95-353O�1Gii�AL
Council File # ���
Ordinance #
Green Sheet # 30757
RESOLUTION
C{TY OF SAfNT PAllL, MINNESOTA
Presented By
Referred To
;
Committee: Date
�3
1 RESOLVED: That application (I.D. #96646) for a Laundry/DC Pick Up Station, Off Sale
2 Malt, Grocery-C and Cigarette License applied £or by Yia Vang DBA Super Mini
3 Market at 1187 E. Minnehaha Avenue be and the same is hereby approved.
�--��—�r� Requested by Department of:
Office of License, Insnections and
Environmental Protection
Adopted by Council: Date
� By: �� ���-- � r"� ls(A� J
� p � � V
Adoption Certified by Council Secretazy
By:
Apps
BY:
Form Approved by City Bttorney
�: �.1�ii1?�tcl 5 -��i
Approved by Ntayor for Submission to
Council
BY:
9s �3 s�
DEPARTMENT/OFFICE/COUNCIL . �IATEINRIATED r REEN SHEE �O 30757
IEP Licensin � �" - - - "
CON ACi PEP � 8 PHONE INRIAUDATE INRIAL/DATE
� DEPARTMENT OIREClOR � CITY COUNpI
• ASSIGN � CSTV ATfOANEY � CRY CLEAK
NUMBEqFOR
MUST BE ON CAUNGIL AGENOA Y(�ATEj �. Rp�� � BUOGEf DIREGTOR O FlN. 8 MG2 SEAYICES DIR.
F'OT Hearing; S' C�'� OpDER a�y���q���AM) �
TOSAL # OF SIGNATURE PAGES � (CllP ALL IOCATIONS FOR S�GNATURE)
ACTION AEQUESfED:
Yia Vang DBA Super Mini Market requests Council approval of his application fox a Laundsy/DC
Pick Up Station, Off Sa1e MaZt, Grocery-C and Cigarette License at 1187 E. Minnehaha Avenue.
(I.D. 4f96646)
RECOMMENOATIONS: Approve (A) w Reject (R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING �UESTIONS:
_ PIANNING CAMMISSION _ CIVIL SERVICE COMMISSION �� Has ihis personH�irm ever worketl under a conVact for this department? -
_ CIB COMMIITEE _ YES NO
_ STAFF 2. Has this personffirtn ever been a city employee?
— YES NO
_ DISiA1C7 GoURT _ 3. Does this pe�son/firm possess a skill not normally possessed by any current city employee?
StlPPoRTSWHICHCOLLNGLO&IECTNE7 YES NO
Explain all yes answers on separate sheet and attaeh to green sheet
INITIATING PROBLEM, ISSUE, OPPORTUNITY (Wlio, What, Whe�. Where. Why):
ADVANTAGES IF APPROVED:
DISADVANTAGES IFAPPROVED:
��i°5��� ���;�;�':"u� �����'�a+'
6
6���as'S Gi 1' �J�.3
DISADVANTAGES IF NOTAPPROVED:
TOTAL AMOUNT OF 7RANSACTION S COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
FUNDIIdG SOURCE ACTIVIri NUMBER
FINANCIAL INFORMATION: (EXPLAIN)
9��s.�
Greensheet # 3o�s� L.I.E.P. REVIEW CHECKLIST Date: Z/10/95 �
In Tracker? . npp'n Received / app'n arocessed
License ID # 96b46
COmpany Name: Yia Vang DBA: Super Mini Market
BUSiness Addresss: 1187 E. Minnehaha Avenue, 55106 Business Phone: 290-2621
Contact Name/Address: 257 Edmund Avenue, 55103 Home Phone: 290-2621
Date to Councif Research: � � � � �
Pubiic Hearing Date: � � � i�'G2�
Notice Sent to Applicart: 3' f.3 � Q�
Labels
NJA
Disirict Council #: 04 ��M : � �
Notice Sent to Pubfic: '�` - �,S�. a-L Li�- i3M Ward #: o�
Departmernj Date inspections Comments
City Attorney ���g� C> �
Environmental
Health ��
3 ��
Fire
� -���' � tL
License site Plan Received:
�,/ A—„/� Lease Received:
• .� �' !/4 �f
Police 2 —�— C� < �-
c3
Zoning � � O �
9s-3s�
CLASS III
LICENSE APPLICATION
CITY OF SAINT PAUL
Otfice of Licer.se, Inspections
zad Environmenta! pmtection
3V St pe�cr St Sunc &�0
SaP:uL�Simcwa 55102
(6!]) 2YAI M ::x (611) ]5691IF
License I.D. �
PLEASE TYPE OR PRINT IN Ii�TK
(foz offcc nse on7y)
Type of Licenc_e being applied for:
Companyl�'ame: .S� P�I� /Liin�Ni /1/lf��G�_f^
Corporztion / Pzrtne:ship / Solc Propricto�L;'�
If business is incorporated, give date of inwrporation:
Doing Business As: �s»o c�es S�o �-P �Business Pbone:
Business Address: _//(P'7 f= /l�iN.c/ i rS�,4 F/,4 �f_- S�- f'Ar<� �LtnJ C'r'/O G
StreetAddress City State Zip
Between wbat coss st�eets is the business located? 7> u�u � Which side of the street? /�r-f-•
Are the premues now occupied? ���at T}pe of Business?
