95-1120Council Fi1e # 'l5 � ,��
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Presented By
Referred To
Ordinance #
Green Sheet # ����� �
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
3S
Committee: Date
1 RESOLVED: That application (ID 1�5945�) for an Off Sale Ma1t, Gas Station and Groceiy-C
2 License applied for by Kwik Trip (Robert White, Manager) at 1608 Rice Street
3 be and the same is hereby approved.
�- _- Requested by Department of:
By:
App:
By:
Office of License, Ins�pections and
Environmental Protection
sy: ; � � �1 ���'
Form Appr ved by City A torney
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Approved by Mayor for Submission to
Council
By:
Adoption Certified by Council Secretary
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DEPARTMENT/OFFICE/COUNCII DATEINITIATED GREEN SHEE "O 30873
LIEP/Licensing __. -
CONTACT PEFSON & PHONE INRIAI/OATE INIiIAVDATE
� � DEPARTMENTDIRECTOR � qTYGOUNLIL
Bi11 Gunther, 266-9132 au��N �cmnnoeNev �GT'CLERK
NUMBEfl FON
MUST BE ON COUNCIL AGENOA BV ATE) ' pOUTING � BUDCaET OIflECTOR � FIN. & MGi SERVICES DIR.
F'OT Hearing: �� Q� ORDER OMAYOR(ORASSISfAN'n �
TOTAI # OF SIGNATURE PAGES (CLIP ALL LOCATIONS POR SIGNATURE)
acrwN aEauESrEO:
Kwik Trip requests Council approval of its Off Sale Malt, Gas Station and Grocery-C License
at 1608 Rice Street (ID �159450).
AECAMMENDATIONS: Apprwe (A) or fieject tR) pERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING �UESTIONS:
_ PIANNING COMMISSION _ CNIL SERVICE CAMMISSION 1. Has this persoMirm ever worked untler a contract fo� this departmentt -
__ GIB CoMMITfEE _ YES NO
_ S7AFF 2. Has this personlfirm ever been a ciry employee?
— YES NO
_ DISTRIC7 CWR7 _ 3. Does thts perso�rm possess a skdl not normally possessed by any current ciry employee?
SUPPORTS WHICH COUNCIL O&IECTIVE7 YES NO
Explain all yes answers on separate sheet and attech to green sheet
INITIATING PROB�EM, ISSUE, OPPORTUNITV (Who, What, When, Where. Why)
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ADVANTAGESIFAPPROVED: ' ����
DISAOVANTAGES IFAPPflOVED:
DISADVANTAGES IF NOTAPPROVEO:
TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
FUNDIHG SOURCE ACTIVISY NUMBER
FINANCIAL INFORMATION: (EXPLAIN)
Greensheet # 30873 L.1.E.P. REVIEW CHECKLIS7
In Trecke(?
9S-��Zn
Date: 8l3195 /
APP'n Peceived / APP'n Procassed
License iD # 59450
Company Name: Rwik Trip, Inc. DBA: Kwik Trip 9k333
Business Addresss: 1608 Rice Street, 55117 Business Phone: 781-8988
Contact Name/Address: Robert White, 4693 ParkridQe Dr Home Phone: 454-7539
Eagan, MN 55121
Date to Council Research:
Public Hearing Date: �.�.� G 5 Labels Ordered: °�����J
Notice Sent to Applicant: Disuict Council #: �
Notice Sent to Public: Ward #: -�
Department/ Date Inspections Comments
City Attomey ��L-
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Environmental
Health � � Q � �� � f �
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Fire "6 � � `'� 6��RV �( ��
License � K " Site Plan Received:_
�(. � 1 � � 5 ✓ Lease F�ceived:
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C�y-�.;� ..�o c�.��,�
Police ��� /_ � p�
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Zoning C�: ��
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CLASS ITI
LICBNSE APPLICATION
CTTY OF SAINT 1'AUL
07c< of Licensq Inspcclions
and Fn�ironmcnta] Profcc�ion
35J R. Pr.cr 9. Su:c �
c.:_. Pav1,Mi�w:a 55101
i612) 669100 tu (61:) YL9:i4
Licease I.D. �-` __���
(for office uu onip)
THIS APPLICATION IS SLBTECI' TO REVIEW BY THE PUBLIC
PLEASE TYPE OR PRINT IN INK
Typc of License being applied for: OFF SALE MAT.T AND GnS STATTnN
Company Name:
Cor�orztion / Partncnhip ( So1e P=opriefo:sti�
lf biuiness is incorporated, give date of incorporatian: 10/7/64
Doing Business As: KWIK TRTP 4k333 Business Phone:
Business Addresr. 1608 XICE STRF.FT ST_ Fqrir , wrt,mTF¢pTp
Street Address G�y S:zte Zip
Behveen what cross streets is the business located? WHEELOCK AND IOWA \�'hich side of tbe street? RAST
Are the premues now occupied? NO What T}pe of Buciness? CON�7ENIENCF. 4T�RR�RFRV7l1F. CTAT7�N
Mail To Address: 1626 OAK STREET LA CRO�SF.� wr4['nnt4ru S[�fin�
Strcu Address Gty � Scatc 7Zp
Applicant Informa[ion:
2��ame and Title•
Fcst
Home Address:
S:rcu Addreu
Daie of $uth:
Middic
Placa of B'uth:
(1.faiden)
Cicy
C2s[ Title
Stafc 7�p
Home Phone:
Are you a citizen of tbe United Staies? I�`ative? h
If you are not a US. citizen, }'ou must ha�'e work autfioriza[ion from the US. Immigration 8 A'atucalization Senice.
