87-1621 WHITE - CITY CLERK �
PINK - FINANCE G I TY OF SA I T PA U L Council � 7_/��
. CANARV - DEPARTMENT
BLUE - MAVOR File NO.
�
Cou il Re ut ' n ;.r- -
Presented By
��
_�: Referred TQ Committee:- Date
Out of Committee By Date
RESOLVED: That Application (I.D.#14160) fo a Gas Station-3 Pumps and 1
Additional Pump by James C. Tone DBA Express Gas at 430 S.
Robert Street be and the same is hereby approved.
COUNCILMEIV
Yeas 1�a�F- Nays � equested by Department of:
Nico�ia ln Favor
Rettrnan
Scheibel c� Against BY
Sonnen
Weida
WilsOn ��V I 0 �987 orm Approv d y ' Atto ey
Adopted by Council: Date
Certified Passe y C ncil Secret BY
By
A►pprove IVlavor: Date -��3�l+�al PProved by yor for Submission to Council
a
By
PUBIfStf�D ��u'v � i 1987
• (�7`'� �'��/���f
• � � � N°_ Q11382 �
�i.v�c�.....w t 1'`C.,.,,,..a. • �A.�• IIEPARTMENT - - - - — -
�ri� �.1±..��v�Q..,, CONTACT NA1rIE
7�t 5C-5 0 5 Co PHONE ;
� � 1 i�1 g-'t , DATE ..
ASSIGN I�IUHBER FOR ROUTING ORDER: (See revarse ide.) `-
_, Department Director , Mayor (or Assistant)
_ Finance and Management Services Director ,� City Clerk
_ Budget Director � (�b�:_...1 s�c..R
1 City Attorney ' _
TOTAL NUKBER OF SI6NATtTRE PAGES: (Clip al locations for signature.)
G C ? (Purpose/Rationale)
--.� .S� �l�� R�-� � �- _ �
�W' b°� �� > `s�.�- h�..�. .�
�G,�,� c�.,,,�dZ c�bl,�:. �s„ .
b�
cos u c s c �
n ,�
FI C U A V C G D O
(liaqor's signature not required if under $10,000.
Total Amount of Trans�ction: � �(�. Activity Nwnb�er: rl t�
Funding Source: � ' /.�
ATTACHMENTS: (List and nwnber all attachments.)
�p�a v�` . .
'�Y�C.0.�R d1' .
ADMINISTRATIVE PROCEDURES y1 1f}
_Yes _No Rules� Regulations, Procedures, r Budget Aiaendment required7 �
_Yes _No If yes, are they or timetable at ached?
DEPARTMENT REVIEW CITY ATTQRNEY REVIEW
,/Yes No Council resolution required? Resolution required? ✓Yes _No
_Yes ✓No Insuxance required? Insurance sufficisn�? _Yes _No
Yes ✓No Insurance attached?
� ������
T�IVISION OF LICENSE AND PERMIT ADMINISTRATIO DATE 91d - l GJ�aa ��`-j
INTERDFPARTMENTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant �,p� l�'• �6 ome Address ��'a _��,�.;�,. Q,,=�� 135�
�
Rusiness Name �� � �;� ome Phone (��3 3 - � �3 J
�
Business Address '� 3U����,�,1,�}� p . T pe of License(s) ,�� ,��{. �,�,,aQ.
---�—
Business Phone � ,�
Public Hearing Dat L'cense I.D. �� l��(9 p
at 9:00 a.m. in the ci h bers,
3rd floor City Hall and Courthouse S ate Tax I.D. �� 3 cY� 7 � CjU
llate Nutice Sent; � � �� D aler 4� � In
to Applicant �y� �s.?
� deral Firearms �� � ��
Public Nearing
DATE INSPECTION
REVIEW VERFIED (COMPUTER) CUMMENTS
A proved Not A ro ed
�
Bldg I & D ,� � � +
�
Health Divn. �
6
� .
i
Fire Dept. I �
10� c� �
I
Police Dept. I
License Divn. �
�
City Attorney �
f
Date Received:
Site Plan �] ���j �g�
To Council Research �� �-�p ( �� _
Lease or Letter Date
from Landlord
,�,�,, ,LD�.�-� � ���sa
CURRENT INFORMATION NEW INFORMATION
� Current Corporation Name: New Co�poration Name:
Current DBA: New DBA:
Current Officer-s: Insurance:
Bond: -
Workers Compensation:
New Officers:
Stockholders:
! �
.� _ .; �,���/��/
CI?"! Or ST. pRuL �
� �E?AR1.'��]T OF r LIAIICE AND MAIQAG'�'1'P Sc."RYICr.^5.
'� LICENSE A.*TD FF�t. DIVISI�tJ
These statea:ent °or..,s are issued ir. d�agl3cste Please ans�+�er all questions _*�l�y and
complete:y. i:is app�:ca�ion is thorocgh�y c ecked. Any .°slsification xill be cause
Por denial. "
aate 19
1. Applica:ion for , � (License) (Pez�mit)
2. Name oY applicant � �- -
� I° ap�lfcen� is/ras be�r. a cm._*�ried °e�ale list �a.iden aacx N��
y. Date of birt:� _ Ll�-�11�/� �e �� � lsce o� b�rth f�4�16t. �,/���
�
5. Are yrn: a c_ti.zer. oP t�e United S�ates f ?Yative v Aatura?±zed
5. Are you a registered voter -P � wlz � �T _ �yr.- L - � fr��i l�n
.'. Fi�me ad cre s s �/�--e �� Ficme te 2e�hone �1�-Zt�'��
� .
Q. °resen� business address -v� � Business telephone
9 Including yo�:r preser.t business/e�al�ymea , wha.t bnsiness/e�layme�t have you
c01iO�C °or �he oast Pive years.
Busir.ess��.--oloyment p,d��ss
C��� L'"�l'�.0 tS 1 ^ O!/v�/G� `1 /< !/i'1 s r C`�f. , f�-�l,c(�� /�.f`l�U�
TN� s l� , � �q �. �� J�. ,/�`�te rs���
1Q. �darriec? �C) If ansraer is "ves", list name and address oP s�vuse
'_1. ?iave yoe: eve- been arreste� Por an ofPense that has resuZted in a co�ictionY /v G
I� ans�+er is ";,res", list dates of arrests, vhere,. cf�rges, cnnvlctions and
sentenc�s.
�ate o? a:res� io Wher
CHA.?GE �;
CCNVT_CTT_OR' Sr'�VTE�.''9CF.'
:rate �� arres� �? ..ere ..
C�;n�G�
,
c�r�-T,:..:.=__. s�`�^�;�
Y
� r . • ��7 l(p�/
, 12. List the names 3n� a:^�esses (i' 'ed, name ot s�ouse also) ot alZ persons,
� corporat�o^s, p�Ttr.e�s:�iYs, assocfati ns or organizations Which in any Way have:
�
a., A mort3age :nterest in the l.icens d preseise, �,y�n �� /��� �- �j'2i/C
4 N- • �� -
b. A sect:_�i�y interest in tae Iicens d gremises, licease, or htrnishings of the
licansed premise, - �. �
c. .: proa:issory note Por funds loane Por the operation of the licensed oremise
or the purcrase o.* �he license, � �"
3. F:nancisl?y contri�uted tp the pu chase of the oreaise or the license it-
sel: /f'
e. Any otaer interest e:t?:e� direct r fa�irect, either °inar.cial or ot::ersrise
. �
ir. the licensec •gre�ise cr the li,. nse itself, .U`/�—
=.�tac^ a copy hereto of any and a'1 �a�:men s referred �o in t:�is aSPidavft.
'_? Gine names and addresses of tao perso , resideats oP St. Pau1, Minnesota, vao
can give ir.�orastion coacerning you.
HA1KE ADDRFSS
_ ,TU� ✓c��r �/—^�2�'► /� (J os p�� fyd�'*/ Uff/L '�/�/�`C..
/�/�'/Z/t�/ lit/�ti G'�/z-/.'� ��✓ - �����c�i� �i��/� ,���
'�. aaar�ss o° prenises °or ahi�ch License r ?ez-�it is made �/�� Jc_ d,��� f�PQ �
Address Zone classi_'icatior.
15. 3etween satzat c_oss streets l— G'p /� �Jhica side of stre�t�
16. �F�..-�e under :►hich this business Fr,ll be conducted L��-an,�Js Gf�s'
1?. �ls i nes s telep�:one n�ber 9�— �O
1~. Attaca to this aapli.ation, a detailed esczigtion Qf the design, loca�ion, anc
saua� _°ootage o� L:�e preaises to be Ii ense�
�
. -. . �.re �re�nises noW occup:ed ��What Lsiness �' fc/L i ' I��� Zanc �v�'lJ
... � i���
20. List license w�:ich you currently hold or Pox�er�y heZd, or may have an intere
i n 7 ir/�' �4 � ��
21. Aave �tn,y of the licenses listed by yo in No. 20 ever been revoked. Yes
No 7rL%�' , If enswer is "yes", list d tes and reaaons:
<^_2. Do you have an interest oY arry type in any other busiaess or business gremises.
