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96-1388 Council File # � � - �� �'.C� �, p �� " �' � � ? � ���� ���1� Ordinance # � . . r . i ... � P .. � . ..u, \\ I � `��° Green Sheet ,� �s RESOLUTION CITY OF SAINT PAUL, MINNESOTA �Q 0 Presented By 'C� Referred To Committees Date � RESOLVED: That application(ID#27473)for a Cigarette, Gas Station, and Grocery-C License by the 2 Reyes Group, Inc. DBA Hazel Park Amoco (Dennis Reyes, Owner) at 1200 White Bear s Avenue North be and the same is hereby approved with the following conditions: 4 5 1. The public telephone will be blocked so that it will not dial to beepers or cell 6 phones from 9:00 p.m. to 6:00 a.m.. � s 2. Signage will be posted on the premises indicating that no loitering will be 9 permitted and that radios and engines must be turned off while at the station. lo O �r�:,�;r.� 1� 3. Security camera(s)will be placed at the rear of the station_ �-�� m�,.�!-�„p�� 12 °'n video +ap�, i3 4. The owner will explore the possibility of placing landscaping against the south ia wall of property. 15 16 Requested by Department of: 17 � NaYs Absent 18 B a Qy 19 _ Guer;n � � office of License. Inavections and 20 21 � Environmental Protection 22 23 24 Bostrom ,i 2 6 � � � ,/7�� 27 Adopted by Council s Date By' �"'�'� r� 28 ��—�—� 29 Adoption Certified by Council Secretary 30 Form Approved by City Attorney 31 32 By: By. , :� 33 � 34 Approved by Mayor: Date f� b �� 35 36 � i, _������ Approved by Mayor for Submissfon to 37 BY: ��� Council 38 By: -t `-'"� ��`� � �����'� � �REEN SHEET N_ 3�4 71 LIEP/Licensin - -` t E �DEPARTMENT DIRECTOA ITUIUDATE O CITY COUPICIL INITUIUDATE Chr3stine Rozek 266-9108 "�" �CITYATTORNEY �CITYCIERK M ON CIL (DA ) �PoR �BUD(3ET DIRECTOR �FIN.6 M(�T.SERVICE8 DIR. For hearin : 1� 4 �b ��R ❑"�"'�cOR"�""n ❑ TOTAL#E OF SIQNATURE P�#E8 (CLIP ALL LOCATIONS FOR 81ONATURE),. ACTION REQUESTED: Reyes Group Inc. DBA Iiazel Park Amoco requests Council approval of its application for a Cigarette, Gas Station, and Grocery-C Lieense located at 1200 White Bear Avenue North (ID �27473). RE��ATIONS''4ppr°w(�)°r Ry�t(p� PERSONA�SERVICE CONTRACTS MUBT AN3WER TNH FOLLOWINO QUl�TItN18: _PI.ANNMic�COMNIIS810N �CIVIL SERVICE COAAM188iON 1. Has thia persoNfirm ever wolked under s oonhtCt fOr ihis dspartmerlt4 - _CIB COMMITTEE _ 1rES NO 2. Has ihis person/Nrm ever besn a city employes,7 —�� — YES NO _oIBTRiGT COUR'r _ 3. Does this psrson/ff►m posesas s ek111 not normvb Posseassd NY anY WrreM city employ�s? SUPPORTS WFIICH WUNCk OBJECTIVE? YES NO Explaln alt yss�nsw�rs on ap�nb�M�t and�tNck to�n�n�hwt M�ITIATMNi Pi�BL.EM�ISSUE.OPPORTUNITY(Wlw.Wlrt.Whsn�Whsro,WAY): � SEP 3 0 1996 CITY A��O�NEY ADVANTAOE8IF APPROVED: DI8ADVANTAdE81F APPROVED: DI8ADYANTi�(iE81F NOT APPRONED: V1�W 14-N �� {�11[01 �.,,- 3 � "�'�� , TOTAL AMOUNT OF TRANSACTION : COST/REYENUE WDtiETED(CIRCLE ON8) YES NO FYNDIIiO SOURCE ACTIYITY NUMBER FINANCIAL INFORMATI�I:(EXPLAIN) Greensheet # 35471 L.I.E.P. REVIEW CHECKLIST Date: 9/20/96 / ��-� 3�� In Tracker? App'n Received / App'n Processed L(cense ID # 2�4�3 License Type: Cigarette, Gas Station, and Grocerv-C Company Name: Reyes Groun Inc. DBA: Hazel Park Amoco Business Addresss: 1200 White Bear Avenue North Business Phone: 772-1478 Contact Name/Address:Dennis Reyes, 1702 Arlington Ave E.106Home Phone: 774-1263 Date to Council Research: Public Hearing Date: Labels Ordered: '�— Notice Sent to Applicant: � � District Council #: � � ��'l, v�f," Notice Sent to Public: / L�� Ward #: � Department/ Date Inspections Comments � City Attorney O � �' (� �. . Environmental Heaith �� � �l- / �o �• � Fire Iv /S d•� • �(o License (� ,� Site Plan Received: Lease Received: 1 � I ��I�� 1'" �`I'{� �,-�,��.,�.� I Police �� �S/ . � �� d Zoning � D !s" °lh o�� . -�° � - . �?