96-1097 �� � i � � �1,� � � Council File # –/� �
Ordinance #
Green Sheet ,� � ���j�
RESOLUTION
CI F SAINT PAUL, MINNESOTA
Preaented By
Referred To Committee: Date
1 RESOLVED: That application (ID #55804) for an Auto Body Repair Garage License by B & A
2 Body Shop Inc. DBA B & A Body Shop ( William Shappell, Owner) at 363 Atwater
3 be and the same is hereby approved.
4
5 Requested by Department of:
6 =_��� Nav� Absent
7 B a �Y
8 Guerin Office of License, InsBections and
9
10 1�����r �` Environmental Protection
11 Re�m n
12 _ T une --�
14 Bostrom
15 ,'►�-�`,r-t� N-
16 Adopted by Council: Date �,�,,�. � . �qq By'
17 —'.--r^`�_�
18 Adoption Certified by Council Secretary
19 Form Approved by City Attorney
20
21 By:
22 BY� �u-c�- �
23 Approved by Mayo . Date � �t�
24
25 /�, , J/ �%���`�'vJ Approved by Mayor for Submission to
26 BY: �l�l�(�' Council
27
By:
9� �/09�
���N � GREEN SHEET N_ 35516
�DEPAATMENT DIRECTOR mA�� �CITY COUNCIL �mALIOATE
Christine Rozek, 266-9108 ��N �cmnrroAr�r �CITY CLERK
OA ( , �� �BUDfiET aRECTOR �FIN.a MOT BERVICES OiR.
For hearin : �0 °� ❑""'''��OR"��"� ❑
TOTAL#t OF SKiNATURE PAOEB (CUP ALL LOCATIONS FOR 81GNATUR�
A�CTION RHGUESTED:
B & A Body Shop Inc. DBA B & A Body Shop requests Council approval of its application for
an Auto Body Repair Garage at 363 Atwater St. (ID #55804) .
����$'�Ow���°f��q� PERSONAL 8HRVICE CONTRACTS IIAWT ANBWER TME FOLLOWINO�UESTIONS:
_PLANNMIO COMM1881�1 �Crv�SERVICE C01Ab11881W�1 1. Has Thfa pe�eoMll►m ever wofk�d und�r e COrNrACt for dNs d�trnsM?
_CIB Co1AMITTEE _ YES NO
2. Hes this psrsondirm svsr bsen a Wty employee,?
—�� — YES NO
_DISTRICi COURT _ 3. Doas thls psreonRirm poa6eas a skill not normeNy poeeaased hy amr curroM dfy smploy�s7
8UPPORTB WHICN COl1NC�OB,IIECTIVE4 YES NO
Expldn all yp answ�n on ssp�niU shNt�ed sttach to prNn�hNt
INIT4ITN�K�1 PROSLEM.�88UE.OPPORTUNITY�Who.Whel.YVMn�WMn,NfhY): �'�: �.�.•.,�1 V�V
JUN 21 1996
�;�_��..� �►��'C���IEY
ADVMITAOES IF APPFiONED:
D18ADVANTIIOES IF APPRbVED:
D181�DVANTAOE8IF 1�T APPROVEO:
� � �
AUG 1� 1996
TOTAL AMOUNT OF TRANBACTION = C06T/REYENUE OUDQETED(CIRCLE ONE) YES NO
FtlNDING SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION:(EXPLAIN)
. ;, ��ij r�.�.et.�h - ��Z a..t.��,�+-�c�
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CLASS III CITY OF SAINT PAUL
ICENSE A.PPLICATION o�r�e or����n�e, Inspections
and Environmental Protoction
.�.,� i30 St.Pclv S�Suite 3fW
.�..�}'�^. �� S�int P�ul,Afinoaob 33102
���+�• `�"�+7 (61:)?66•9090 fax(61.)266•91?� �
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THIS APPLICATIOV IS SUBJECT TO REVIE\�V BY THE PUBLIC
�c;�; PLEASE TYPE OR PRINT IN II�'K �
�� �
T��pe of�nse(s)being applied for: ��.3�� �iLG� ��/ L /I' 7 !'' �3��. �•
Company Name: �j "'t- � (� ("j�L( ._S h Cj
Corporation/Paztnership/Sole Proprietorship
If business is incorporated,give date of incorporation: �
Doing Business As: Business Phone: �*-'-'--`---3��,
Business Addrzss: �c,� �'� �.1J '� � '�_�
Sueet Address City Scate Zip
Beh�•een�vhat cross streets is the business located? �1-wA'�C�����-- `�,}�I `��i side of the street?
Are the premises no�v occupied? N � What T�pe of Business? � C� � U W U LQ �
Mail To Address: •�� � � �',-
Sveet Address Ciq� State Zip
Applicant Information: �
Name and Titte: _�_1�..,L 1�d'� �(�-l�� ?1R pt Q ��-(� n��e-�\
Fi:�t PAiddle (Rlaiden) Lut Ti:le
Home Address: �`_7 3 �p � �7 R� �� (.v '�--
Sutet 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 traffic7 YES NO�,
Date of arrest: Where?
Charge:
Conviction: Sentence:
List the names and residences of three persons of good moral character,Jiving within the Twin Cities Metro Area,not related to the
applicant or financially interested in the premises or business, �vho may be referred to as to the applicant's character:
NAME ADDRESS ' PHONE
List licenses�vhich you currently hold, formerly held, or may have an interest in:
1��c7 l��-( S h c� (� L c�_�'— rv�-�;��
Have any of the above named licenses ever been revoked?_YES ,�„NO 1f yes, list the dates and reasons for revocation:
Are you going to operate this business personally? �YES NO tf not, who�vill operate ii?