Have you ever beea com�cted of any felony, crime or ��ol�don of any city ordinance other than tr�c? Y�S � NO
Da[e of arrest:
Charge: ^
Contiction:
V✓here?
Sentence:
List che names and residences of thzee persons of good moral chazacter, li��ing within tbe Twin Cities Metzo Area, not related
to tbe app&cant or fwancially interested in tbe premises or business, who may be referred to as to the applicant's character:
IsAME
ADARESS
PHOI�TE
List licebses which you currently bold, formerly hel� or r�zy have an interest in:
Have any of the above aasaed licenses ever been revoked� _ YES _ NO lf yes, Gat the dates avd reasons for revocation:
(over)
- '. .-, -�- _ . . . . � IY.'Mw� 4.�3.T _ ;
„ . 'O'.If not, x•bo v�4Il operate it? �� ���,a� . ,�
pre you going io operate this business personally? ___. �---�
1 Lzse D=m a -xh
?.liddic Initial (:'�iud<n� - '
FntNamc ___,__ M�d 679-454-7539 �
Suic Zip Phoac \c�.Scc
Gy
Homc Address: Scrccc ��m� hQ lf the m2n2ger is not tbe s�c as tbc
Are you going to have a manager or assistant in this bi:suess? _�-S �--
operator, please complete the follov.ing information:
� � � DiiLdic lr,itiai
Homc Address: Strect F=m�
(?.!tid<n�
Gy
p�ease Iist your employment bistory for the pre�3ous five (� ye2r period:
Bu iness Em io��rnent
Lxst
Statt
Address
Da:e ot Bir,h
Z Phone �vmbcx
List all otber officers of the wrporation: HQ ,�,� E gUSL1�SS DATE OF
TITLE HOr4E PHO:�'E BIRTH
O�CElt PHOr�
hTA.�4E (O�ce Held) ADDRESS
0
30HN J. HA27SEN PRSSIDFNT W1250 CTrI U BAN — _ �
IYJJNALD P. ZIETT.OW SECRETARY 2 27 0
tF h�iness u a parmership, please indude the followinS in�o�ation for each partaer (use additional paSeS if necessary):
Fxst �`ame
Homc Abdicss: Stroet ;�amc
fi}st Nane
Middlc Tnitial
Middlc SnitiaV
Home Address: Strcct ;�ame
(!,!aiLtn}
Gty
(?.?aid<n)
CiTy
jast
Stat<
Last
State
D=tc of B�r.S
7j Phant .'�'umb<r
patc of Binh
yp Phonc Kvmb<r
Attach to this application:
1) A detailed description of ihe design, locaUon and squam foofaoe of tbe premises to be iicensed (site p�an).
2) A copy of your lease agreemeat or proof uf oNVership of t6e property.
ANY FAISI� I �I.L RESLILT II�I BENL'�L OF TH APP IC TA IQ`d BA11T7'ED
I hereby state under fam t�o b ag �ae�li� I b eUy st qe �fnr�her under oath I ba e d money or otL e
correct to the best o y
consideration, by way of loan, B�T+ COA�bvtion, or otbenvise, other already disclosed in the application wlvch I herev.5t
svbmitted. '
7/,�? �f.
Subscrabed and swern to before me thss li t JOHN J. HANS�2i, PRESI ENT
� day of ��,�}LY—• 19 _�5
Signatw� of App
! �e-�=��c' �`"'""`O.�•o� WISCONSIN
Not�y Public ���OSS�ounty>
My Commissioa expires: 1 /'�S (q