_`� �3 �L-� ��� CLASS III CITY OF SAINT PAUL LICENSE APPLICATION ,,,,�y Office of License,i„S���o�s • , and Environmental Protection O � `� 350 S1.Pder SL Suite:WO � O Saim Paul,Min�uqa 55102 � (6I I)266-9090 fu(6I2)266-9124 Y THIS APPLICATION IS SUBJE�"r'TO REVIEW BY THE PUBL��' P EASE TYPE OR PRINT IN K Ca v�y G���- -- � �a0o o� o �� Type of License(s)being applied for: -'a � ' � � ' �� �� '� � ` Company Name: 1�e4�eS �r h���p� Z'�uC . A b c.. �-{c�'z,e� �o.-�l`k �-/'►�-OC�3 Corporation/Partnuship/Sole Proprietorship If business is incorporated,give date of incorporation: �f"Y�YEj Doing Business As: I-I (�'Z.El. Q a'�F� �.rn•�p c o Business Phone: �'1�- l 4 7 8 Business Address: _ l`a Oo ���i�. B E�� r���� • sr 1�r4U'L- ' (�► N ',$"SJ/q . . Strcet Address Ciry ,State Zip Between what cross streets is the business located? Ca 1TF C3 a� �� - MV��YIun►1 Which side of the street? G as i Are the premises now occupied? VT What Type of Business? �-{rt Z�L p r}rQ K �W��c o Mail To Address: l��u t,�(,`;�c �e.��-�` A-QJ. S T•(�q vL �t?�� ,�-7d �, Street Address City State Zip Applicant Information: NarneandTide: VENNIC �►4V W��NO RE�(ES �,.�u[� F�� Middle (Maiden) Last TiUe Home Address: 1 l 0 7, (a�L 11•1 GToN (�u F E, �T (��}�,,� 1�1� I'l) S S^/c� Street Address City State Zip Date of Birth: _�" 3�`°� f Place of Birth: k�1�4Wt Y►..o�1�0 �u 10��4 iu�4 Home Phone: ��-/- / �l �3 Have you ever been convicted of any felony,crime or violation of any city ordinance other than traffic? YES_ NO '� Date of arrest: Where? Charge: Conviction: Sentence: List the names and residences of three persons of good moral chazacter, living within the Twin Cities Metro Area, not related to the applicant or financially interested in the premises or business,who may be refened to as to the applicant's chazacter: NAME ADDRESS PHONE e!' � -T� � �` �l�i� b$'zt Ch.�}N 1U�1 p�ttq�i�ct.�.�.x��lN 'S�lO� 7?d •-77y� �`���;-- �.�,v��=�.s e�.61,�,�,.,,,,, 7 4 8�.. �-E�a s o� (�� La(�e�.�.ti-n tt�t N s s o k2 S�71 �s'Z 3 Tn��, -�I..trv�Q.� Co SSi�Qy ��� W�cwit�C 5'i �o��(. �ct+,u $SS'Lo� (a �� 3P7p List licenses which you currently hold,formerly held,or may 6ave an interest in: ���� Have any of the above named licenses ever been revoked? YES ✓ NO If yes,list the dates and reasons for revocation: Are you going to operate this business personally? `�YFS NO If not,who will operate it? Frst Name Middle Gtitial (Maiden) Last Date of Birih Home Address: Street Name Ciry State Zip Phone Number ,'.."��:,, o" .9 v,_ �, � ✓ Are you going to have a manager or assistant in this business? YES �" NO If the manager is not the same as the operator,please ��. complete the following information: � �"` -���� Frst Name Middle Initial (Maiden) Last Date of Birth Home Address: Svcet Name Ciry State Zip Phone Number Please list your employment history for the previous five(5)yeaz period: Business/Emp�oyment Address -�C('C � t�t� W�W 1 L- t�e�o w���� e '�3�.,(' 14-C� • S-t',1 {�a cs�: � GW,Y� �J((D�, 7��— �c�S�� - �4�To�o�-��-�. lle�1�-�,r� c G-ro�,� �° s� �°a�ti►e. �. S�� ('�� �, �,a� .sm'o ( _ ���-���y List all other officers of the corporation: OFFICER TITLE HOME HOME BUSINESS DATE OF NAME (Office Held) ADDRESS PHONE PHOI�TE BIRTH ��� (�a.i.�e5 ���5 • Se.�Tres, 1��� l��lt+��:`� 77� t z-6'°'; '7'1x i`t7 Y �'3d 5�� �.,.T,.;cc�i �u.ir�e5 �/•1/11'e s � �� � , c . �x k'SZ— If business is a parmership,please include the following information for eac6 partner(use addi[ional pages if necessary): First Name Middle Initial (Maiden) Last Date of Birth Home Address: Street Name City State Zip Phone Number First Name Middle Initial (Maiden) Last Date of Birth Home Address: Strea Name City State Zip Phone Number MINNESOTA TAX IDEIJTI�'lCATION NUMBER-Pursuant to the Laws of Minnesota, 1984,Chapter 502,Article 8,Section 2(270.72) (Taz Clearance;Issuance of Licenses),licensing authorities