96-1266 c ': f � Council File #` " ��
Ordinance #`
Green Sheet #` -�`��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA 29
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Presented By , �,, y 11_�..._
Referred To Committee: Date
i RESOLVED: That application(ID#55489)for an On Sale Malt(Strong Beer) and Wine On Sale
2 License by Byerly's Inc. DBA Byerly's (Diane Stehura, Manager) at 1959 Suburban
3 Avenue be and the same is hereby approved.
4
5 Requested by Department of:
6 Y� Nays Absent
7 B a e,y
8 Guerin �� _� Office of License. Inspections and
9 Harris
10 te ard —�� Environmenta� Protection
11 Re man �
12 T une �—
15 Bostrom ✓ -�
16 Adopted by Council: Date � -� �{ `q°l So By' � /
- c —�
17
18 Adoption Certified by Council Secretary
19 Form Approved by City Att . ey
20 � '
21 By:
22 BY'
23 P.pproved by Mayor: Date �� �S/ � �P
24
25 Approved by Mayor for Submission to
26 By: � �L ��� Council
27
By:
` 1•~��+1�`
LIEP/Licensin �" �Nm�r�o �`iREEN SHEET N°— 3�4 9 2
� �oew►a�eNr aRECta+NmAUO+�� �cm couNCi� __- �rrw�on�
Christine Rozek, 266-9108 �N �CITYATTORNEY �CRYCLERK
M BY( R�NQ� �BUDOET DIRECTOR �flN.6 MaT.SERVICES DIR.
For hearin : 0 �1 5 b °n�" p AAA1O"t°a"�ss�sTa"n ❑
TOTAL#E OF SIONATURE PAOES (CLIP AL�LOCATIONS FOR SKiNATURE�
ACiWN REQUE8TED:
Byerly's Inc. DBA Byerly's requests Council approval of its application for an On Sale
Malt (Strong Beer) and Wine On Sale License at 1959 Suburban Avenue (ID #55489).
RECOMMENDATIONS'Appr°w���°r Ryact(R) PERSONAL BERVICE CONTRACTS MUST ANiWER THE FOLL01NIN0 QUE8TION8:
_PLANNMIO COMMISSIOI�1 �.CIV�8ERVICE COwiM188101�1 1. Has tltls psrsonlfkm eVOr worked under s C011trtCt ta thls dYp�rd�Nnt9
_��E _ YES NO
2. Hea d�is person/firm evsr bes�►a city employee?
—�� — YES NO
—�TR�T�pT — 3. Doe�riNa personRtrm posssas$akill rwt no►nwly possssssd by eny a,msnc cay�oy.e�
suPPORTB wllKkl COUNCx.OBJECTIVE? YES NO
Ezplaln dl y�s answ�n on ap�r�b�M�t a�d attach to�rwn N�t
M1ITIATMKi PROBI.EM.188UE.OPPORTUNII'Y(Who.Mlh�t.VN�sn�Whsis.WI+YY
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AUG 12 199�
, Ct � � �� ��K
ADVANTAGES IF APPRO'VEO:
018AD'VANTAOE8IF APPROV.ED:
� � �� �
SEP 0 21996
OISADWINTMOEB IF NOT APPROMED: ... •
TOTAL AMOUNT OF TRAN8ACTION = C08T/REVENUE dUDQETEO(GRCLE ONE) YES NO
FUNDINA sOURCE ACTIVITY NUMBER
flNANCIAI INFORMATI�1:(EXPlA1N)
Greensheet # -��1� L.I.E.P. REVIEW CHECKLIST Date: 8���96 � ��i'�''`G
In TraCkel'? App'n Received / App'n Processed
License ID # 55489 License Type: On Sale Malt (strong beer), Wine On Sale
Company Name: BYerly's Inc. DBA: Bverlv's
Business Addresss: 1959 Suburban Ave. Business Phone: 735-6340
Contact Name/Address: Diane Stehura,
Public Hearing Date: �L7 Labels Ordered: ���,���
Notice Sent to Applicant: � District Council #: �
� � ��,g �
Notice Sent to Public: �? `f ��i,( Ward #: �
Department/ Date Inspections Comments
�
City Attorney
•2� •9 lo a.
Environmental
Heaith
�.Z� �i� o`� .
Fire
�•�~�� D� �
License Site Plan Received:
l.ease Received:
� �$. I NS
Police
8•?� •`��o c�• � -
Zoning
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CLASS III CITY OF SAINT PAUL
LICENSE APPLICATION Office of License,i�5���0�5
and Environmental Protection
350 Si Pa«S�.Suite:�00
Saiet PauL Ninneaan 35102
(61I)2669090(u(612)266-9120
� ac.-�a�c�
THIS APPLICATION IS SUBJECT TO REVIEW BY THE PUBLTC
PLEASE TYPE OR PRINT W INK
Type of License(s)being applied for: On Sale Beer and Wine
CompanyName: Byerly's, Inc.
