96-421Council File #` � � � � � �
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e � � _ - ° ,'. � �� � Ordinance #
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Green Sheet # S��/
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA ��j1
� .. � �'7
Presented By
Referzed To
Committee: Date
1 RESOLVED: That application (ID #59825) for a Restaurant-B and Hotel/Motel-to 50 rooms
2 License by Minnesota Humanities Commission DBA Minnesota Humanities
3 Commission (Cheryl Dickson, President) at 987 Ivy Avenue East be and the same
4 is hereby approved.
5
6 Requested by Department of:
7 ��Yeeass a s Absent
8 B a� �
9 Guer_ zn Off�ce of L�cense Inspections and
10 Harris
11 �Me ar� � Environ�ntal protect�on
12 Re t� man
15 T ostrom � � (� �
16 CO d i U �. �� ��.�,.. J
17 Adopted by Co�ncil: Date {J ' �y �qq � B Y ° �� s� —
18 '
19 Adoption Certified by council Secretary
20 Form Approved by City Attorney
21 {� \ \\\
22 BY����— � . I
23 � �°��,/ By: '�:� o�v oa_J � ��.�,.�
24 Approved by Ma r• Date �4,�i,�
25
26 Approved by Mayor for Submission to
27 By: �-� Council
28
By:
��-4 �.\ �
DEPARTMENT/OFFlCE/COUNCIL DATE INITIATED N 3 L � ` s 2$�
LIEP/Licensing GREEN SHEE _ . _ _
INITIAL/DAiE INffIA1JDATE
CONTACf PERSON 8 PHONE � DEPARTMENi �IFECTOR O CIT' CAUNCIL
Christine Rozek, 266-9108 ��ex �crrvanonNer �arvc�AK
NUYBEfl FOR
MUST BE ON CAUNqI AGENDA BY (DAT� pp�� Q BUDGET �IRECTOR O FlN. & MG7. SERVICES DIR.
r'OT hearing: �L` OflDER �MpyOR(ORASSISTANn �
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACfION REQUE5iED:
Minnesota Humanities Commission DBA Minnesota Humanities Commission requests Council
approval of its application for a Restaurant-B and Hotel/Motel-to 50 rooms at 987 Ivy Ave E.
(ID �E59825).
AECOMMENDA710NS:Approve(A)aRejectlPo pERSONALSERVICECONTRACTSMUSTANSWERTNEFOLLOWING�UESTIONS:
_ PLANNING COMMISSION _ CNII SEfiVICE CqMMISSION �� H35 thls pB�50Mlfin eVef wOfked UIIdBf 2 COrYtraCt fOf this dBp2flment? �
_ CIB CoMM17TEE YES �NO
— S7ACF 2. Has this person/fvm ever been a city empfoyee?
— VES NO
_ DISTRICT CpURT _ 3. Does this person/firm possess a skill not normally possessed by any curtent city employee?
SUPPORTSWHICHCOUNCILO&IECTIVE? YES NO
Explain all yes answers on sepa�ete sheet anE ettaeh to green ahcet
INIMTING PROBLEM, ISSUE, OPPORTUNIN (Who, Whet, When, Whera, Why�:
ADVANTAGES IF APPFiQYED:
������
F�AR 19 199�
���Y TT EY
oisnovaNracES iF aavaovEO:
g*� ,� ", ''r';1 ��i�?�
lii�CaYS`,a �...,.o...
��� �R � ����
DISADVANTAGES IF N07APPROVEO:
70TAL AMOUNT OFTRANSACTION $ COS7/REVENUE BUDGETED (CIRCLE ONE) YES NO
FUNDIfdG SOURCE ACTIVITV NUMBEH
FINANCIqL INFORMATION: (EXPLAIN)
Greensneet# 352s� L.I.E.P. REVIEW CHECKLIST Date: 3/14/96 /�`
In Trackef? app'n t�ecaivea / npp'n processea
License lD # 54825 License Type: Restaurant-B & Hotel/Motel-to 50 rooms
Company Name: Minnesota Humanities Co�ission DBA: mP
Business Addresss: 987 Iw Avenue East Business Phone: 774-0105
CoMact Name/Address: Chervl Dickson, 134 Victoria St S_ Home Phone: 222-7384
Date to Council Research: 55105
Public Hearing Date: � • �� • � �/ Labels Ordered: �f � / � � ��ll�
Notice Sent to Applicant: '/�i p District CounCii #: ✓
'�.L,., . �h'!. �.'�t3�li'
Notice Sent to Public: /'"" ` � 3 � Ward #: �
Department/ Date Inspections Comments
City Attorney
Environmental � ' 2 � ' � � � � � �
Health
Fire �'2_�.9j0 0.�,
License Site Plan fleceived: �
Lease Hecervea: ✓
Police 3 • 2 �' •`� �O D ' � .
Zoning
3•2� •�il� o�t� .
,�.s]AR-li-1996 08�55 FROM CITY OF ST PAUL LIEP
�
�TO � � ��
� . �� L a
"� S Q ()
LTCENSE APPLICATION
9�rae2es P.eez
1 ir� 7 vn
QTY OF SAINf PAUL
OHia of lioeve, Lupxcrns
. �� , "�'°°"�� „ 9�-�ia t
SSCSiPeQ5t5nhs�00
st.nW.rn,wau ss�oc—
�����5
PLEASE IYPE OR PRINT IN INK
Type of Licenu(s) being applied for:
COmpanyNaale: MINNESOTA HUMANITIES COMMISSION %)! (c) 3 Corporation
Cotpcxauon! Pazuenhip / Sole Roprieeorship
If businas is inc�porated, give date of incoiporation:
DoingBuSinessAs: MINNESOTA HUNLAN TF.S OMMT457pN $L37[1t5SPI10�G: fi12 774-O7p5
BuunessAddress: a87 FaG 7vv AV ni '' Sa�n+ Panl MnT SS7Oh
SvxtAdd!au . City Sute Zip
Between what cross stxeets is [3ie business ixatedl „F�,-PGr �. T�,�. W6ich side of che street? nr�,-+h
Are the promises now occupied? v« R'hat Type of Business? ����a�a� een�e�
MaiI TO AddreSS: . 987 East Ivv Avenue Saint Paul MN 55106
, SumtAddress Ciry Stam Zip
applicant Informadon: �i
Nameand Title: Chervl 4usan rash»v n;rk4�n v PG;dPnr
, Firsc Middle (Maidrn) Lu[ Tttle
HomeAddress: 134 South Victnria Rtraot Cnint U,�nl nnnr SSZ�S
SKeetAddress City Smta Zip
DateofBin6: 11/09/36 PlazeofBirth: Mitchell, SD ftomePhone: 612 222-7384
Have you ever been co°vzcted of any felony, ccime oc violacion of any cicy adinaace othec thaa ccafficl YES � DIO �
Date of azresr.
C6azge: _
Conviction:
Sencence:
List t6e naznes and residences of tlux persons of good moral chazaeter, living wittrin t6e Twin Cities Merro Area, uot celated to tha
applicant oz fiaancial3y interested in the premises oz business, wfio uwy be teferred W at to t6e applicant's chazactet:
NAMB ADDRESS "'- PTIONE
n�a„ nart,man 120�2 Grandview Terrace Apole Vallev M�T 55124 686-9342
Andrew W. Boss 2247 Hendon Avenue, St. Paul, MN 55108 647-0131
Thomas H. Boyd 1641 Highland Parkway Saint Paul, MN 55116 290-5528
Lisc licenses w6ich you cucrevQy hold, formerly held, or may 6ave an interest in:
Have any af ttse above nazued licenses evec been revokedl _ YES _ NO If yes, list the dates and [easoas for xevw:ation:
Me you going to operau this business pecsonally? _. YES �_ NO If not, who Will opaste it7
MarilVn R Schultz l�/15/S�
Firet Netue Middle Lririal (Maiden) Iast Datc of Birth
3401 E Minnehaha Parkwav Minneaoolis PL 55477 679 794-6561
}[omc Addrws: Saect Nnme Ciry Sure T�p Pharc Numbcr
VJhue?
�4R-11-1996 08=55 FROM CITY OF ST PRUL �IEP TO 97749205 P.003
Are you going so have a manager or assistan[ in this busivas? � YES _ NO If ihe manager is not the same az the operarae plea,u
tomPlete rhe follow�ina infoima[iem
_ FSrst Name
Address Sax[ Name
Please list your employment history for rhe previous five (� yeec period:
�usiQesslEamlovment Address
Lisc all ochhrs officers of the co�pontion:
OFFICER TI?LE HOML^"
NAME (pffice Held) ADDRESS
Stnte
IiOME BUSI\'ESS
PHOA'E PHO\'B
� qG-y 1.
