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95-1049Council File # � J — /� 1 Ordinance # Green Sheet # 30851 RESOLUTION CITY OF SAINT PAUL, MINNESOTA Presented By Re£erred To Committee: Date 1 RESOLVED: That application (I.D. #97163) for an Off Sale Liquor License applied for by 2 Aaskell's Inc. DBA Haskell's {JOhn F. Farrell, Jr., President) at 2221 Ford 3 parkway be and the same is hereby approved. r _—��—�r--� Requested by Department of: Office of License, Insnections and Environmental Protection By: ����.R.% � Adopted by Council: Date Adoption Certified by Council By: Appx By tary Form Ap roved by Cit Attorney BY: � � �r.r 5-i5 -95' Approved by Mayor for Submission to Council SY: a5 - lO'-{}� DEPARTMENTfOFFICEICOUNG�L DATE7NITIATED GREEN SHEET N� 3 0 8 51 LIEP/Licensing - CONTACT PERSON & PHONE INITIAUDATE WRIAVDATE �DEPAeTMENTDIPE �CITYCOUNdL Bill Gunther/266-9132 nssi�n �CITYATfORNEY �CI7YCLERK MUST BE ON CAUNCILAGENDA BY DATE) pQ�NG � BUDGET DIqECTOR O FIN. 8 MGT. SERVICES DIfl. FO'L HEdT1Rg : ���Q R s ONOEH � MAYOR (OR A$$ISTANT) O TOTAL # OP SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) 0.CTIQN HFAUESiEO: Haskell's Inc. DBA Haskell's (John F. Farrell, Jr„ President) requests Council approval of its application for an Off Sa1e Liquor License at 2221 Ford Parkway. (I.D. 4197163) RECOMMENDATIONS: Approve (A) or Rejact (R) PERSONAL SEHVICE CONTRACTS MUST ANSWER TME FOLLOWING �UESTIONS: _ PL4NNING COMMISSION _ CIVIL SERVICE CAMMISSION �� Has this personffirm ever worked under a contrect for this department? _ CIB COMMITfEE _ YES NO _�� 2. Has this personttirm ever been a ciry employee? — YES NO _ DIS7qIC7 CoU� — 3. Does this perSOnKrm possess a skill not normally possessed 6y any current ciry employee? SUPPORTS WHICH COUNCIL O&IECTIVE? YES NO Explain all yes enswers on separete sheet entl atteeh to green sheet IMTIATING PPOBLEM, fSSUE, OPPORTUNITY (Who. What, When, Where, Why): This is a change of officers to remove C. Rex Rice and replace him with Thomas J. Schneider as VP/Secretary. ADVANTA6ES IF APPROVE�. DISADVANTAGES IF APPROVED: OISADVANTAGES IF NOTAPPROVED' TOTAL AMOUNT OFTRANSACTION $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUtiDIHG SOUHCE ACTIY{TY NUMBER FINANCIA� INFOHMATION: (E%PLAIN) � r Greensheet# 30851 L.I.E.P. REVIEW CHECKLIST �ate: 4/2s/9s /�S'�O�-}'q In TraCkel'? App'n Received / App'n Processed License ID # 97 t tia License Type: Off Sale Liquor Company Name: T� �- � i� r DBA: Haskell' s Business Addresss: ZZZ1 Ford Parkway Business Phone: 333-2434 Contact Name/Address: Steve Lyons, 2170 Lincoln Ave. , Home Phone: 698-5468 St Paul, MN 55105 Date to Council Research: Public Hearing Date: J � Notice Sent to Applicant: �/ �a� �11 e-'�7 Labels Ordered: 5/3/95 District Council Notice Sent to Public: �-�! N �` �' a � Ward #: 03 Departmentf Date Inspections Comments City Attorney �, � �y� � G� Environmental �,� �� �,�, 1___ � �;,,�' Health .� - ��- � ` � Fire � .�.��.� D� t�.