Mail To Address: _�S_7_ ��� �f2�ti� �!/�__ _ ��-�L
Sireet Address
Applicant Infona�tion:
I�'zme and Title:
THIS APPLICATIO'�T IS SliB7ECC TO RfiVIEVJ BY THE PliBLIC
City
State Zip
Frst Aliddlc (?vfaidcn) I.ast Tit]e
Home Address: a-S 7 t-�� •'Lr ci N� �!/J - . S'� �,9u l /Llot/ .�f /� 3
Street Address Ciry State 2ip
Data of Buth: iS -/-- � Place of B'uth: Lr9-6S. Home Fhone: /,i�- 3-�d -ZG.#/
Are you a citizen of the United States? Native? Y�- I�Taturalized?
If you are not a U.S. citizen, you must have work authorization from the U.S. Immigration & A'aturali7ation Sen�ce.
Y.ave you ever been con�ticted of any felony, crime or ��o14�on of any city ordinance other rl�an tr�c? YES � NO�
Date of arrest:
Charge: �
Conviction:
Sentence:
List the names and residences of three persons of good moral chazacter, living x�ithin tbe Twin Cities Metro .Area, not related
to the applicant or financially interested in the premises or business, wfio may be referred to as to the applicanPs chazacter:
-��• •
: .�'� � i� � a� i
� � � _ t ii �� - �' � �
r' - � � I.� �' / lC
List licenses which you cwrently hold, formerly held, or may have an interest in:
Have any of the above named licenses ever been revoked? _ YFS � NO If yes, list tbe datei and reasons for revocation:
VThere?
<over)
Are }'ou going to operate this business personally? ��FS _ NO If not, wbo �ill operxte it? 1�-��
Fxst K�zmc Middle Ir.iti�3 (>`.tidcn) Iast Dzu of Binh
Hone Abdress: Strcct ?�zmc GS Stztc Zip Phone \umbe[
Are you going to have a manager or assvstant ia this bus:�ess? _ I'ES .� NO If the manager is not tbe same as tbe
operator, plezse complete the folloaing iaformation:
fi=st ?�zne
'..Siddle Snitizt
(�`.ti3en)
Lzsc
Statc Zp
Address
Dz;e of Binh
HomeAddrus: Sireet'.�ame
az
Please list your emplo}>ment history for the pre�ious five (�� year period:
Business 1EmpSo�asent
Phone \umber
/ ` i /. �j � �
i � . �, os '�- // •
List all otber o�cezs of the corporation:
OFFICER TITLE HOME HOME BUSII��SS DATE OF
I� (O�ce Held) ADDRESS PHOI�iE PHOI�'E BIRTH
If business is a partnersbip, please include tbe follouing information for each partner (use additional pages if necessary):
Ant \�ame
Middle Initial
(.'.iaiden)
�ry
(�faiden)
Ciry
Last
Statc tip
Iast
Daic of Binh
Phone NumbeY
Date of Birth
Phone 13umber
HOme Address: Stxet \'ame
Fxst ;�ame
Middle Initial
HoneAddress; Strett \ame
Stafc Zip
Attach to this application: '
1) A detailed descripfion ot the design, location and square footage oC the premises to be licensed (sife plan).
2) A copy of your lease agreement or proof of owvership of the properfy.
AA'Y FALSIFICATION OF ANSFi'ERS GIVEN OR MATERLIL SUBT4ITCED
WILL RESULT iN DEIi7AL OF THIS APPLICATION
I Isereby sfate under oath tbat I Save answered all of the above questions, and that the information contaiaed herein is true and
correc[ to the best of my knowledge and belief. I bereby state further under oath that I have received no money or other
consideration, by way of Ioan, gifr, contribution, or otherwise, other than already disclosed in the application wlvch I herewith
submitted,
Subsaibed and swom to bePore me this
day of . 19 _
`l/..-,� q
Signature o Applicant Date
Notary Public County, MN
My Commissioa exp'ues: