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96-1414 � Council File � ` " ' 1� "�' ' ' � `b-' � i'� �� � Ordinance #` Green Sheet # S O RESOLUTION ITY T P .L, MINNESOTA �� Preaented By Referred To Committee: Date i RESOLVED: That application(ID#15967)for a Dance or Rental Hall License by the Department of 2 Nrlitary Affairs, State of Minnesota DBA Cedar Street National Guard Armory(Gary s Bloedel,Military Auditor) at 600 Cedar Street be and the same is hereby approved. 4 5 Requested by Department ofs 6 Nays Absent 7 B a $Y 9 —Harr;n Office of License, Inspections and 10 Environmental Protection 11 12 13 Bostrom 15 ' � ,�� 16 Adopted by Council: Date `�� _�� \qy �� By' 17 18 Adoption Certified by Council Secretary Form Approved by City Attorney 19 20 - 21 By: - - ' � 2 2 I By: � �. �-.O 23 Approved by Mayor: Date / � 24 25 � Approved by Mayor for Submission to 26 By� Council 27 By: ' - {`���'4 ^ N_ 3�470 � LIEP/L�censing ��'N'�A�D �71REEN SHEET � + �oEw►arMENr a�cr�rc�� �ciTr couNCi� _ - iNrrauan� Christine Rozek, 266-9108 �� �CITYATTiOFiNEY �cmc��uc MU Il DA ) �� �BUDOET DIREC'fOR �FIN.8 M(�T.SERVICEB OIR. For hearin : °"D�R ❑"""��°R"ss�ST"rm ❑ TOTAL�OF SK#NATURE PAGES (CLIP ALL LOCATION8 FOR SIONATURE� ACTION REGUESTED: Department of Military Affairs, State of Minnesota, DBA Cedar S�reet National Gusrd Armory requests Council approval of its application for� a Dance or Rental Hall License located at 600 Cedar Street (ID 4�15967) . RE��NDATIONg'Approv�(A)a Ry�t(R) PERSONAL SERVICE CONTRACT�MU8T ANSWER TME FOLLOWING QUESTIONB: �PLANNMIQ COAAAAISSION _CIV�8ERVICE COt�tMIS81QN 1. Has this p9fi0Nfirm sver worked under a oonlfaCt fOr thls d�p�Art1aMT � _���E _ YES NO 2. Has dus psroonRirm ever b�en e cityr err�loyse4 —�� — YES NO _o�s'rnicr couar _ s. ooes aas person/firm poaeess a skin rwt nom,aNy po�sasa by a�r curr�e onY•mployN� SUPPORTS NMlpi CaHrCIL�,IECTIVE4 YES NO Explsin dl yas emwKS on�rab iM�t and�tt�oh to pn�n ahNt INITIATINfd PROBLEM�f88UE�OPPORTUNITV(YVho�NIIwt,1M»n.Wh�n.WhYI. AO�VANTAQES IF APPFiONED: DISA�IMITAGE8IF APPHOVED: ; WBADVAWTMGES IF NOT APPROVED: � �� V�1L�1 OCT 3 0 1�96 TOTAL AMOUNT OF TftANlACTION i COST/REYENUE dUDQETEp(CIRCIE ONE) YES NO FUNDIHti SOURCE � ACTIVITY NUM88R FMiANC1AL INFORMATbN:(EXPLAIN) Greensheet # 35470 L.I.E.P. REVIEW CHECKLIST Date: 9/23/96 / In Tracke►? App'n Receivea / App'n Processed License ID # 15967 License Type: Dance or Rental Hall �� �'� � ` Company Name:Devartment of Military Affairs. State of DBA: Cedar Street National Guard Armorv Minnesota Business Addresss: 600 Cedar Street Business Phone: 282-4041 Contact Name/Address: Gary Bloedel, Home Phone: Date to Council Research: � Public Hearing Date: 1�v Labels Ordered: Notice Sent to Applicant: � � District Council #: � //� s � O�✓�/d`�� Notice Sent to Public: U C�" �� � Ward #: Department/ Date Inspections Comments � City Attorney o �5 (� d Environmental Health N •� • Fire � ������ �C� License S��e�an Rece�ved: Lease Received: IO -- Z� ` � I� Police � � � �� �'� . Zoning (o i � �L� D •� • ,.�� i�Gi/. '1 CLASS III CITY OF SAINT PAUL LICENSE APPLICATION Officto(License.Inspections and Em•ironmentil Protection 35o S�Paa St suite?C10 Saim Paul.�iinneson!!102 (612)2G6aGN0 tu 161.):Cfi-9121 � c��_� y�t� THIS APPLICATIOV IS SLBJECT TO REVIEW BY THE Pt'BLIC PLEASE TYPE OR PRINI'II�L�K Type of Licease(s)being applied for: �`"^��M 1�l�`' ���tJ e CompanyTame: 17 D �MtrJf o'f {'hi�i�t�u �T?'�frJ _ S�v7'e o7�/'yli.�htso�� Co ntion/Partnership/Sole Proprietorship � If business is incorporated,give date of incorporation: �ot� e� rew"�t,f� Torh ����ta►�!C�" � Doing Business As: � Sl�i' �i PNlor Business Phone: ���' '��y� Business Address: �ODO CecX�rr' S'� S . Qac�,� �'`� SS/�/ Strxt Address Ciry State Zip Setv��een w�hat cross streets is the business located? � l�� k Cdtt�w�K S Which side of the street? L�aS� Are the premises now occupied?�,t�. R'hat T��pe of Business? �)�'!'h�ry �rQl�t��w� DCCQS/O+rw.[ 1'�a.i l�Al( Mail To Address: l0�(� �PCpa,�'" S�• .S7'�. ��es,,�( !�?•✓ ,�.Y'/o� Street Addras City State Zip Applicant Information: a¢�� o� �j/I�rl/ ��7'al�'r ' � �+ � q� p' I ,[�,� \'ameandTitle: t9AR�l �. �' V����L— �nt�fi'VT!�''` �� First Tiiddle (Tiaiden) Last Thle 1�8 , (�L�M�eAddress: � �. �.�,� ,� �� Street Address Ciry Swte Zip Date of Birth: Place of Birth: ��fcme Phone: �8a-f�y'�7 Have you ever been con��icted of any felony,crime or violation of any city ordinance other than tr�c? YES_ NO� Dau of acrest: Where? � C6arge: � Convictioa Sentence: List tbe names and residences of three persons of good moral c6aracter, living w•ithin the 'Twin Cities Metro Area, not related to the applicant or fmancially inurested in the premises or business,w•ho may be referred to as to the applicant's chazacter: NAME ADDRESS PH�;�'E List licenses which you cuRendy ho1d,focmerly beld,or may bave an interest in: �V 0"YtfZ Have any of the above named licenses ever been revoked? YES NO If yes,list the dates and reasons for revocation: /v�f�" - Are yon going to opence this business personally? YFS �NO If no�w�ho will operate it? %!L►� — — WJi��r�7�r ��afidta.���,Ma�.i�re� Firs�!�ame 1�tiddle Initial (Alsi en) Last Date of Binh GdD r r- S�. S�. Pa� �� Ssrol a�a• t�os�� _ Home Addras: Strsu:�ame Ciry Sute T�p Phone Number � �n- a-� .,., .__,. . . _ .,;. ,., _ �:--- . . �; -� �. ,.... , A.re��ou gomg to ha��e a manager or assistant in this business? 1'ES \O lf ihe manager is not the sarne as the operat�r �4 �b� complete the follo�•ing information: ��`���� S`� ., First A'ame ;�Siddle Initial ('�iaiden) Laxt Date of Binh aa� i Home Addrus: S�eet::ame Ciry State Zip Phone Tumbet Please list your emplo�•ment history for the pre�•ious fi��e(5)�•ear period: '�` � '�"� '� Business/Emnlo��ment ddres 31 List all other officers of the corporatien: OFFICER TTTLE HOME HO�'IE BUSI'��SS DATE OF NA.�'� (Office Held) ADDRESS PH01E PHO\E BIRTH If business is a parmership,ple�ce include the follow�ing information for each partner(use additiona]pages if necessac}•): Firsc Tame '�iiddle lnival (Tiaiden) Lut Dau of Bvth Home Address: Saxt!�une Ciry State Zip Phone Number First Fiame Middle Inival (Maiden) Last ' Dau of B►rth Home Address: Saea Tame Ciry Sute tip Phone Numbu MINT'ESOTA TAX IDENTIFICATIO\'NUMBER-Pursuant to the Laws of Minnesota, 1984,Chapter 502,Article 8,Section 2(270.72) (Taz Clearance;Issuance of Licenses),licensing authorities are required to provide to the State of Minnesota Commissioner of Revenue, , the Minnesota business tax identificavoa number and the social security number of each license applicant Under tbe Minnesota Govemment Data Practices Act and the Federal Priv�y Act of 1974,we are required to advise you of the following regarding the use of tbe