�� �'� License �-{ �- n� �� u � Site Plan Received:_ Lease Received: Police R � �'"'`'� �"�,A l ilz(YS (� I,v �' f' Zoning '7 �� � Jj� � ��' �v�- "„"'-2'� �� �� OFFIC6 OF LICE�SL-. I?Sr^LC710\S .A�" G��'1ROX?9E?�TAL 1'RO7ECTl0>' �� � I� �C Rohert,l'esslrr. D;r«tar CITY OF S�T PALZ ��cr�p CG�emGn., '�;et Gs UCE.1"Sr .5 �"D I �SPc'CTIO.�S J�� $1. �Plfr $;rf[I �11iP : �Q Semt Pcvl, !Jir.r,esaa SS)G? JIQUO2 - OLr SAJJ LIC�NS� ????LICAT�ON 7ele�,hcr.e 61?-_G5-91GD Fccs�r„ie: Gl_'-:G6-9i?; This form must be typewritten or printed in ink by the sole owner, by each partner, by each person who has interest in excess of 5% in the corporation and/or associatioa in which the narie of the license will be issued. lY1s �??�_TCAl1�N IS SU?J�C_ TO REVIc.W BY 1'F:: :U?v.ZC , _ ?.�<iness :-.cc.e_=s � �� 1 �orc� �Kv.�.� '�� t�1�1 'a�,Illo 2 3 c 5 6 7 B 9 Husi-ess �a-�e Nn.�KQ�\'S 1nt r ?i �•�s_aess is _r.corporat�d, cc•._ da,._ cE _-cc__ _a�icn � , 19 7'l� Do_rg 3csine_s =s `'�"c�SKP��'S -vsi^=_ss 9:^.o^e - b i p—`3`ri�4 N.�SS LO �C�PE55 (1= Cl_°°'_"E:7� CLc1 CL`SiL�ESS cCC:E55� .__ oT MN SS4e� Ycvr ?:a-�e Mc � �.� �..e '.�a � fP \\ Title 7'SZ�C.��V��P:C� -ome �ccress 1�1`ris �vne.t�c, �P s Mn\� MtJ e4�G3 ?.*.or.e n 3�1 �ate ef 3irth (N,onth, Day, Year) ' (e'" ��—�� ??ace c`_ 3irth TJ�..r�riFc�DC7��5 N�� r � 1D. P.ze you a U. S. citize^? S ]:ative � �=tuzalized If nzturalized, submit pzoo£ f.^.aturalization cr valid docu^e.^.tatien o£ Xesicer.t alien status. *(in zcccrdance with I�N Statuce 350.<02A, .^.o Ca Sale ox Off Sale Liquor Licer.se �ay be issued to anyone who is nct a U. S. citizen or resider.t alien.) 11 1z 13 1S i5 16 -a��e yc'� evez b�e.^. ccnvict=_� c_ a.^.y `elcny, cr;-.e, or violGticn o` z::y c'-tY crdiaa-ce cL^er :^�a tra"!c? IJO �S �ate c' zr:esc 7ire:e CC?:V1C=_C:1 �ate c_ �rrest itinE COi]V 3 Ci:O:' 'ic� 1< �E�ceS b:l?LC1 y01 Cl:TTEGLSY _^.O�d Cr iOZIDETl}� .^.E�C� CT IDcY ..cv_ u!1 i�ter__.. _... Y�aZ�P�\�S �i�'f(ix � v� I��.�+�nPG�IX��S �1�v�r�2�[7.��q ��` w.�v�a'i'tYl o�XL2�S.�'� T ' H�ve any ci t:^.e lice�ses 1_sted in s;l� ever be=n revdted? _�o -c yes, lz'� tY.e cates �-c -ezs;,-s. Are yc•� cc_ng to c,e-�te �:'_s ���=i�ess nersor.�zlly? ,��/� -= no, wro :ill c�erace _t? K�me �or,.e -cdze=_s =.re yci ccirg to ::ave a-a::�c=_: cr assistznt ia t?�is bus_ne<s? V''vS I_ yes C1'J2 :c'._� hcne acdre==, p:^.one >, and date cf birtn. —� ?�_�'° .�'�'�evP t vc�'1S ^c-:e =_,.cress �?l�'O �..�r�C�?��-, �v2 � S'� pa \ MN ` - <:c�e � �`j�$- S�-lb`3 �es 3 �?� v , 19 C^�rce _ SEi]CE.^.CE _ '- C.^.aTCE SE::CEi.CE =.^.ciccing yoUr _ ser.t ..,. _s/e-.plcynen�, w,yat busi ;e_s/em�loyme^t h�ve yca _'cilcued _'c- c:e �ast�:ive ._ars? (3us_ness/Hmploy^�e.^. , Accress) � L-- ?7. L^' �?? cther c'__. cc c:-e cczweraticn. (?:ame, Title-O:f-ce 'r.eld, !:c-e �dcre=_s, =cme r: e-e, ?�csi: zss :.`.cae) �i - i7ax; o� 1� �wm a3�5 L.-,d.cxrn.� �n�S�n�le�pr,�.e.�cR. '-t�'i 5vy �yS(� VQ/`-,�=tte.}cas'.i - '�L.o ��c�s �c�re c1-E.t 3�C? - T'�'� `�t � Si-��iec'C�'o��� ti51-o�55 7N �- ��13! 18. := bcsi-:ess is pari.^.ers:tip, 1'--' - - --^e-(s) ,.s,.