87-1523 WHITE — C�TV CLERK
PINK — FINANCE COI��ICII � Q
CANARV — DEPARTMENT G I TY O F SA I NT PALT L e�
BLUE — MAVOR � FIIC NO. �� ��
�
Coun 'l esolution
Presented By G�
Referred To Committee: _- Date
Out of Committee By Date
RESOLVED: That Application (I.D.#81465) for the transfer of an A-2 Grocery,
Off Sale 3.2 Malt Beverage, and Cigarette License by Gary W. Brummond
DBA Shop Rite Super Market at 380 Thomas Avenue be and the same
is hereby transferred from Louis Kvasnik DBA Shop Rite Super Market
at the same address.
COUIVCILMEN
Yeas Drew Nays r Requested by Department of:
Nicosia ry [n Favor
Rettman
�r � Against BY
Sonnen
weiaa QCT 2 01987
Wilson Form prove by Ci y t rn
Adopted by Council: Date �'
Certified P� •s d u il ec eta BY �
By
t�ppro by 14avor: D ► D�T 2 � ��7 APProved by Mayor for Submission to Council
By
Pt�I..ISl�ED 0 C T 3 1 1987
. � G,����s�3
,
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� • DEPARTMENT ' - '
CONTACT NA?IE
PHONE
4Dl� _ DATE �
A � N ' �t (See reverse side.)
_ Departmen Director Mayor (or Assistant)
_ Finance a d Management Services Director � C ty Clerk
Budget Di ector Z �,m,�Q��_
1 City Atto ey _
TOTAL N SGNATURF PAGES: (Clip all locations for signature.)
WHAT W 0 C 4 (Purpose/Rationale) �
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-t,� c�7Q,-iti.o � c�-�- ob l;�� , -
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COTS D L M C •
�l �A ,
N C C V BE ED 0
� (Mayor•s aigna v�re not required if under $10,000.)
Total ll�ount of Trans�ction: 1� l'�
�/1,�(� Activity N�mber:
Funding Sour e: � � � �
ATTACHMENTS: ( ist and nwnber all attachments.) �
` ,�.C,a�(.,�'`�n �
�P.�.`��
� �,p�t. C�[� . 's-�
ADMINISTRATIV R0 U � 1�
_Yes _No Rules, Regulations, Procedures, or Budget Amendment required?
,Yes _No If yes, are they or timetable atxached?
DEPAR�MENT REV. W CITY ATTORNEY REVIEW
�es _No Council resolution required7 Resolution required� �'�e� _No
=Yes �No Insurance required? Insurance sufficient? _Yes ,_No
Yes I�lo nsurance attached?
-�.�..—
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DIVISION OF' LICENSE AND PERMIT ADMINISTRATION DATE �� [dl`�IFf7
INTERDEPAR�MENTAL REVIEW CHECRLIST
Applicant ��,,,-„�,rQ Home Address tS� �v •� •
oD,�-
Business Name �� ,.,�, a� ,,,n,�Irnr.r�c�. Home Phone
��e
Business Address ��p!��,,, �-,� 03 1�pe of License(s) _� �Z
Business Phone ��- t��.(�O �G�-
Public Hearing Date -. �;-� -� �.. .�. License I.D. # ���yS�
at 10:00 a.m. in the Council Cham�ers,
3rd Floor City Hall and Courthouse State Tax I.D. # 7�Z � at
Z - �-4-o cx� �1� 6� s-
VIEW DATE DATE INSPECTION
APPN REC'D VERFIID COMPUTER COMMENTS
roved Not raved
Housing & B�.dg �
Code Enforcement �
I � .
Public Health �
I
I
I
Fire Prevention �
� i
i
Police �� �
i
City Attorney �
l
I
EN S �
I
i
300 Foot Notice I
I
I
License Inspector's Comments: ��,
I HAVE BEEN GIVEN A COPY OF THIS NOTIFICATION AND UNDERSTAND TAAT MY ATTENDANCE AT
THE PUBLIC HEARING IS REQUIRID.
-.���,., � C� l I 3�f
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Application No. Date Received By
CITY OF ST. PAUL, MINNESOTA
APP�ICATION FOR ON SALF II`lTOXICATING LIQUOR LICciVSE
SUNDAY ON SALE INTOXICATING LIQUOR LICENSE .
PRIVATE CIUB INTOXICATI�VG LIQUOR LICENSE
OFF SALF INTOXICATIN6 LIQUOR LICENSE
ON SALE MALT BEVERAGE. LICENSE
ON SALE WINE LICENSE
Oirections: 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 the lic�nse wi11 be issued.
THIS APPLICATION IS SUBJECT TO REVIEIJ BY THE PUBLIC
1. Application for (name of license) �( � �� �� � �r��
2. Located at (address) � 2, � /
3. Name under which business will be operated S U ( �— -2�/` ��
4. True Plame � vv � Phonep2 " �Da
Fir Middle Maiden Last
5. Date of Bi rth ��j,�� P1 ace of Bi rth � ' � , �i�
�onth, Oay, Year
o. Are you a citizen of the United States? v Native Naturalized
7. Home Address L �Ue• �/� . �� � Home Telephone G/SS-222�
8. Including your present business/employment, what bus��ss7 mployment have you followed
for the past five years? .
Business/Employment Address
, c�l Sef�l/ice � �U , �`- S cr�1/ it/, � o
�r� O 5 l,� . �
,vc � � DD J�' e 7` L,��L��'�Uu , /3
9. Married? �� If answer is "yes" , list the name and address of spouse.
S'-lf/K 2 �'CS # �
� ���-i.�a ��
•:0. ` Have�you ever benn convict�d of any felony, crime or vioiat�on of any city ordinance,
ot;�er than traffi c? 'tes No �
Oate of arrest I9 !dhere
Charge
Conviction Sentence
Oate or arrest 19• '�Ihere �
Cnarge
Convictian Sentence
1:. Retail 3eer Federa] Tax Stamp �etail Liquor Federal Tax Stamp �Nill be used.
IZ. Closest 3.2 Place 71�1� f� Church GGK Schaol � 2- � /�J�
�PV' Gl V' e
I3. Closest intexica in liqucr piace. On Sale�Cl/'G'SS S�Y'e��f Sale
i�l. List tf�e names and r�sidenc�s of three persons of Ramsey County of gaod moral craracter,
not related to the applicant or financialTy interested in the premises or business , �Nho
may Ce rzferred to as ta tf�e applicant' � character.
Name Rddress
`� v� � �� f,v ��t s-�� C1��
I5. Address or premises for whict� application is made ��(� I 1�/0 I�VI G� S v�,� uU i�iU
. �Qo3
Zone C1 ass i fi catf en � 5/��S S Phone — �
16. Between what cross street5? 2 ��ING� �C"!/.l�rl ��ide of Street -/ W
17. Are premises now occupied? �l �� What Business1 � lT I�C pl�� e G�l��
-/ �- G ' G� Ye,
How Long? OUl E'q•1�'� �✓ �
'_3. List license5 whict� you csrrently ha1d, or ro rnerly ne1d, or may have an int�ras� in.
���
i9. !�!ave any oT �he lic�nses tisted by Jou in ,Vo. 18 ever 5een ravoked? Yes No �
Ir answer is "�es" , l�s� the dates and reasons
�• . � ���7�s� 3
:
f� 20. • If business is incorporated, give date of incorporatfon /l/v 19
and attach copy or �rticles of IncorForation and minutes of first meetiag.
21. List all officers� of the corporation, giving their names, offi.ce held, home address and
home and. business telephone numbers. ,��/ C�/f/'�
22. If business is partnership, Iist partner(s) , address aad telephone numbers.
vame ��/�� Address Phone
23. Ls there anyone else wha will have an interest in this business or premises? �/ �
24. Are you gaittg to operate this business personally? � If not, who will operate
it? Name Home Address Phone
25. Are you goin ro haiz�mana er or assistant in this business? If answer is
"yes", give n�1 a� s, and home telephone number. �
vri �GIG/���� `
Name C Home Addres � Ue � �one /��'"��2�!J/,,
��
r1►�TY F.4LISFICATION OF ?.NStiv'ERS GIV.F�ii OR :�1ATERZAL SLBMITTID WILL RESULT IN DENIaI. OF THIS
:�PPLICaTION.
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 be.Lief. I
nereby state further under oath that I have received no money or other consideration, di.rectly,
or indirectly, ia connection with the traasfer oE this licease, from any person by way of loan,
gift, contribution or otherwise, other t:�an already disclosed in the application whic:� I have
herewith submitted.
State ot :�.rtnesata) •
� l
County of Ramsey ) ignature ot applicant)
Subscribed and swarn to beiore me this
day o r" �a�cc� 19 S y
�otary Public, �msey—MOUn���ae�c�,annr.nti�.���
�Iy Commission e:cpires� ,.::�_> ,_ s�^',��"! _
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R:tir a�.� _� � :'.i�ei
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----=-------------------------- AGENOA ITEMS ---- ------------------------ �-�-7-/S�3
ID#: [326 ) DATE REC: [10/07/87] AGENDA DATE: [00/00/00] ITEM #: [ �
SUBJECT: [OFF-SALE MALT,A-2 GROCERY & CIGARETTE LICENSE TRANSFER - SHOP RITE ]
STAFF ASSIGNED: [NONE ] SIG:[RETTMAN ] OUT-[X] TO CLERK [�86f8@�f60] /�/�
ORIGINATOR:[LICENSE DIVISION ] CONTACT:[SCHWEINLER - 5056 ]
ACTION:[ ]
C ]
C.F.# [ ] ORD.# [ ] FILE COMPLETE="X" [ ]
� � � � � � � � � � � �
FILE INFO: [RESOLUTION/CHECKLIST/APPLICATION ]
C ]
[ ]
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� � `1�--�/Sa3
Sl� T�7�' PnL�Z: CTTY COtJN� IL
City C1erkHall � Ll��`�..���'l�lY � �1 O � J� V 1.�'.1
386 C1tY
_ ���S � �a���T C��ION
-" � ' � ��• 81465
T0: All Concerned Parties:
Application for transfer of an A-2 Grocery, Off Sale 3.2 Malt
Beverage, and Cigarette License
��1 ,p�s�
�
�
�.'.��L j C�'�T' Gary W. Brummond DBA Shop Rite Super Market �
�
�f,OC�iTCj�j 380 Thomas Avenue
M
�+ � October 20, 1987 9;Q0 �,�,
���-����% Cicy Council. C:�ambers, 3rd :loor C�tj �2.L? - COL':t �ouse
By License and Per.ait Division, �epartment oL �:�ance and �
V01�C�. S��*j' wanagement Services, 3oom ?03 Cit7 3ai1 - Court :ouse, �
Sainc Paul, w_,innesoca I
298-�056 I
This eat� may be changed without the consent ar_a/or �nowledge or t�e
License and Per�nit Division. It is suggested that ;rou ca1? the CitTr
C1erk' s Of�ice at 298-423I �i you wish confi�at=on.