Minnesota Taz Ideatification Number: -Ttus information may be used to deny the issuance or renew•al of your license in the event you owe I�'Iinnesota sales,employer s withholding or motor vehicle excise taxes; -Upon receiving this inforcnation,the licensing autbority w�ill supply it only to the Minnesota Departn�ent of Revenue. However, under the Federal Ezchange of Information Agreement,the Department of Revenue may supply this information to t6e Intemal Revenue Service. Minnesota Taz Identification I�umbers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records Department, 10 River Puk Plaza(612-296-6181). Social Securiry Number: Minnesota Taz ldentification Number: �0 ODOD � � _�, If a Minnesota Taz Identification Number is not required for tbe business being operated,indicau so by p)acing an"X" in the box. .,� - C�RTIFlCATIO\OF«'ORKERS'CO1'fPENSATION CO��RAGE PLRSL'.�.\�T TO ML�T'ESOTA STANTE 176.182 �� I hereby certify tbat I,or my company,am in compliance w•ith the��orkers'compensation insurance co��erage requiremenu of T4innesota f� Statute 176.182,subdivision 2. I also understand that pro��ision of falce information in this certification constitutes su�cient�rounds for ad�•erse action a�ainst all licenses held,including revocatio and suspension of said licenses. �\ Nan�e of Insurance Company: . �f ��HN�°ld�a ` � Policy;�'umber: Coverage from to I ha��e no employees co��ered under w�orkers'compensation insurance ' AT1'FAISIFICATION OF A1S«fERS GIVEI�OR AiATERIAL SUB:�IITTED R'ILL RESULT IN DEIIAL OF THIS APPLICATION I hereby state that I 6ave answered all of the preceding questions,and that the information contained herein is we and correct to the best of my know•ledge and belief. I bereby state fiutber that I ha�•e received no monep or otber consideration,by Way of loan,gift,contribution, or otberwise,other than already disclosed in tbe application a•hich I herew�ith submitted. I also understand ttvs premise rnay be inspected b}'police,fire,health and other city officials at any and all times w•hen the business is in opetation. � 9 �3 ,� Sign ture(REQL D fot all applications) Date p� b-F u�;I,�. �-�'���-1 � ""'�ote: If this application is Food/I.iquot related,please contact a City of Saint Paul Health Inspector,Ste.�e Olson(266-9139),to re�iew plans. U any substantial changes to structure are anticipated,please contact a Ciry of Saint Paul Plan Ezaminer at 266-9007 to apply for building permits. If there are any changes to the pazking 1ot,floor space,or for new operations,please contact a City of Saint Paul Zoning In�pector at 266-9008. Additional application requirements,please attach: A detailed description of the design,location and square footage of the premtses to be licensed(site plan). The follo.�ing data should be on the site plan(preferably on an 8 1/2"x 11"or 81J2"x 14"paper): -T`ame,address,and phone number. -The scale should be stated such as 1"=20'.^N should be indlcated toward the top. -Placement of all perttnent features of the interior of the licensed tacillty such as seating areas,kitchens,offices,repair ares,parl�ng,rest rooms,etc. � - U a request is for an addition or e�cpansion of the licensed tacility, indicate both the current acea and the proposed eapansion A copy of}•our lease agreement or proof of o�Tership of the property. FOR SPECIFIC APPLICATION REQUIRE�1iENTS, PLEASE SEE REVERSE >>>>