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96-78Council File � �U ��f�� Ordinance # Green Sheet � '3`s°`�p ` RESOLUTION CITY Q�SA![�l.T--PAU�,-MiNNESA�'A- - �'°�- _ . _ _ Presented By Referred To Committee: Date 1 RESOLVED: That application (ID #74978) for an On Sale Malt (strong), Restaurant-B, and 2 Wine On Sale License applied £or by 830 Raymond Avenue DBA Panino's at 821 3 Raymond Avenue be and the same is hereby approved. � u � — � � n � ti, „� Requested by Department of: By: Approved by yor: Date / By: � �CtiE' Office of License. inspections and Environmental Protection By: C'��- �4�,� Form Approved by City Attorney By; �� ! _ � 2 -YG Approved by Mayor for Submission to council By: Adoption Certified by Council Secretary GREEN SHEE N � Bill Gunther, 266-9132 For hearing: TOTAL # OF �I 6 -'��' 35261 — sumnwntE — O DEPAflTMEM DIflECTOR � GITY COUNCIL F � aCRYAT(OFiNEY aGRYCLERK __ � BUDGET DIRECTOR O FlN. & MGT. SEFlVICES DIR. ■ ❑ MAYOR (OR ASSISTANn ❑ _ (CLIP ALL LOCATIONS �30' Inc. DBA Panino's requests Council approval of its application for an On Sale Malt (strong), Restaurant-B, and Wine On Sale License at 821 Raymond Avenue (ID 1174978). o� _ PLANNMGCOMMISSION _ CIViLSERVICE _ p6 COMMITfEE _ _ S7APF _ __ DISTRICTCqURT __ SUPPOFiTS WHICH COUNdL O&lEC71VE? PERSONAL SEHVICE CONTHACTS MUST ANSWER THE FOLLOWING QUESTIONS: t. Has this personRirm ever worked under a conhact tw this department4 - YES IJO 2. Has Mis persoNFlrm ever been a city employee? YES NO 3. Does this parsonfirm possess a skill not nOrmally possesseA by any curtent cFry employee? YES NO Explafn all yes answers on aeparate sheet and attach to green sheet ' � r � °'"�- ;=. �rtnt v. e; �� F.. .,. � W - � -- �� - � -- � „ " . . , `"`"'��:m.v.�-,;e� ADVANTAGES IF pPPRpVE�: �� v�E ?�� 9��f J�� 16 1�� IF NOT APPFlOVED: OF THANSACTION S COS7/REYENUE BUDGETED (CIRCLE ONE) YES NO FUNDING SOURCE ACTIVITY NUMBER PiNANqAI VNFORMATION: (EXCLAIN) Greensheet # 35261 In TrackeR� L.I.E.P. REVIEW CHECKLIST Date: 1/5/96 / � � _ `�t J9E ApP'n Received / ApP'n Processed License ID # 74978 License Type: � Sale Malt (strong) . Restaurant-B. W;.,e n., sai a Company Name: Raymond Inc. DBA: Panino's BusinessAddresss: $Z1 Raymond Avenue Bus inesS3_hOne:--6�+- �� _C_o , es'ter Kurtz. 2339 Han� nn�e_ Home Phone: 484-5452 osevi e Date to Council Research: Public Hearing Date: ��lO labels Ordered: ` Notice Sent to Applicant: District Council #: f� Notice Sent to Department j CRy Attorney Environmental Heaith Eire License Police Wazd Date Inspections � � 1 z� � (o Comments � 1V Gcs-e.�� ^ u�-�x-`ei ��..�zh ��.� �-ll-`!C m ��_�. 4 � ��, � Sita Plat� Received:_ �r*-K.c. tease Received: � — !/ - R.L Q � � t.c�ax..;,�� S � h��ku at�r��z�z��'t� �"'�. � - // - �� ?oning ( � �� 6� � -,- - � : CLASS III LICENSE APPLICATION CITY OF SAINT PAUL Office of License. Inspectians and Em•ironmentat Psotection i'0 St Pne Sv Svi�r iM $xin�Pavl*linnaa�z c5102 j61,):66-90^0 fat(bl.):6691_4 TH7S APPLICATION IS SUB3ECT TO REVIEW BY 7HE PtiBLIC PLEASE TYPE OR PRINT IN I2�'K Type of License(s) being applied for: Company I�'azne: � Corporation / P ,� a-� � n an ��-i� 4 / Sole If business is incorporated, give date of incorporation: _ I L-� � Doing Business As: PAfiS �t�S O 5 1 ^^', c BusinessAddress: �a� �1M0i1L1 /T!� �J� ��tline - Ol1 Sr�l� Business Phone: 1�� —� �d / Svezt Address � /�� City / State Zip Between what cross streets is the business located? KJI A/mCn c�� 7��Y ! TL'J 1GJWhich side of the street? 1� bJ 1 �25�'rx �.r Are the premises no�v occupied? �f n What T;pe of Business? Mail To Address: Svezt Address Ciry State Zip Applicant Information: �/� � ATame and Title: ��12$'�2( { fr(A1� C i 5 �ti-WY f Z Fint Middle (TRaiden) Laz[ Title HomeAddress: a3� (�iav1G� /�riL �oSFit'i I �C mY� ssll.3 � �— SVeet Address Ciry Sfate Zip Date of Birth: �0 a'" Place of Birch: �Lt l i C.�LL .