required if under $10,000.) �
Total Am t of Trans�ction: '�I�. Activity Number: �'-f}
I�unding ource: �`
A'
TT C (List and number all attachments.)
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c�1�Jv� '
1 .�, �
ADMINISTRA �;`P'ROC�DURES � �
Yes No Rules, Regulations, Procedures, or Budget Amendment required?
_Yes No If yes, are they or timetable attached?
D ARTM tT REVI W CITY ATTORNEY REVIEW
�Yes No Council resolution required? Resolution xequired? ✓ Yes _No
_Yes No Insurarice required? Insurance sufficient? _Yes _No
Yes o Insurance attached?
l � ` / ��/ �'�o��
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DIVISION OF LICENSE ANI) P�:RMIT ADMINISTRATION DATE ��i /���
INTERDF.PARTMENTAL KEVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
A�plicant '����� � _ �,��,�,,�a7 Home Address l�(�j �� I�v
i ..�,/1�,
Rusiness Name �� S � ,�i� I►�t�pc c,R Home Phone (g (D�j - �j(9�[;�
�•
Business Address �Ya� �,v�.�,,�•ev�.�, Type of License(s) "��,N,,,�� ' „ _
Business Phone ��C,�� -�(Q�i 3
--P
Public Hearing Date ��"�,.1�'�`� License I.D. 4l �Q3 '-'(��c�
at 9:00 a.m. in the '�'ouncil C�iambers,
3rd floor City Hall and Courthouse State Tax I.D. 4t � 3� r?�`�7
llate Notice Sent; Dealer �� � �.�
to Applicant ('�,f . S < <�I Y-1
Federal Fi_rearms �� �(1 �/a'
Public Nearing \
��/�� �� 1
DATE INSPECTION
REVIEW VERFIED (COMPUTER) CUMMENTS
A proved Not A roved
�
Bldg I & D i
t° la ,
Health Divn. �� '
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— �
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Fire Dept. I ' �
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Police Dept. I
- O�-
License Divn. �
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c� .
City Attorney Iv I �
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Date Received:
Site Pl.an ('j V� � �� �-�
' To Council Research i�>�'t I �('1
Lease or Letter Date
from Landlord -
.�{�9--��� C� I 13�3
�'_"�7-is��-.
�� ; � - CITY OF S'i. PAIJL
' ' DEPARTMENT OF FINANCE AND MANAGEMENT SERVICES
LICENSE A1QD PERMIT DIVISION
Please answer a11 questions fully and completely. '�his application is thoroughly checked.
Any.. falsification will be cause for denial..
� Date ��- /�- 19 �7
. / '-- '
L". Application for ,G,� , �c� icense)(Permit)
� 2:. Name o f appli c ant 7��-�J� �� ��"/�c
3.: If applicant is/has been a married fema.le, list maiden name �
4-, Date of birth � ��a��7 Age��_Place of birth � �'-���u �
�
5=: Are you a citizen of the United States��Native Naturalized
6. Are you a registered voter Where ���-���c �-.� /���'.�r G�'v ��'�ti
�� q
7. Home Address /� g0 �� �, Home Telephone � � /- �6 93
8, Present business address �3� /�1i� �I�ItiL . .��,Bus:iness Telephone ���l��/
9: Including your present business/employment, what business/employment have you
followed for the past five years. .
Business/employment. Address ..^"•,'•
,, w f
� r ,,,_
� ��x�,w �3 ,���-�. � G�'�'�"�V�-5�o s
� �"�
10. Maxried if answer is "yes", list name and address of spouse
�
�"/� �, -;, /9�'o �..���'�a �-�-e , � ���C. Ss'�o J-
.
11. I this appli�at'on is for a Massage Therapist License, list time so occupied.
������ ���`��
� Years Months.
_ . �
12. Have you ever been axrested if answer is "yes" , list dates of arrests, where,
charges convictions and sentences.
Date of arrest 19 Where
Charge
Conviction • Sentence
Date of axrest 19 T+�here
Charge
Convic�ion Sentence
. ���/5.�a-
13. • Give names a.nd addresses of two persons, residents of St. ?aul, Minnesota who can
give information concerr.ing you.
iVAt� ADDRESS
?`S�Z�.�e��-v ����/ 1�3�_1 :� G� .� io,��
��'—�;s s�„
���� ' � 9 9�• �,��� ,�. ,� � SS io.�
✓ � '
State of Minnesota )
) SS
County of Ramsey ) �
being iirst duly sworn, deposes and says uAOn oath
that he has read the °oregoing statement bearing his signature and knows the contents
thereo£, a.nd �h�.t t:�e sa�.e is true of his own knowledge except as to those ma.tters
therein stated upon information and belief and as to those matters he believes them
to be true.
Subscribed a.nd sworz to before
���� �.
� �p� Signature of Applica.nt
this _. � � dayA of 9 �
I� J �`�
G�� �' •
Vot y Pu ic, R_ �� nnesota .
'� o�
r�y commissi �' s
L'�=�>-i�s��
-----•—=------------------------ AGENDA ITEMS --------------------------------
-------------------------------- --------------------------------
ID#: [327 ] DATE REC: [10/07/87] AGENDA DATE: [00/00/00] ITEM #� [ 7
SUBJECT: [MASSAGE THERAPIST LICENSE - VI'S THERAPEUTIC MASSAGE CNTR, 1821 UNI]
STAFF AS5IGNED: [NONE ] SIG:[RETTMAN ] OUT-[X] TO CLERK „(QOf�At86]" �a��
ORIGINATOR:[LICENSE DIVISION ] CONTACT:[SCHWEINLER - 5056 ]
ACTION:[ ]
C ]
C.F.# [ ] ORD.# [ ] FI�E COMPLETE="X" [ ]
+� � � +r +� r +� � � � +� +�
FILE INFO: [RESOLUTION/CHECKLIST/APPLICA7ION ]
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