96-595Council File # - �O_L�y?
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Presented By
Referred To
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Green Sheet # �✓��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
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Committee: Date
1 RESOLVED: That application (ID #19416) for an Auto Body Repaiz Garage License by T C
2 Paint & Collision Repair DBA T C Paint & Collision Repair (Thomas Kulp,
3 Partner) at 550 Vandalia Street be and the same is hereby approved.
4
5 Requested by Department of:
6 Yeas Nays Absent
7 B1ake� �
8 Guer.zn � Office of Licenae Inspections and
9 Harris ✓
10 Megard .i Env+ronmental Protection
11 Rettman
12 Thune �
15 Bostrom ✓
16 Adopted by Council: Date B Y' ���� ��
17
18 Adoption Certified by Council Secretary
19 Form Approved by City Attorney
20 ..,,II _` �) q
22 $Y. ' �a.��-�l�Y`l..�.1� BY�/ "/� /VI - (I� ° %6
23 Approved by Mayor: Date '"j(s
24
25 �� v (�� /J ,- Approved by Mayor for Submission to
26 B � ��� Council
27
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By:
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�EPARTMEN /OFfICFJCOUNCIL DATE �NRIATED GREEN SHEE N� 3 5 2 8 4
ZIEPJLicensin INITIALNATE INRIAIJOATE
CANTACT PERSpN & PHONE a DEPAflTMENT DIflE � CT' COUNCIL
Christine Eozek 266-9118 "�'�" �CITYATfORNEY �CRYCLERK
MUST BE ON CAUNCIL AGENDA BY (OATt7 NUMBER FOR � BUDGET DIRECTOR � PIN. & MGT. SERVICES Dlq.
ROUTING
r �/_ ORDEN O ypVOR (OR ASSISTANT) O
For hearin : J ��
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION flEQUE$7ED:
T C Paint & Collision Repair DBA T C Paint & Collision Repair requests Council approval
of its application for an Auto Body Repair Gatage License at 550 Vandalia Street
(ID 9F19G16).
RECOMMENDA7ioN5: Appra�a (A) or Reject (Fi1 PERSONAL SEfiVICE CONTHACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PLANNMG CAMMISSION _ CIVIL SERVICE CAMMISSION �� Hes Nis pBfSO�rtn eVef WOfked Undet a ContraC[ fOf thi5 dBp2rtmeht? -
_ CIB COMMRTEE _ YES 'NO
— �� F 2. Has this person/firtn ever been a city empioyee?
— YES NO
_ DISIRICT C�URT _ 3- Does ihis personlfkm possess a sicilf not normatly possessed by arry curreM cily employee?
SUPPORTSWHICHCOUNCILOBJECTIVE7 YES NO
Explain aff yes answers on separate sheet a�W attacfi to green aheet
INITIATING PROBLEM. ISSUE, OPPORTUNIT' (VJho, Whpt. Whan. Where. Why).
ADVAN7AGES IFAPPROVED:
DISADVANTAGES IFAPPROVED:
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= ''k"^.2,.�� eJ�a�.t�5
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DISADVANTAGES IF NOTAPPROVED: _ _ _ __„
TOTA� AMOUNT OF TRANSACTION S COST/REVENUE BUDGE7ED (CIflCLE ONE) VES NO
FUNDIfdCa SOUIiCE ACTIVI7Y NUMBER
FINANCIAL INFOflMATION: (EXPLAIN)
Greensheet # 35284
In Tracker?__ t � /J
L.I.E.P. REVIEW CHECKLIST Date:3/22/96 / 9`
APP'n Received / APP'n Processed
License iD # 19416 LiCense Type: an Auto Bodv Reoaix Gaxage
Company NamB:. T C Paint & Collision Repair DBA: T C Paint & Collision Repair
Business Addresss: 550 Vandalia Street Business Phone: 603-1395 —
Contact Name/Address:Thomas Kuln, 1246 Edmund Ave, 104 Home Phone: 644-3486
Date to Council Research: � ��
Public Hearing Date: �O Labels Ordered:_�
Notice Sent to A�alicant: ��g� Districi Council #: f�
Notice Sent to
Department/
City Attorney
Environmental
Health
License
,
Date Inspections
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Ward #: �
Comments
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Site Plan Received: �
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CLASS III
LICENSE APPLICATION
��ylC�
CITY OF S� PAU�.�
offim oFlicenu, Inspections
zmi Envisonmmtal RoteUion
3505�. Peer Sc S�ne 300
Saim PaW. MioKwo 55102
(61� 2669090 faz (612) 26b912d
THIS APPLTCATION IS SUBJECT TO REVIEW BY Tf� PUBLIC
PLEASE TYPE Olt PRINT IN INK
Type of License(s) being applied for: �
Company Name:
Cotpo�ation (Partnusfiip �ole Proprieiorship
If busioess is incorporated, give date of incorporation:
Doing Business As:
BusinessAddress: �a/,�_( [jy�Q{}1/,�_a
Business Phone: /n /7 3 —
St�eelAddrus City State Zip
Between what cross streets is the business located? j�� (R ���UP C� Wtuch side of the street? �v��
Are the pcemises now occupied? �,�_ What Type of Business?
Mail To Address:
Street Address
City
�
Stale Zip
y
Applicant Informat�ion:
NazneandTitie: ll1DYI7ftS �'�SPd�P .�����li1t°.�
Frs[ Middie (Maiden) Last Titie
Home Addsess:
StreetAddress City State Zip
Date of Birth: 7� c� �- 5 O Place of Birth: <�� PR ✓� Y� "�. Home Pho�e: �o yY ` 3 y C��O
Have you ever been convicted of any felony, crime or violation of any city ordinance other than haffic? YES _ NO �
Date of arrest:
Chazge: _
Convictioa:
Where?