Due of BiM
P1ane Number
DATE OF
BIRTH
Phvi i i May—Ma r.,,-+a �. {��#$rt Le�.� 007 a �� � � 8 236 2975
Moorhead, MN 56560
lf business is a parmership. please iaclude tbe following infotmarion for each partner (use additional pages if necessary):
FuriAame Middlcinival (Maidrn) Iast DeteofBinh
HonY Addcess: SvW \ame City $txte 7.ip Phonc Number
Fus[ Namc Middle ]nid�! (.+.faidcn) Lu2 Dam of Binh
HomeAddreca; StrutNamc Ciry S••«
MINtdFESOTA TAX 1DENI�ICATION NUMBER - Pursuanc to [l�e I.aws of Nfinnesota, 1984, Chapter �02, Article 8, Sadon 2(270.72)
(Tu Cleatance; Issuance of Licenses), licensing authorities are required to provide to the Staze of Minnesota Commissioner of Revenuo,
the Minnesota business taz identification numbu aod ttc social securiry number of each license applicant.
Under the Minnesota Govemment Data Practices Act and the Federal Privacy Act of 1974, we aze required to advise you of ihe following
:egarding cfie use of che Minnesota Taz Zdenaficatio¢ Numbez:
- Ihis infamation may be.ased to deny [he issuanw o[ renewal of your license in the event you owe Minnesaca sales, employets
with6olding or motor ve6icle ezcise faxes;
- Upon receiving this info:mafiou, the licensing auchoriry wiU supply it only [o the Minnesota Departrnent of Revcoue. However,
undec tbe Federa! Exchange of Inforn�a6on Agc�emen4 the ]�eepartment of Revenue may supply ttus information ta the Intexnat
Reuenuc Stsvicc.
Minnesota Taz Identificatian Numbers (Sales & Use Tax Number) may be obtained from che State of Minnesot� Business Records
�P��4 SO River Park Plaza (612296-6181).
Social Sneurity I�umbu: 503-30-9143
MinnesouTaxIdenafinationllumber: ���SF
_ If a Minnesota Taz Identificatiou Number is not required for the busicess being operared indicate so by placing an "X' in the
box.
996 08=55 FROM CITY OF ST PRUL LIEP TO
97740205 P.004
CFRTIFlCATION OF WORKEIZS' CAMPFNSATiON COVET2AGE PURSUANI TO MINNESOTA STATUTE 176.182
I he�ebY cutifS't6at I. or my wmpany, am in compliance wich the workers eompensation insuranee coverage requ'aemen[s of Minnosota
StamGe 176.182, subdvision 2 I atso undtrstand that provision of false infoxmation in this certification constituus snfficiem gounds for
advcxse action agaiast all Iicenus hetd, includwg revocation and suspensioa of said licenses. � �!��� 1
r
Name of Insucance Company. Berlcley Administrators
PolicyNumber 04-045212-06 Cove[ageftom 11/19/95 �p�ll/19/96
I have no employees coverad ander wo�rs' compensation insurance
ANY FAT.SIFICATION OF ANSWERS GIVEN OR MATERIAL SUBMITTED
WII,L RESULT TtV DENIAL OF 1`E�tS APPY.ICATtON
I hereby state thac I Lave answued all.of [he pcecediag questioas, aad that the infoimation contained harein is tcue aad coaect ta che best
of my lmowledge and belieE I 6ereby state funher [hat I have received � moaey or other consideration. by way of loan, gift, eonaibution.
or othecwise, ottur than already disclosed in the applicarion wluch I herewith submitted. I also undastand t6is premise msy be inspected
by police, fire, health and other ciry officials at aay and all times when the busineas is in opetation.
Signa[ure ( QUIItED for
.3•/2•9
Dace
*RNofe: If ehis appiicafion is FoadlLiqnor related, please contact a C5ty of Sains Paul Health Inspector, Steve Olson (266-9139), to review
plans.
If any substmfial changes m shucbue are anficipated, please coutact a City of Saint Paul Plsn Sxaminer at 266-9007 to apply for
building petmits.
If there are suy chaqges to t6e patking lot, floor space, a for new operatioas, please contact a.CSry of Saiot Paul Zoning Inspector
at 266-9008.
Additional appllcatlon reqottements, please attach:
A defetled descripNon oP the design, locatlon and square footage of the premtses to be ticensed (site plan).
The (ollowIng data should be oa the site pJan (preferabkv on an 8 7/2" x ii" or 81f1" x 14'• paper):
- Neme, address, aad phone number.
- The scale should be stated such as 1" = 20'. ^N should be 1ndScated toward the top.
- Placement of all pecUnmt Peatures o7 the inter}or oP the llcensed facllttp such as seating areas, ldtchens, offices, repair
area, pazldng, rest rooms, et�
- Tf a request 1s [or an addttlon or ezpansinn of the licensed facllity, indicate boW the current area and the proposed
expartsion.
A copy o[ pour tease agreement or proof of ownership of the propertp. .-
FOR SPECIFIC APPLICATION REQUIREMENTS, PLEASE SEE REVERSE >>>>_
. ...
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