are requirerl to provide to the State of Minnesota Commissioner of Revenue, the Minnesota business tax identification number and the social security aumber of each license applicant. Under the Minnesota Govemment Data Practices Act and the Federal Privacy Act of 1974,we are required to advise you of the following regarding the use of t6e Minnesota'faz Identification Number: -This infom�ation may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales,employer s withholding or motor vehicle excise taxes; -Upon receiving ttus information,the licensing authority will supply it only to the Minnesota Departn�ent of Revenue. However, under the Federal Exchange of Inforcnation Agreement,the Department of Revenue may supply this information lo the Internal Revenue Service. Minnesota Tax Identification Numbers (Sales & Use Taz Number) may be obtained from t6e State of Minnesota, Business Records Department, 10 River Park Plaza(612-296-6181). Social Security Number: �I 1�� �'�' ' �3�`�` Minnesota Tax Identification Number: �� c�� ��! `��� � If a Minnesota Taz Identification Number is not required for the business being operated,indicate so by placing an "X"in the boz. _ , . . _ � . .. -.H1.-- , f.,l� ..'� .�� ..� . - . � , . �� _ . . . .. .. ; . . . . . . � . . ��'���/���y�';'. .,. . . � L`ERTIFICATION OF WORKERS'COMPENSATION COVERAGE PURSUANT TO MINNESOTA SZ'ATUTE 176.182 �� ���� I hereby certify that I,or my company,am in compliance with t6e workers'compensation insurance coverage requirements of Minnesota • Scatute 176.182,subdivision 2. I also understand that provision of false information in this certification constitutes sufficient gounds for � adverse action against all licenses held,including revocatioa and suspension of said licenses. Name of Insurance Compa�ty: - - Policy Number: Coverage from to I have no employees covered under workers'compensation insurance ANY FAISIFICATION OF ANSWERS GIVEN OR MATERIAL SUBMITTED WILL RESULT IN DENIAL OF THIS APPLICATION I hereby state that I 6ave answered all of the preceding questions,and that the information contained herein is true and correct to the best of my knowledge and belief. I hereby state further that I have received no money or other consideration,by way of loan,gift,contribution, or otherwise,other than already disclosed in the application which I ber�with submitted. I also understand this premise may be inspected by police,fire,health and other city officials at any and all times when the business is in operation. _..__�, � � �/ �gnature(REQUIRED for all application Date **Note: If this application is Food/L,iquor related,please contact a City of Saint Paul Health Inspector,Steve Olson(266-9139),to review plans. If any substantial changes to structure are anticipated,please contact a City of Saint Paut Plan Ezaminer at 266-9007 to apply for building pernvts. If there are any changes to the parking lot,floor space,or for new operations,please contact a City of Saint Paul Zoning Inspector at 266-9008. Additional application requirements,please attach: A detailed description of the design,location and square footage of the premises to be licensed(site plan). The following data should be on the site plan(preferably on an 8 1/2"x 11"or 81/2"x 14"paper): -Name,address,and phone number. -The scale should be stated such as 1"=20'. ^N should be indicated toward the top. -Placement of all pertinent features of the interior of the licensed facility such as seating areas,kitchens,offices,repair azea,parking,rest rooms,eta � - If a request is tor an addition or expansion of the licensed facility,indicate both the current area and the proposed expansioa �1,1 � :.h.�.,..pt S � F s�f c ' A copy of your lease agreement or proof of ownership of the property. FOR SPECIFIC APPLICATION REQUIREMENTS, PLEASE SEE REVERSE >>>>