=_(s), hone zdcress, .`.cr=_ - \S — ��� 1 _ ycr.e, :,cs:^ess _.`.cr_. :9 20 21 n_L'+EEII �..c,. C_C55 ..LEECS '_5 _'=5:'E55 �GCcT.Eu? C rP���'1 c � Mqsh �+1"\iP �lJ� i•:^;CR 51C0 Oi S�ZEEt? =T6 JTE115E5 IICW OCCL'D1EG? VPL'l \ \ 'T�` — 1'+^c� LV^..B O' DU51'�E55? t�R�S�C'���`J : c,a 1c-q� S�nc.e. 19 .� Yen :�;11 be recaired to ebtai:: �:cetail Lic�cr Dealers Tox Stam�. (See z�tac: efi) F_K•v :: _c??=C^-?=C'�' C- -\S;i?RS GIVB'4 CR .^'r^.TE�IAL SuB:di??E7 i9?LL RPSub. ?'.' �c9•�AL Cr ""S A?PLIC:�1^i09' 2 he-eby s zte �-cer cath ^-- I.a =�s%:e=e3 zll o= �:_ zbeve ccesticns, �r.d that ia=crr„ation ce^taired �er=_ � is "�ne '^d cc_:ect to `:^e best of -y kaewlecce a^d 'aeliei. ? ne_e'ny stace '_nrc^er nder cacz tn�t ?^ave rececved ao mor.ey e: ot�er coasicer�t:oa, �y uay c: lca.^., 5ift, cent_ibution, cr othe=a•==°, other c^aa already ci=clo=ed _n t.._ ���Lcatien wr� z I �e:ewi`n �-'^ ( ] ' �t Q�.0 ��tw.r0 �� � � / �\ �Ll\�,, Sta�e c= N.in:=_socz S_�`.._e ei .rp ic �acz Covnty o'_ Re-seY ) � 1 ����� L� �� �;2� Cr� �,e,�, r- �`„ Sunscr_bed �r.3 sucra to be'c-z xe �---s �.9 �a�y oi �..-�c�c��✓ , i=� � �C �-,�.� Q �otary ?vblic (.:�-+-��/�✓ Cccaty, i-2 ,sy Co�-i=_sica e>:pires C9ciL_ S� /5 9 S 1 � .,,,,�,�,�,,,. _ r ARLENEI.HAYMONO � � hOTARY PUBLIGMlNkESOTA kNOKA CWNTY My Cor,:T�ss�en Expitet Oq. S,1S98 r vvv�vvwJJ�www./v.hNANV��`�" ° sw[„t rwa c � A�A CI�IY OF SAIIv7 PALZ XCnn Colei%en, .'� a. G� OFFICE GF LKE�SE, I�SPECTIO��S :�]�U L\'VIRO�VE!�7AL PROTECTIOV (� S �,Ol.tq n'ohert!:eesJcs. Direr�or � UCf�SE.i1D Te7epl:ene.6]?-'G6�9i00 1.1'SPECTiG.�S ��csi�r.iie: Gl_'-=G6-Sl:+ 370 St. 7e�er S1rct1 Sv6e 3G9 Sair.t Pcvl. 1!iimesaa 5510? LIQu03 - Orr SPL� L � C�ISS.: PapLICATIOti This form must be typewritten or printed ia ink by the sole owner, by each oartner, by eacin person who has interest in excess of So in the corporation and/or associaticn in which the n�me of the iicense will be issued. TYIS .�PPL � CP.T � G_N IS Sli?J�Ci TO R�Vi�i�J BY TH� Pu3i_,IC � z 3 c 5 6 7 8. 9. =��=;r.ess :cc_ess �Ca.�� �oi c� ��wJ � st, ua...� 5�11 �c =cs_aess :c•a-,e �'�aSKe\\'s S.nC_. r -= b�_si::e_s '_s _ace-�c-at=d, c:-:=_ dzte o� _-cc__ c-at:en �� � U , i9 7� �oi- 3nsiness ?.s �d�S�2-��� S _.--::=_ss Phc�e = (�9�' !tail to Address (i' c:'__`eseat �..az bvsiness accress) M��S� MN SS40� Ycur ?:ame �o�,r � �e�c'e\� J�. i Ti�1e �C'�?S:c�¢y�� 'r.c �e :,CG_ess `� J.7 �w.Q.t'�s:�'l NV�� (���\S r M11 �Syt�3 ?hcr.e -' ?�'�77'33� Date o� 3irth C�o.^.th, Day, Year) � ?lace o_` 3irth _L�_�L� � Z.L 10. Aze you a U. S. c_tizen? �E-5 rative �7 :�atvralized ?£ naturalized, submit proof of ::aturalizatioa or valid docvmer.catioa of =esicent alien �Laivs. *(in accerdsnce with 1✓.N Statute 340.502A, no Oa Sale ez Off Sale Liguor Licer.se -ay be issned to anyone who is noc a U. S. citizeh or zesice.^.Y alien.) 11. :ave ven ey�er beea ccnvitt=c c'_ s::;+ `_elcny, czi-e, cr v`_c?atiez c_ 2-.y city erdir.�r:ce et'r.er .r.an t=a_"'_c? hyo � S- �o�t.�j Dzte cf ar-es` 'g— ���e:e C^arce Ccnvcc[-ca �zce c_ �_-est i; �E CG:.VICL-C:� .