� /
First Name Middle Initial (Maiden) � Last i�ate of Birth
� ��
Nome Addrcss: Sueet Name rity . Statc Zip Ph� on—e Number
�.
_..._ _ ,. .n:...,,.�,�
0
Are you going to have a manager or assistant in this business? �YE,S NO If the manager is not the same as tb,e oper�t�r, � �
please complete the following infonnation: �/ _/0��
(O
First Name 1�7iddle Initial @laiden) ; Last . Date of Binh .
Home Address: Street Name City State Zip Phone T'umber
Please list your employment history for the previous five (�) year period:
Business/Emplovment Address
�- � ' d 4�� u _ r
List all other officers of the corporation:
OFFICER 7ITLE HOA�IE HOME BUSINESS DATE OF
NAME (Office Held) . ADDRESS PHONE PHONE BIRTH
If business is a partnership, please include the follo��•ing inforniation for each partner(use additional pa�es if necessary):
First 1�'ame T9iddle Initial (Ataidcn) Last Date of Birth
Home Address: Sueet\'ame Ciry State Zip Phone\'umber
First T'ame Tliddle Initial (1�4aiden) Last Date of Binh
Home Address: Sueet Tdame City State Zip Phone 1.'umbe�
MINNESOTA TAX IDENTIFICATION NLJMBER - Pursuant to the La�vs of Minnesota, 1984, Chapter 502, Article 8, Section 2
(270.72)(Tax Clearance;Issuance of Licenses),licensing authorities are required to provide to the State of Minnesota Commissioner
of Revenue,the Minnesota business tax identification number and the social securiry number of each license applicant.
Under the Minnesota Government Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the
follo�ving regarding the use of the Minnesota Tax Identification Number:
- This information 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 this information, the !icensing authority �vill supply it only to the Minnesota Department of Revenue.
However,under the Federal Exchange of Information Agreement,the Department of Revenue may supply this information
to the Intemal Revenue Service.
Minnesota Tax Identification Numbers(Sales& Use Tax Number)may be obtained from the Statc of Minnesota,Business Records .
Department, 10 River Park Plaza(612-296-6181).
Social Security Number: � -
Minnesota Tax Identification Number: �
If a Minnesota Tax Identification Number is not required for the business being operated, indicate so by placing an "X" in
the box.
,,
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CER7'IFICATION OF WORKERS' COMPENSATION COVER.AG� PURSUANT TO MINNESOTA STATUTE 176.1 2
I hereby certify that I, or my company, am in compliance ��'ith the �vorkers' compensation insurance covera�e requirements of
Minnesota Statute 176.182,subdivision 2. I also understand that provision of false information in this certificationconstitutes sufficient
grounds for adverse action against all licenses held, includin�revocation and suspension of said licenses.
Name of Insurance Canpany:
Policy T'umber: Coverage from to
I have no employees covered under workers' compensation insurance�
ANY FALSIFICATION OF ANS�VERS GIVEN OR AIATERIAL SUBMITTED
\VILL RESULT IN DENIAL OF THIS APPLICATION
I hereby state that I have ans���ered all of the preceding questions, and that the information contained herein is true and correct to the :
best of my }:no�vledge and belief. I hereby state further that I have received no money or other consideration,by �vay of loan,gifr,
contribution,or othern�ise,other than already disclosed in the application���hich I here�vith submitted. I also understand this premise
may be inspected by police, fire, health and other city officials at any and all times�vhert the businPss is in operation.
_ . _.��� �,.
_. _ . - -
.�-� ' ��3`
Signature(REQUIRE or all app ' �ons) Date
**Note: If this application is Food/Liquor related,please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to
revie�v plans. �
If any substantial changes to structure are anticipated,please contact a City of Saint Pau1 Plan Examiner at 266-9007 to apply
for building permits.
If there are any changes to the parking lot, floor space, or for ne�v operations, please contact a City of Saint Paul Zoning
lnspector at 266-9GG"a.
Additional application requirements,please attach: '
A detailed description of the design, location and square footage of the premises to be licensed(site plan).
The follo�►•ing data shouid be on the site pian (preferably on an 8 1/2" x 11" or 8 1/2" x 14" paper):
- T`ame, 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
area, parking, rest rooms, etc. '
- I!a request is for an addition or expansion of the licensed facility, indicafe both the current area and the proposed
expansion.
A copy o!your lease agreement or proof ot ownership of the property.
FOR SPECIFIC APPLICATION REQUIREMENTS, PLEASE SEE REVERSE > > > >
Greensheet # 35516 L.I.E.P. REVIEW CHECKLIST �ate: 6/11/96 / ��o�/()�7
In TraCket? App'n Received / App'n Processed
License ID # 55804 License Type: an Auto Bodv Repair GaraQe
Company Name: B & A Bodv Shop Inc. DBA: B & A Body Sho�
Buslness Addresss: 363 Atwater St Business Phone: 489-3404
Contact Name/Address: William Shappell, Home Phone:
Date to Council Research:
Public Hearing Date: • `'� '� � Labels Ordered:_��/,
Notice Sent to Applicant:_�/7�O District Council #:
��m� 3� �j
Notice Sent to Public: � Ward #: ✓
Department/ Date Inspections Comments
�
City Attorney
8 • •�• / �o Qr 1\'•
Environmental
Health
� .i� •
Fire
�'�3•`�� p.t� .
License ���e^�i��� r
�.ease Recetved: T
`i�`I15 � �7(o O �
Police
8• �3.�j(o ��� .
Zoning
�• 13�91� �.�C �