Sencence:
List the names and residences of three persons of good moral chazacter, ]iving within the Twin Cities Metro Area, not related to the
applicant or financially interested in t6e premises or business, who may be referred to as to the applicanPs chazacter:
Are you going to operate this business persooally? � YES _ NO If not, who will operate it?
First Narne
Address; StreetName
Middk Inival (Maiden) Last
City
State
s.3� � �
Date of Birth
Zip Phrn�e Number
List licenses which you cuirently hold, formerly held, or may have an interest in:
o��P
Have any of the above named licenses ever been revoked? _ YES _ NO If yes, list the dates and reasons for revocation:
Are you goi�g to have a manager or assistant in Ihis business? _ YES � NO If the manager is not the same as the operator, ple��`�.-
compiete the following informatioo: ��� 5 � �
FirstName MiddleLtitial (Maiden) Last DateofBinh �
Home Address: Street Name City State Zip Ptrone Number
List all other ofFicers of the corporation:
OFFICER TTTLE AOME
NAME (Office Held) ADDRESS
HOME BUSINESS DATE OF
PHONE PHONE BIRTH
ff business is a partnership, please include t6e foliowing inforn�a6on foi each pazfier (use additional pages if necessary}:
Narne
Address: SVeet
Address: Street Name
Middle Initiai
City
City
La�t Date of Birth
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State Zip PhoneNumber
��ce � 1 a3� �Y`7
C.ast Date of Birth
State Zip Phone Number
MINNESOTA TAX IDENTiFICATTON NUMBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72)
(Tax Clearance; Issvance of Licenses), licensing authorities are required to provide to the State of Minnesota Commissioner of Revenue,
the Minnesota business tax ideofification number and the socia] sccurity number of each license app:;cant.
Under the Minnesota Govemroent Data Practices Act and the Federal Frivacy Act of 1974, we aze required to advise you of the foliowing
regazding the use of the Minnesota Tax IdenGfication Number.
- This inf'ormaGon may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employer s
withholding or motor ve6icle excise taxes;
- Upon receiving tfus information, the licensing aurhority wiil supply it only to the Minnesota Department of Revenue. However,
under the Federal Ezchange of Information Agreemen[, the Departtnent of Reveaue may supply this information to the Intemal
Revenue Service.
Minnesota Ta�c Idenaficafion Numbecs (Sales & Use Tae Numbex) may be obtained fcom the State of Minnesora, Business Records
Department, 10 River Pazk Plaza (612-296-6181).
Sociat Security Numbec: `!�S " �o "� c`C,� ( �'f' �� �' ' �f 7
Minnesota Taz Identification Number. � Y! ���D�
If a Minnesota Tax Identification Number is not required for the business being operated, indicate so by placing an "X" in the
boz.
Please list your employment lustory for the previous five (5) yeaz period:
� � _ 9�-595
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CER"4TFTCATION OF WORKERS' COMPENSATION COVERAGE PURSUANT TO MINNESOTA STATU'IB 176.182
I heceby cer[ify that I, or my company, am in compliance with the workers compensauon insurance coverage requirements of Minnesota
Staw�e 176.182, subdivision 2. I aiso understand tha[ provision of false information in this certification consututes sufficient grounds for
adverse action againsc all licenses held, i�luding ievceation and suspension of said ticenses.
Name of Insurance Company:
Policy Number: Coveiage from io
I have no employees covered under workers' compensation insutance _�
ANY FAISIFICATION OF ANSR'ERS GIVEN OR MATERIAL SUBMITTED
WII,L RESULT IN DENIAL OF THIS APPLICATION
I hereby state that I have answered all of the preceding questions, and that the information contained 6erein is uve and coaect to the best
of my knowledge and belief. I 6ereby state further that I have received no money or other consideration, by way of loan, gift, contribufion,
or otherwise, otlier ihan already disclosed in the application wtrich I herewith submitted. I also understand tlus premise may be inspected
by police, fire, health and other city officials at any and all dmes when the business is in operation.
C�.1�e.Y CJ//�i� J� f �, l� �O
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Signature (REQUIItED for all applicat ns) Date
"'Note: If this application is FoorUi.iquor related, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review
plans.
lf any substantial changes to strvcture are anticipated, please contact a City of Saint Paul Plan Ezaminer a[ 266-9007 to apply for
building permits.
tt iliere are any changes to the parking l04 �oor space, or for new operauons. please contact a City of Saint Paul Zoning Inspecror
at2G6-9008.
Additional application requirementr, please atfach:
A detailed description of the design, location and square footage of the premises to be licensed (site plan).
The tollowing data should be on the site plan (preCerably on an 8 U2" x 11" or 81/2" x 14" paper):
- Name, address, and phone number.
- The scale should be stated such as 1" = 20'. ^N should be indicated towazd the top.
- Ylacement of all pertinent features of the interior of the licensed facility such as seating areas, kitchens, oftices, repair
arca, parking, rest rooms, etc.
- If a request is for an addition or expansion of the licensed facility, indicate both the current azea and the proposed
espansion.
A copy of your lease aereement or proof of ownership of the property.
FOR SPECIFIC APPLICATION REQUIREMENTS, PLEASE SEE REVERSE »»,