__ ce„�F�ce , 15 C.^.arce _ S°_-:CE::CE 12. r.ist �; cen=es »..'_ch you c�rre-c � y:^.e? d. or ie-merly �e � d, er may 'r.a'✓e aa inte-<_st --.. � � 1 tsk�\\'S S �n M.�ao ,� N�� r,ne�v. Va b\�,cHr;,.xa�n - > ?�ceLs:�C' 13. ?ave a:y o: ^e lice^ses li=te3 `_z ai� ever been °evcked? 1�1c' _°_ yes, 1__c ca�es a�c rez_..as. lc. ?re yr� cc_::g to c�erate tais ----�ess perscr.ally7 T25 T_= �o, u:�o ��ill ooerate ic? ��-e =c-e =.cc.ess 15. A_e ycn cci^g to =ave a r cr assistant iz t:^.is tJL`51.^.E55? VQ� _= V25, c_v2 ��'. ,^C^�E cCCTE55, ,.:C.^,E =� cAa CBL° OL D1TtA. 5c.^..° �l�P 'Q \ Y�� ro-= : �,.-e=_s �i70 � '�ncn\r� Pc�t2 ` � �c�-� N�l1 �51G5 ?:^.c.^.e � �,�i"5 Syb� Do3 � 15. =acicci-g •yeU: _ sent bvsine==%ea,�lo}�+ent, '.:??at bvs_,^,zss/employr•ent have ycv fcllc::ed - >"cr l .:e :�st i_.e �ears? (3usi.^.ess/ET.gloyme.^.t, Ado.res=J i ��' 17. L� a?1 ct^er ci�zcers o:" �:=.e ccrpcsaticn. (�ame, TiCle-Cff•:ce i:elri, Eene �cfizess, F.c-�e p:c-=, Bnsr.e<s �.`.c-;e) v� - S70. �.� M�,r r� .��tSS 1.. r,d�ceY, l�n, 7�,�:�e�,cc? 54�i- �I4S � � N� �f SI -oa s5 �l:z -,� 4 s 7 9 s -10`�9 18. =f 'ccsi-e�s ;s ^_-t.^.ers�:�, 1;_- part.^.erfs) ..acefs), he-=_ a�fire_=s, i:cre ^`ore b ,o 20 21 _et::�e� a..zt ccss _�__ets _s -_s_r.ess leczted? < <ek �, -U�� M - ,.� � �.z H\.�J, '�':;=cn s'c° ce -�zeet? =re pretises ncw occupie3? �� t•:^at ty�e ci bus±ness? N'c. :c.� icncz 5,.�ce l`15`� yeu ••;li be -ec��ired to obtai� a Retail �iacer �ea?ers Tax Star:p. (See actzc`ec) -K :?iS?F?C^TSC?� C: =?�S;i?RS GIVH?4 C3 P'_:PS�I.^-.L SliB:drS?5D idILI, R�SULi ?'3 7=5?AL OP _..=5 A??L:CA?ION I i:e_e:y scate Lr.ce- ezth t: ec I`a•:e - uered zll o= �r._ a�ove c,:e=tioa=, �^d t:�at :e _..=cr .ation ccat ec 'r.er__ c is ne z::d cc_zect to t:^e �_=t o= ^,y kro�rledce - rd bel•:ei. 2' -eby stzte under ozca `h i rzve rece;��ed .^.o �o.^.ey or ot:er coasiceration, 'cy way c lcan, 'ft c�t-±�e`'a�, c_ othe-mi=z, � ot}e- L=�az alrezcy ¢Ssclosed :z the - ��licztiea _ ' _ itn e ��itte�� \�' ��t � � Sta�e ce ;+,_: :`soca) ) Ccvnty o� 3zrsey ) Subsc=i�ed ar,. eucrn to be'_cse -�e �..is � c c ^ Y7i1 -�r`c.� C�✓ , i9�_ c Z�� �. �-,.-�Q ?�ctary ?cbl'_c `�`^""'�^J Ccnnty. ]•^. My Cor-�_ssic� exnires G��. S��`��iS 7ate � �/�� �� �. �,�,�' zL JGz � 2�S 1 / . /W wJ.��M/�e��.nAN � �"� ARLENE L. N�'d �'OND � � hOTARY PUBLtG!�?� sNES07A ANOKA CCUVTv IAy Commission Ezp:res Oa. 5,1948 r vvvrnnMlvvw�nntiw�.w•�v.nMnr✓�NV r Cl�' OF SAI\� I PAL �'cnn Co%rmcn, .':ci w OFFICE OF L1C[�SE. 1\'SPECTIO>'S A�U (� ��\O�CI L�V1R0��7E?�TAL PROTECTIGV � � V Robo! l�eesltr. Dirodar UCE.��SE.S.�D Tdepher.c hl?-:GS�YJGO 1.�$PECTIO.�'S �ccsirmie: GI_'-_66-Yl:l i:0 Sr. 7e;er Snrer $�i1e �00 Sair,tPcv( 1,'i,:nesaa S:IG? JIQUOR - Orr SALa L_CENS� ??P?LICPTIO?v This fori must be typewritten or �rinted in ink by the sole owner, by each partner, by each person who has interest in excess o£ So in the corporation and/or associaticn in which the nz�e o� the license will be issued. 1'Y,15 APP'L1C.