Corpontion/Partnership/Sole Proprietorship
If business is incorporated,give date of incorporation: 2-10-70
Doing Business As: Byerly's St. Paul Business Phone: �612) 735-6340
Business Address: 1959 Suburban Avenue St. Paul MN 55119
Sveet Address City State Zip
Between what cross streets is the business located? �ite Bear & Ruth Street W�ch side of the street? North
Are the premises now occupied? Yes What Type of Business? Restaurant within a grocery store
Mail To Address: 1959 Suburban Avenue St. Paul MN 55119
Sveet Address City State Zip
Applicant Information: �
Name and Tide: Donald Duane Byerly vT-f-1C��
First Middle (Maiden) Iast TiUe
HomeAddress:
Svcet Address City State Zip
Date of Birth: Place of Birth: Home Phone: (
Have you ever been convicted of any felony,crime or violation of any city ordinance other than traffic? YES_ NO X
Date of arrest: Where?
Chuge:
Conviction: Sentence:
List t6e names and residences of three persons of good moral character, living within the Twin Cities Metro Area, not related to the
applicant or financially interested in the premises or business,who may be referred to as to the applicant's character:
NAME , ADDRESS PHONE
Tom Moe
List licenses which you currendy hold,formerly held,or may have an interest in:
Byerly's, Inc. holds On—Sale Beer and Wine Licenses in four of its other Restaurants. �
Have any of the above named licenses ever been revoked? YES X NO If yes,list the dates and reasons for revocation:
Are you going to operate this business personally7 YES X NO If not,who will operate it?
Diane L. Slotsve Stehura
First Name Middle lnitial (Maiden) Last Date of Birth
Home Address: Sveet Name City State Zip Phone Number
- ; . _.,..�.��� . �VN�
Ar�you going to have a manager or assistant in this business? YES NO If the manager is not the same as the operator,pl�� ,Di�`!'
complete the following information: Manager will be the same as operator
� �--��
First Name Middle Initial (Maiden) Last Date of Birth
Home Address: Sveet Name Ciry State Zip Phone Number
Please list your employment history for the previous five(5)yeaz period:
Business/Emplovment Address
Retired 1990 — present
List all other officers of the corporation:
OFFICER TITLE HOME HOME BUSINESS DATE OF
NAME (Office Held) ADDRESS PHONE PHONE BIRTH
See attached list
If business is a parmership,please include the following information for each partner(use additional pages if necessary):
First Name Middle Initial (Maiden) I.ast Date of Birth
Home Address: Street Name City State Zip Phone Number
First Name Middle Initial (Maiden) Last Dau of Birth
Home Address: Street Name City State Zip Phone Number
MIIVNESOTA TAX IDENTIFICATiON 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 taz identification number and t6e social security number of each license applicant.
Under the Minnesota Government Data Practices Act and the Federal Privacy Act of 1974,we aze required to advise you of the following
regazding the use of the Minnesota Tax Identification Number:
-Ttus inforu�ation may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales,employei s
wittiholding or motor vehicle excise taxes;
-Upon receiving this information,the licensing authority will supply it only to the Minnesota Deparh�nt of Revenue. However,
under ihe Federal Ezchange of Information Agreement,the Department of Revenue may supply this information to the Intemal
Revenue Service.
Minnesota Taz ldentification Numbers (Sales & Use Taz Number) may be obtained from the State of Minnesota, Business Records
Department, 10 River Pazk Plaza(612-296-6181).
Social Security Number:
Minnesota Tax Ide�tification Number:
If a Minnesota Taz Identification Number is not required for the business being operated,indicate so by placing an"X"in the
box.
t
'�4r� ��`_''�'`,
/ b .
ItTIFICATION OF WORKERS'COMPENSA'TION COVERAGE PURSUANT TO MINNESOT'A STATUT�E 176.182 `v"�,`'r
I hereby certify that I,or my company,am in compliance with the workers'compensation insurance coverage requiremenu of Minnesota
Statute 176.182,subdivision 2. I also understand that provision of false infom�ation in this certification constitutes su�cient grounds for
adverse aciion against all licenses 6eld,including revocation and suspension of said licenses.
Name of Insuraoce Company: Self Insured
PolicyNumber: W-1150 Coveragefrom 4/1/88 to ContinuinQ
I have no employees covered under workers'compensation insurance
ANY FALSIFICATION 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 conect 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,otl�er than already disclosed in the application which I herewith submitted. I also understaad this premise may be inspected
by police,fire,health and other city officials at any and all times when the business is in operation.
(
T � Signature(REQUIRED for all application Date
**Note: If this application is Food/I_iquor related,please contact a City of Saint Paul Health Inspector,Steve Olson(266-9139),to review
plans.
If any substantial changes to sWcture are andcipated,please contact a City of Saint Paul Plan Ezaminer at 266-9007 to apply for
building pemvts.
If there are any changes to the pazking lot,floor space,or for new operations,please contact a City of Saint Paul Zoning Inspector
at 266-9008.
Additional application requlrements,please attach:
A detailed description of the designy location and square footage of the premises to be licensed(site plan).
The foilowing data should be on the site plan(preferably on an 8 1/2"x 11"or S 1/2"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,lcltchens,ot[ices,repair
area,parking,rest rooms,eta
- If a request is for an addition or expansion of the licensed facility, indicate both the current area and the proposed
expansion.
A copy of your lease agreement or proof of ownership of the property.
FOR SPECIFIC APPLICATION REQUIREMENTS, PLEASE SEE REVERSE >>>>