96-1030 R� � �` � �� � �', � �1 � council File # � �o I C�3 O
.� ��� i �.." �w , ;
Ordinance #`
Green Sheet # �
RESOLUTION
O SAINT PAUL, MINNESOTA ��
Presented By
Referred To Committee: Date
i RESOLVED: That application(ID #38652) for a Liquor On Sale-B and Sunday On Sale Liquor
2 License by Sakura Inc. DBA Sakura(Miyoko Omori, Owner) at 34 6th Street West be
3 and the same is hereby approved.
4
5 Requested by Department of:
6 Yeas Nays Absent
7 B a ey Z
9 Harris —� Office of License, InsBections and
10 Me Environmental Protection
11 Re tn an
12 T une
13 Bostrom
14 Q �
15 `
16 Adopted by Council: Date o�-(� By°
17
18 Adoption Certified by Council Secretary
19 Form Approved by City Attorney
20
21 BY: — � �
��� By: I
22
23 Ap�r•ov�d �y Mayor: Date � ��
24
2� /� Approved by Mayor for Submission to
�r ��' �� _ �, Ili .�"_ � COUIlCll
1�
By:
N. DATE INITIA D O �_ �O 3 Q
N_ � 5487
�REEN SHEET _ _ _
LIEP Licensin - -
�` �DEPARTMENT OIRECTOR NITIAL/OJ1TE ❑CITY(�IJNCIL INITIAUDATE
Christine Roxek, 266-9108 � �CITlATTORNEY �CITYCLERK
il NDA ( I p�pyT�jNp� �BUDQET DIRECi'�OR �FlN.3 MOT.SERVICEB DIR.
For hearing: 97 � o�o�n ��,uroa ta+nssisr�um �
TOTAL#t�SIONATUlIE PAOE8 (CLIP ALL LOCATION$FOR SIGNATURE)
�c7ia+RECU�srEO:
Sakura, Inc. DBA Sakura requests Council approva�: of its application for a Liquor (hz Sale-B
• and Sunday On Sale Liquor License at 34 6th St. W. (ID #38552).
RECOMMENOATION8:Apprew(A)a Rysct(R) PERSONAL SERVICE CONTAACTS MUST AN=WER Tt1E FO�LOWING G�IE=TIOF18:
_..._PLANNMK�WAAAAIS810N _�CIVIL BERVICE COI�II�BION 1. Has tllis psreon/Ilrtn evsr worksd under a ca�traCt for this dipi►hnent? -
_C�C�AITiEE _ �S �
_STAFF _ 2. Has this peraonRirm ever bsen a cftY emP�oyea9
YES NO
_DIeTRICT COU1iT _ 3. Does M1a perwnlfirm posssss a sk�l not nonneNY Po�eeted bY�M a�rrsM cily emp�o�S1
8UPRORT8 WNKSM(�lNrCll O�CTIVE9 YE3 NO
Exptsin NI�na an�w�n on s�p�rab da�t aW�ch to pewn Na�
INITIATN�K9 PROBLEM.�88UE.OPPORTUNfN Mnw.Wlmt.Wha��whsro�VVhy):
AOVANTAQES IF APPRO'VED:
DISADWINT/�pE8 IF APPROVED:
OIBAONAMfApEB�NOT APPROYED:
� � �
AU G 2 0 1996
TOTAI.AMOUNT OF TRANSACTION i COST/REVENUE BUDOETFO(CIRCIE ONE) YES NO
�UNDIHQ SOURCE � ACTIVITY NUMOER
FINAWCIAL INFORMATI�1:(EXPI.AIN)
. ._. 1�;� // � (�l!� 1.'?�
. . � �o' ��`�O
� CLASS III CITY OF SAINT PAUL �
LICENSE APPLICATION Oflice of License,i�s���o�s
and Environmental Protection
• 330 S1.Paer St.Suiu 300
Saiot Paul,Minnesda 35102
(612)4b69090 fax(612)266-9124
�
THIS APPLICATION IS SUBJECT TO REVIEW BY THE PUBLIC
PLEASE TYPE OR PRINT IN INK
Type of License(s)being applied for: : !� i� �
CompanyName: �Q. �,Lrci ��YIC�
Corpo�/Partnership/Sole Proprietorship
If business is incorporated,give date of incorporation: ' � J���
Doing Business As: Y'ot �� Business Phone: �lo� v�a�'���S
Business Address: t~ 5 y�d Z
Street Address City State Zip
Between what cross streets is the business located? �1- �V Which side of the streei?
Are the premises now occupied? � What Type Business? 4 �v�c�. cL '
Mail To Address: �� `� iv � -��Z
Sveet Address Ciry State Zip
Applicant Information: �
Natne and TiUe: ��� 1�n i'�U � YI'l Dl'1 GU 1'1�G Y'
First �- Middle (Maiden) Lau TiUe
Hor�Address:
Stroet Address Cit tate Zi
Date of Birth: _���_ Place of Birth: � Y Home Ph����� �
Have you ever been convicted of any felony,crime or violation of any city ordinance other than traffic? YES_ NO�
Date of arrest: W6ere?