�110N 1'$ S"U3JEC1 10 RBVIEW 11Y TH.? YU'?IiIC 1. =_'�s_;:ess Accress ���1 �rt'd �Kv�t�, ��cw� M1, SSI�� � 2 3 e 5 6 � _`__-ess ?Pa-e �'�G�'f�2\\'S Z;-�C- -= acs_::e=s =s ---:c-�orzted, cc•:= cate o: _-corpe-zt:cn 9 — I� , � s 'IC �oi^g 3•�sir.e=s =.s ��'�S�^.�1\'S 3•�sir.ess �;cne - (��1`S—.�4� i✓.a:l to Accress (i'_ ci'°ereat t:an bcsi-ess acc_ess) `� ` S � � ra� �J�1' M�\S N.r.1 SStiC� �cv- ��zr..e Se�tin � Farrna\ -I1t Tit'_e `J'fz.L.�-,�nc���.P_� 8. 'r"cme =.dc-ess .�51 C�-,\e��x'c�� �cj. 1�.1 v� o�v 7 c��-ca Mtv �53`� I ---�— ?hor.e r `�Z3 9. Date cY 3izch Sxc: th. �ay, 1'ea-} 4 4° I�— ?lace o_` 3irth �`��i�Wc�,� ��C¢ �� m 10. P.re you a U. S. cetizen? yQ� Native � �.sturalized I£ naturalized, scbmit proof of r.aturalizstion or valid docvmentaticn ef resident alien statvs. •(In accerdar.ce with I�v Statute :40.SD2A, r.o Cn Sale oz Off Sale Liquor License ^�ay be issved to anyone ��ho is not a v. S. citizen or resicer.t alien.) 11 ,z 13 ic i5 15 'r'a��e ycu ever �Fen ccav�ct=d cc ':=Y [elcny, c=ir.,e, cr •oio?atic� of a^y cicy q o_dir.z':ce c[^e= ".a.. �-a'_=c? 1�\r� Q��,01� 4 6 ��te c' z_resc i•:?:eTe CG .�V'C__C.^. .,ate c_' �__est 'v7�ere CG,^.'J1CC:0:: . _ _, 19_ C:^.�rce _ S E.^.YE.^.C° —i � ��_ CnzrC= _ Se:;teace ,.;_� �; �E^cc5 'w..:Ul ',v0'1 c.:rseac:y i:cld, cr `_osr.,erly he?d, cr zay ^av= an _._tere=_c -�. 1�u�i��\'� S�ces '�rt l� r„-u-�-\s N� nne�a�k« C'�\oc;� d�xc����C' :�ve ar.v of t'r.e ?zce::ses l:ste3 ia �i? ever been revd;ed? 1VG' _` yes, _-sc the cat=_s aac =ea_.,�s. �:e yc� ccS�g to c.erate c�is :�.:si-e=_s perse^aily? U� A -: �o, who w+_11 o�.era.e _t? Na-e Eone .._..zess � .,��e � -_e ycn cecag to :ave a r..- :ce_ or zssista^t iz t3zs bns_ne=s? �l�` ?i y'es, c1V2 ^c-. , PCID° cCC�Ecc, �, @ �— ^c.^.e ^d date ci birt:�. �am= �.J� L-�,nrS - �o�„� ..cc_'ess ���7Ci �Y�C �✓. {��e `J1 i�c.�l t��N �S1DS r ?=c-e � � �Ibq �os 3 -- - =nclvci::g yev: _ -_..� bcs;^z=_=/e:nplo�^�er.t ::hat bcsineselem�loy;nent have ycs _'ellc�ed :'cr _'ive :e�rs? (BUSiness/�mplcy�e.^.t, ::ccress) G � LL" < �Nl. i7 i v ' � 2- i j �i//�1-�/�'2�L- � � List =11 c�hez c_'icers e� c.= cc-ccraticn. (IGame, Title-C_f-ce ?:eld, !:c^e acdre=_s, -c^�e �^eae, 3usi-zss _�.cne) Vp- 17.a�i �1 Mc.a�ri n� ='��SS" li��a:e.� l.�r� "T�-,de�e �ence. `-17°-19�"`l ' T-- StiiU-44�(� �1 Q/��ec c�kz.r. �- ��\.�n.-r1S Sc1 e cde.t' 3�iJ�7 -�73`�` S} t�. S.�u� C:c�e �S �{5i-oasS 54a- a437 ia i9 20 21 If i�,:r ness is - ii== czr�^e-(s) r.a-.e(s), hc-e acdress, :^.c-e _ :cr.=, bc=_zne�s �.._. =��aEE: :...2� CTC_<5 ..LEE.S iS -"=5'_L°55 �CCcCE�^..7 C cP�,-� Mv •.� C�...c��e �i�d 'x:�ica sice oi st;eet? �s_���`� --e p=eaises ^ow occn�°_ea? �_ P:: at ` �e of busiaess? �cSKP\\'S -cw lc-.a? �:ri[r I`�`� '=cu ai11 be reqaired to cbta_� a 3etai? �'_qti:cr �°a?2rs Tar, S�a-p. (See a�tzc::ec) p��y F-�c?: ?C=.?=CN Q? ?�5:;3RS G=V�9 C� N_:-?�IAL Siin!dIT?_°� 19IiL R°_Si;s3 ?:3 ^='vi=?. OF _..iS =??iICASICN I i:�ere:.v scace �-cer eat'� L:^.a;. S`.ay-_ _ 're=zd zll o- c: _ abcve qvestio^=, ar.d that :^e ia'cr-ation centained re:=__:: ��oe - nd cer.zcc to ^e be=c o'_ -y kncwlecce aad beliei =^e_ecv _=ta�e 'urt.`.er unne: oa;.� ".at i:�ave rece:ved ^o mor.ey or et}er cor.sicz_atie�, by uay e' lcan, g_°c, ceatributic�, or ot?�erui=e, ct}er c^z� aL-eady di=c2osed ia t;�e a_�1 0. •'�; T_ ' v;�' �.,atte ��`�� `��-�.�1 h� s�a�e �_ :<_::::__o�z� � Cour.ty oi ��z=ey ) Subscriied _�d =wera to be'c-e ^.e �--=' ��� c o_' ,.. y � ��-� , 19`3 S l� oL . j�f-e.�,.,,._,.,.a_ :�ota:y ?ubl:c ��`� Ccunty, :-: N,y Co-a�issicn er.pires C�� S�, /S 5� J�Y�.s�' � �f�Yw�� j � ■ � /�"'e kRLE\. I.. �!AMA�lID i� IvOTARY PUGLiC-MINNESOTA � ANGKA COUNTY hty Cemm�ss!cn Ezp« es Od, 6,1998 rv�vsnnnMnnnH.NV�w.vNAN✓.�nN.NV c CITY OF SA� PAUZ �'onn Colemon, S;c�'cr OFFICE OF LICE�SE, I\SPECTIO\S .4\D � � � `^ �q E\V1F0\\iE\7AL 1'ROTECTIOV w Y Rabrn KessJrr, D�reclor LICEj'SE .i.jD 7eleyhcr,e: 61?-:66-97G0 1�'SPECTiO.�S Focsnr,iie.673-?66-97?! 3�0 S7. Peter Slreet Suiie 300 Soir,(Povl, 11ir.r.esota SJIG? LIQliOR - OFr SALB LICEATS: APPL?CAT_ON This £orm must be typewritten or printed in ink by the sole owner, by each partner, by each person who has interest in excess of So in the corporation and/or association in which the name of the iicense will be issued. 1HIS APPLICP7'10N IS SIi?JECT TO REVIEia BY TH.3 Pi7BLIC , 2 3 � 5 6 3v=_:ness Accress a��� �^( \'KwJ r 5j \�� MIS h�l�� � , 3v=_�ess :��a-e Yfc.S�'-��`S =nG: Ii business is _ncorporated, c_ve da.e oi _;:corxration 1 ��U � '- ��i�' �o+_ng svs_aess :s �o.SKzt�'S 3usiness ??�one � � '.�ail to P.ddress (if riif°erent t::az besiness �dcress) `.31 S N',rk�-, Sk-. Mo�S MN 5��-fC� 7. YouT Nam� �hfl0�0C'�� 1YafC'Q.�1 Title 'J�k�.,�\�.P.(" 8 9 ;:ome Address � 1`T`� Fwrzz �.t2- `-� Mg\S MN SS�v� r ?ho�e 4 3�7 �— 33:� (o Date of Birth (N,onth, Day, Year) � /� 21ace of 3irth M���nr�Pa.IX���S �/�,�1 � 10. P.re you a U. S, citizer.? �jk,�j Native ✓ Naturalized If naturalized, s�bmit nroof of r.atvralization or valid docUrr.entaticn of resideat alien status. *(Zn zccerdance with M*7 Statute 340.502A, no On Sale or Off Sale Liauor License may be issved to anyone who is not a U. S. citizen or reside.^.t alien.) � 11 �z 13 14 15 15 :ave ycu ever beea co�victed c: a::y feloay, crire, or violaticn of a::y city o_dina�ce ether tnaz trz_`fic? 1J� ns�`Q�q _ Date c_' arrest uhere Cc .vic�_c:� �ate c' arrest K�!eYe Co: victio:� _, 19 — Cfiarce _ Sent=.^.ce _, 15_ C:^.azce _ Sentence ' st liceases u;_ch yon cnrre�ciy :�eld, or formerly held, cr may :^.ave an ±nterest _... 1�c�K��\'S S�-rces ., N�l„�ea�\'s M�v�nv�c�nka �1o�r'.-�k��-n�.XCe.1S.ut' 3ave a�y of the lice�ses ?iste3 ia �7.� ever been reveked? 1�C� if yes, li=t the cates znd reaec:?s. P.re you coi::g to cperate tn_s �'_sir.ess personally? N�1� I: no, who will o�erate it? rane Ecme :.ccress ?�o.^.e n �re you goi^g to :^.ave a-,>^ac=r or assistant in this busi�ess? V ZS i� yes, give r.an=, hcme �ddre=s, pnone ;,, aad date of birtn. N�me 'l}QVP � ��'v�S 4 , 'r'cme Acdress •�17G �rcc,�� �uP. �a- ��,. N��l SSt C� ?hone � ��l�J'���� D03 3 includir.g your �rese^t busi^ess/emDloymeat, what busir,ess/emplo}^�ent have you followed £cr the past £ive }'ears? (3usiness/Erployment, F.ddress) �L.�S ��� J S% r.zJ�,E�� -�Ll fi'Yt 17. List all other officers o£ t':e corporation. (Name, T:tle-O:£:ce held, Home adczess, Home phoae, 2usir.ess �.`.one) V'1� �a.xi el 1"tcar,r; .-,n �i�55 �.•-vle�c l..r� S�-�c�. ' e�E �I�9-I"r57 ' S4y-N�+Sb V�/Sec ce�acv -�hc.�-a5 Sca-„-,e.c�e.� ?i`!O'7- 73``� 5 � �rves �.ro�e t��'S y5i-oas5 �i a- ;,�ti37 18. =f bus:.^.ess is nart^e-s�+_p, L_ cart.^.=r(s) r.ame(s), ho�e address, :^.c�e i�`���� _: or.e, bcsiness p'�one. 19 20 21 __�+:EE:1 ....at cress streets :s __=i^_=s lccate3? C t'2�"�r. cv'�c1 �`/��'�.n�" �.�s1�e. Y'b�.ick 'r:hich sice o: street? ..re Dre�ises row occunied? �p.S ' ' T i+�at ty�e oi busiaess? �0.5k�\�`S -ow lcr.g? S�r'Y�- � You will be recvi:ed to ebtz_z a Retail Liqvcr Dealers Tax Staco. (See Gttac'r.=d) FNY PALSIs?C=.TICN C? FtiS;+?RS GIVB'.7 CR A'AT°RIAL SUeM"iT?PD k?LL RnSL':,3 ='�� P.P9'?AL Oc ^_3IS ???LICATiON I hereby state ur.cer oath t:^.at I hzve answzred all oi the above qcestions, a^d that t^e in_`crmation contair.ed 'r.erec� is true - r.d correct to t:e best o= :vy knowlecge ar.d �elief. I hereby state fnrt!:er undeY oath at have r eivzd no mor.ey or oti;er consice-atioz, by way c_ loaa, cif r -e : ion, o- erwise, / other thaa already discic=ed in the �_plica ^ J w' rewith , t $� , � �f/iti.�� ^� \iL('l\C� State ci N_raesota) ) County oz R�-.sey ) Subscribed �nd sworn to before me t�:s ��� �G oi `/V� Q.� c.�,./ , 19 �7 S � � ��s-------�---Q Notary ?ublic �-��� Ccunty, !^v !✓,y Commiss_oa expires V�_�'"/ � re of Applicznt / Date � � �° 1= ti L ���� L � � �� � � t y � �''"'� kRLENELMAl010qD ��g� N4TARY PUBl.fC�{Ytp1ESpTA ��.�� ANOKA CRN(n My Commission Exptp Q�, 4 fggg r �vN t OFFlCE OF LICE\SE, I�SP@CT10�S A�U � S` � ^ L\V1R0\�1E'�TAL 1'ROTfCT10V 0 �, R�hrill:essltr. Arrnor CITY OF S�1'v�T PALZ ��arm �Or'em.en. .'�1eiGr LICE.�SE.S�"D I.�S?ECTiG.�S JJ�.$1 /'P!e).Sbf[t S::Ue 3G0 S�ir,1 Pcvl, iLr.r.esc:a �:10? LIQuOR - OrF SALS LICENS� A?:LICP._IO?v 7t1epF,one 6J?-:G5-5iG0 �otr.":mre: GI:--66-91Y. This form must be typewritter_ or printed in ink by �he sole owner, by each partner, by each person who has interest in excess of So in the corporation andJor associatioa in which the nz: of the iicense wi11 be issued. ThIS APPLICAtION IS Sli?J:,Cl 10 R�ViEW BY TH� ?ii�LIC , 2 3 c 5 6 7 e 9 3��s_.^.ess Acc_ess ,?.?�1 �c �kw.1 ��.l�ci:.�\ M�1 :Sflb � :__<i-ess '�F-_ �c;.SK'i�\`5 �-, __'- :_ �Dl!$i^ESS ?5 �^COIDOIcCE�� Ci':° Cci2 Ci _.^.CCS�CSc�10R -I�, _.9 %� �oi�g 2�_si.^.e�s :s nv<__::e=s ^:^.cne ' 6�`,5—'4i !{ail to =ccre==_ (i' ci=_'ere ;t �..aa b�___ ess zcd_e�s) �� � N�rt� �'J}. M�iS M9.i ��c-�D.:� Ycur ?�z�.e � C'�a'r� �, �cxz�C�e\1 ii�2e '�`OCK�oIc�C�s' :c�e ,=_ccress �`5\ 5. KFa ;�- St 5fi-�ct;;,\ MA1 _r.�::e rt aa�-1- ��ao �ate cf 3ir[h (N,o^th, Day, Year) )�'31 rlace c: 3izth M��u�a.;.kee V,1� — 1D. :,ze you a U. 5. citize::? 