I° ansWeT is "yes", list husiness, bus ness a.ddress and telephone number. iLo )
T�
�l�'-�-X /r 1' � -� 7. .•�. �-- �� 3�/ G8f f ,I7l.�' J'T�/a�
2?. I.° bLS�ness is incarparated, give date of incoroora�ion 19�
an� at�acn capy oP Articles of Incorpo at{on ar.3 minutes oP fir me�ting.
2��. L�st a?1 af°icers oP the corooration g ving their n2ses, oP°ic� neld, hame
address, and home and business telepho e n�bers :
. �
r � /�e " - -� s�..1�.�,0 �/?)�
�� � .�����'�..zL
l� �' �i��:�
25. =° bus:ness is oart;�ers:zi�, list partn r(s) address and telephcne a�bers:
N� � Add_ess Te3.Aa.
25. Is there a
nyone eZse vho will have an terest in this busiaess or pre�iaes?
IP answer is "yes", give name, h�e ad ss, telephone n�bers and in �+�at
maaner is their interest:
27. Are you goinR to operate this business rsonally I�T/iS aat, vho vi11 cpeTate
it. ��"�.
A� �/ / /�_ H address 1�r1.Ao.
, �
. . . . � � � �r- ����a�
� , ' � Are you �oin:, t� t�.ave a !�ana�er or assis ant in this business? It a.nsWer is
R
'�yes'�, give na.*� and ho:�e address and k telephoae r�umber:
Name ,%,¢-_ ���/J�J�e �/� Home address y7? � ,'e,� ,f��Te1.No i��=D�O"C
29• Iias a�►one you have named in questions 2 throu�h 25 ever been arres�ed? �P
ans��+er is �'yes", Iist name oY oersoa, da es oP arrest, vhere, cha�ges, convic-
tions and sentence
_�
?0. I /%��i �1 i1i G�'� understand this premise �y be ia-
s�ected by the �o?ice, ;ire, hea.Lth and ther city ofFicials at a�r and aIl
�imes wnea the business is �n aoeration.
State of '•tinnesota)
)SS
CoL::�y of Fca:asey )
��
Si stu:e oP Atrolicant
� being P „ du1.y sworn, depvses and sa}rs �.roon.
oat:� t!�at ne t;as re�d the °oregoir.g state�neat bea_rin� his si�ture and !ciorrs the
co�ter.�s thereo°, and th�t tne same is true o his o•an lmowledge except as to t:�ose
�at�ers tne�ein stated upon i;.f.orma�i�n ana b ?ie? aad as to �hose matters ae be-
lieves them to be trse.
Subs �ibe^ and sxorn to ePo�e me n) ��
�� i ature o? A�Dlicant
this d o 1d� �
1
' ta r ?�_�1ic, �acasey �� �, �!innesoia
.:r:ca�..
� ���'���,• MARCcL�:A G. SCNILLINGER
`�!r c��ission expires � �i ,;r �
.�F�_.�� NOTAF.Y�U9LIC—?AINNESOTA -
�•;�r:a�� ��.,'v',:.�" ��U�JTY
z .`�•`I�. Niy^,om���_...� �xpires y1ar.21. ,:;91
. �P9N►�ARi.s'�i"�Ps�e+�Pvr`Id1+.�d�� �.
��
----5--------------------------- AGENDA ITEMS =__________-------------------- ��_/(p�/
, -------------------------------- --------------------
ID#: (372 ] DATE REC: [10/20/87] AGENDA DATE: [10/21/87] ITEM #� C ]
SUBJECT: [1-DAY GAMBLING PERMIT (RAFFLE) - BET ESDA FOUND. - LANDMARK CENTER ]
STAFF ASSIGNED: [NONE ] SIG:[RETTMA ] OUT-[X] TO CLERK {88f88fA8-}--- /%Z /
ORIGINATOR:[LICENSE DIV. ] CO TACT:[SCHWEINLER - 5056 ]
ACTION:[ ]
C ]
C.F.# [ ] ORD.# [ ] FILE COMPLETE="X" [ ]
� � � � � � � � � � �
FILE INFO: [RESOLUTION/CHECKLIST/APPLICATION ]
[ ]
L ]
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