Charge:
Conviction: Sentence:
List the names and residences of three persons of good moral chazacter, living within the Twin Cities Meiro Area, not related to the
applicant or financiaily interested in the premises or business,who may be refened to as to the applicant's character:
NAME ADDRESS PHONE
Y _ e i n r; �
°/
List licenses which you currend 601 formerly held,or may have an' terest in:
(^�n �'v' o�.l� YY1Q D�: o� �,� i Q - ��4�� r �
Have any of ihe above named licenses ever been revoked? YES �NO If yes,list the dates and reasons for revocation:
Are you going to operat,e this business personally? ��ES NO If not,who will operate it?
Frst Name Middle Initial (Maiden) Last Date of Birth
Home Address: Street Name Ciry State Zip Phone Number
� ._ _
�U � � .
' Are qou going to have a manager or assistant in this business? �YES NO If the manager is not the same as the operatoi,,�,--� ��-..,
complece the following information: � �_(O 3 p '',� � °g' '�
1 r�� h�Q 1'1Pd!l
6-'7 � z o
Frst Name �Middle Initial (Maiden) V Last Date of Birth
�oa� l� v�e S �)s �5�a7 �a7- f.��,
Home Address: Street Name City State Zip Phone Number
Please list your employment history for the previous five(5)yeaz period:
Business/Emplo m�ent ddre s
�/9.���— n �-�`' Q�_ G+�
�� h — . �'
List all other officers of the corporation:
OFFICER TIT'LE HOME HOME BUSINESS DATE OF
NAME (Office Held) ADDRESS ,� PHONE P ONE BIRTH
� o I�a a '
If business is a partnership,please include the following inforn�ation for each partner(use additional pages if necessary):
l��o(��
First Name Middle Initial (Maiden) Last Dau of Birth
Home Address: Street Name Ciry State Zip Phone Number
Frst Name Middle Initial (Maiden) Lazt Date of Birth
Home Address: Street Name Ciry State Zip Phone Number
MINNFSOTA TAX IDEIVTIFICATTON NUMBER-Pursuant to the Laws of Minnesota, 1984,Chapter 502,Article 8,Section 2(270.72)
(Tax Clearance;Issuance of Licenses),licensing authorities are required to provide to ttie State of Minnesota Commissioner of Revenue,
the Minnesota business taz identification number and the sacial security number of each license applicant.
Under the Minnesota Govemcnent Data Practices Act and the Federal Privacy Act of 1974,we ue required to advise you of the following
regarding the use of the Minnesota Taz Identification Number:
-This infom�ation may be used to deny the issuance or re�wal of your license in the event you owe Minnesota sales,employer s
withholding or motor vehicle excise taxes;
-Upoo receiving this infortnation,the licensing authority will supply it only to the Minnesota Department of Revenue. However,
under tbe Federal Ezchange of Information Agreement,the Department of Revenue may supply this information to the Intemal
Revenue Service.
Minnesota Tax Idendficadon Numbers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records
Department� 10 River Park Plaza(612-296-6181).
Social Security Number: '
Mlnnetota Tut identification Number: �
il a Mlnoesota Tu ldentification Number is not rcquired for the business being operated,indicate so by placing an "X" in the
bo�.
� :,� _
��- .
�-:5, . .
1 �
7 do� . � � �C-fo��e
; n � „y�;ATION OF WORKERS'COMPENSATTON COVERAGE PURSUANT TO MINNESOTA STATUTE 176.182
G � � '`� �certify that I,or my company,am in compliance with the workers'compensation insurance coverage requirements of Minnesota �
� ,� � ,�176.182,subdivision 2. I also understand that provision of false information in this cer[�cation constiWtes sufficient grounds for
� :rse action against ail licenses held,including revocation and suspension of said licenses.
.ame of Insurance CompanY��C�..:2�n.�1!�L!�. '.�•ti6s�-!'�p �� �Fitrm���'� -�''�j—
Policy Number:,� �Jl3 tX�O .�Gi 0�00 Coverage from �/ to 7 '
� I have no employees covered under workers'compensation insurance
ANY FAISIFICATION OF Ar'SWERS GIVEN OR MATERIAL SUBMITTED
VVII,L RESULT IN DENIAL OF THIS APPLICATION
I hereby state that I have 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,other than already disclosed in the application which I herewith submitted. I also understand this premise may be inspected
by police,fire,health and other city officials at any and all[imes when the business is in operation.
\ ,
.� ,, — / •
� Signature QUIRED for pplications) 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 structure are.anticipated,please contact a City of Saint Paul Plan Ezaminer at 266-9007 to apply for
building pemuts.
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 81%L"x 11"or 81/Z"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,latchens,offices,repair
area,parldng,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 >>>>
Greensheet # 35487 L.I.E.P. REVIEW CHECKLIST Date: 7/25/96 / ��— ���o
In Tracker? �p'n Received / App'n Processed
License ID # 38652 License Type: Liquor On Sale-B, Sundav On Sale Liauor
Company Name: Sakura, Inc. DBA: Sakura
Business Addresss: 34 6th St W Business Phone: 224-0185
Contact Name/Address: Mivoko Omori, Home Phone:
Date to Council Research: r �
Public Hearing Date: ' .2� CY Labels Ordered: �
Notice Sent to Applicant: �0 9� District Council #:
Notice Sent to Public: v e�� � Ward #:
Department/ Date Inspections Comments
�
City Attorney
8•zp•`ib O.� .
Environmental
Health
�.Z'D �`� D. � .
Fire
8'ZD '�lo �' �'
License Site Plan Received:
Lease Received:
Police
S•ZD•`�!� � tc .
Zoning
g• 20 •`�'!o O•iC' .