4E'% natzve t0 Natvralized ?f �atusalized, submit proo: of ^aturalizatioh or valid docuner.tatic� of resident alien statvs. t{in accerda.^.ce uith M.'�' Statute :50.402A, no On Sale or Off Sale Liquor Licer.se nsy be issued to anyone who is r.pt a U. S. citizen or :esic'er.t alien.) 11 lZ 13 ic 15 16 :'.ave yeu e�•er `e°-� ecnv!cted c= a-y 'elony, cric.e, cr v:eizt:c� c_' a.y city erdina-ce ct: er t^=� tra."_±c? F��� ` t�l�� qS �ate c_' arre=c 7•;here �c =vcc__ca �zte c_' zr_e=_t tt^=re Co.^.v! ct:o� ,o C`:a_ce Se;?t<_:?ce _ 19_ C:^.azce Sec�te.^.ce 'icC �10E:5°S '•..]C1 yC1 Cl:TrE'L1V 'C1Q. Cr _pr-�o:lY nE1Q� C_ TcY �cv� c:l _r.te-=__� __.. 1-1 �S�c�s ' n 1� .- �c� \ s M�hr,� �\�� y�c., �xck�s � 'r'�ve �^y oi tae ?icenses list°a iz �i? ever beea revc{ed? I��c: :r VES� lict �..... ..��ES c:!4 :EcSC.^.5. �=e yc's cci^g to c_=-ate ta_s -----'-ess �ersonally? T�1_,,j�c �c no, who w;ll ODETcL2 .t? ..a�,e =c-e ?.cd_=_=_s _'r.o^e � � =se yevi cec^g to `ave a- cr =sistar.t i:: thi's bus_aess? --� -= yes, c:ve :a-_, ^cme �cdse.=, _^o�e �, aad date of birt�. ���^°_ �"1��CVP � �a Y'1S -G'1°_ -CG.E55 a� I� `1Y�C"�h � ti�T 1�cu-\ t�tiN �.S�CS --- � :i:one � b 5�-t1oS' �os 3 -.^.c1'oni:tg yocr _-szr.t busiaz=_=_1ex�lo�r.r,ent, what busir.e=_s/emnloyateat have ycu _'o?lcw•ed _'er past five ��e�rs? (3usiress/Em�loyr�e�t, Add=ess) �/ � �t"s�/�' r �-F� / S '�", � _ 1 �/.�i A/ G �_ � l 17. L� all ctae: '_cers c� �:_ ccrecrzticn. (�ame, Title-O`£+_ce ?�eld, Ecr.e Gcnre=s, >SC^�e �`e-e, 3vsiness V(�- O� 21 1�a;-, 'V,t� .�c�SS 1 �n �v,clene;l.�ence �{`t`L � 54y - 4�t5� �lP/`�-cf��-a;•.�- \hv�mcis Sc�-,.-��:de.t' 3'7G��-73'`�Sj T�ve.r C�cw�!-�1S �- 451-� �5� � ia- �cy 37 ti 18 19 '<0 21 _- bus:ness is - _c�ers�i�, i'_s_ _ - _�ner (s) ..a-.e (s) , }o-e adcress, :^cr..e G�� „t�l�q -or.e, .,___ne=s ^.cr._. l l -'T.:EEZ �: ut CZC55 ._�_..E�S _5 —'c""55 �GCc�E:� � �¢ k n Mcun�' L - ve ����� 1•, sice o: st�°et? -_ premises r.cw occc�iec? ���� i•;^at t��e o: business? 1-};�,�Sl!.0 -cw Sc-�c? �incF I�i91� _cn w<11 :,_ -eccired to ebtz_� = teta+_1 Licucr �ealers Tax Star.�. (See a��ac=ed) FC� :R-S??=C^?=CN C? ��:5'.;=RS GiV�1� C3 Nn,?�3IAL SUB1d?=.=7 i4iLL .'<�Si:b_ =ti .,<.`��_:.� C? Ti?IS t??:.�iCi,?iC?3 I'r_�ere:•p z:e •�.^.cer cath `> I_�. > __ed zll oi �:_ above cces.io^s, ar.c that tcz _n'c--aticn cc�tainec :e �-� is ^d cerrect to `:-e b°s� o' -�y k.^.o•�+lecce �^n beliei. :^ere�y stz�e '���rc^er uncer cacS tY.at I^�v=_ rece±red ^o �c. ey er ec�er consicezatioa, �y � ay c lca.^., ai_t, ceat-_bution, e-_9t:^.erw_=e i. ether c^an a_-eacy disclese�9 _a t:-�e a:�l;czc_o� wh_c^ r r�ew��n ��t c. / %� �/, ,� �- /' � ��"''��,� State c' M � Sicaa��f o: Ap�lic ..� / Date � �� Cov^ty c= Rar..sey ) S_�=crc::ed ar3 wcra to be`c-z re �.--' o�� c�y o" �4n C�.. :9 c 1 S �.�-.,.-�_ �. �--.,�--„�-....Q �otary ?vbl:c Cl-��� /�� CcLnty, i_: !✓,y Cc-:-iss:eZ ea�ires ��- S i �yy� �� / �N� /ffll,e,� �,C/ , re ppLENE L HANNOND � �� NOTARY PUBLIGMINNESO?A � ANOKA CAUNTY My Cortmission Eapces Oa. 5, t49! r vvvs.nnnnnrmnn�v�+v�vw�n/�✓�^"�^^'`^' x