� Home Phone:��Z� �� -� 4��-, � Have you ever been convicted of any felony, crime or violation of any city ordinance other than traffic? YES _ NO � Date of arrest: Chazge: _ Conviction: V✓here? Sentence: List the names and residences of three persons of �ood morai character, livin� within the Twin Cities Metro Area, not rela2ed to the applicant or financially interested in the premises or business, who may be referred to as to the applicant's character: NAMfi ADDRESS ' PHONE Are you going to operate 2his business personally? � YES _ NO If not, who will operate i2? Fint Narne �ddle Initial Home Address: Street Name _ Ciry � Staze Date of B'mh Z(p Phone Numbw,. ,,� _ ., � ;�:^;'��ew z , . List licenses which you currently ho]d, formerly held, or may have an interest in: L�s�nd l a�xt�n - flor Oa12� Yhn Have any of the above named licenses ever been revoked? _ YES � NO If yes, list the dates and reasons for revocation: Are ;�ou going to have a mana please complete the following �nr�r� ul or assistant in this business? � YES �� Fnt Name \1'iddle Home Address: Strekt Name Ciy (S) }•ear period: $usiness/Emnlovment List all other officers of the corporation: OFFiCER � TITLE NAME , (Office Held) First Name Home AdBress: Sveet Name First \ame Home Address: S¢eet Name Middle Initiat Middle [nitial HOME An1�RF.CS (\Ssiden) Ciry (Alaiden) City NO If the manager is not the�same a: the oper�� 171 r,��,� er �,1 I so Last Dzte of B'mh " /�n S.S- `/ �SS 393� State Zip Phone t:umbtt Address � _ HOME PHONE BUSINESS PHONE Last State Zip Lut State Zip AATE OF &IRTH Date of Bitth Phone Number Dzte of Binh Phone Number MINNESOTA TAX IAENTIFICATION 1�'UMBER - Pursuant to the Laws of Minnesota, 1984, Chapter 50?, Article 8, Section 2 (270.72) (Tax Clearance; Issuance of Licenses), licensin� authorities are required to provide to the State of Minnesota Commissioner of Revenue, the Minnesota business tax identification number and the socia3 security 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 the following regardin� the use of the Minnesota Tax ldentification Number: - This information may be used to deny the issuance or renewai of your license in the event you owe Minnesota sales, employer's withholdin� or motor vehicle excise taxes; - Upon receiving this information, the licensin� authoriry will supply it only to the Minnesota Department of Revenue. However, under the Federal Exchan�e of Information Agreement, the Department of Revenue may supply this information to the Intemal Revenue Service, Minnesota Tax Identification I�TUm6ers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records Departrnent, 70 River Park Plaza (612-296-6181). Socia] Security Number: � u' y y' s�� Minnesota Tax Identification Number: a�"� 2`� � � 3f a Minnesota Tax Identification Number is not required for the business being operated, indicate so by placing an "X" in the box. If business is a partnership, please include the followin� information for each partner (use additional pa�es if necessary): � °�`-?� CERTIFICAT��N O�.\VORKERS' COMPENSATION COVERAGE PURSUANT TO MINNESOTA STATUTE 176.182 I hereby certify that I, or my company, am in comgliancz ��ith the workers' compensation rnsurance coverage requirements of blinnesotaStatute 1 i6182, subdivision 2. I also understandihat provision of false information in this certificationconstitutes sufficient grounds for adverse action against all licenses held, includinQ re��ocation and suspension of said licenses. I�'ame of Insurance Company: �L�y)! qQ/� {�h L1.Sl(�.( (� �GL�lCQ� v " PolicyNumber: l=�� Co�era�efrom lc��to � 3. ---'--- I have ANY FALSIFICATIOY OF ANSR"ERS GIVEl�` OR MATERIAL SUBMITTED WILL RESULT IN DEIIAL OF THIS APPLICATION ] hereby state that I have answered all of the preceding questions, and that the information contained herein is true and correct to the best of my 3:nowledge and belief. t hereby state further that I have received no money or other consideration, by way of loan, gifr, contribution, or otherwise, ocher ihan already disclosed in the zpp]ication which I herewith submined, I a3so understand this premise may be inspected by police, fire, health and other ciry officizls at any and all times when the business is in operation. /� -.3�=� Signature (REQUIRED f�'r all Date '"Note: If this application is FoodlLiquor re3ated, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review p7ans. If any substantial chan�es to structure are anticipated piease contact a City of Saint Paul Plan Examiner at 266-9007 to apply for building permits. If there are any chan�es to the parkin� lot, floor space, or for new operations, please contact a City of Saint Paul Zonin� Inspectorat266-9008. Additional application requirements, please attach: A detailed description of the design, location and square footage of the premises to be licensed {site plan). The follo�ving data shou3d be on the site plan (preferably on an 8 1!2" x II" or 8 1/2" x 14" paper): - Name, address, and phone number. - The scala should be stated such as 1" = ZO'. ^N should be indicated toward the top. - Placement of all pertinent features of the interior of the licensed facitity such as seating areas, kitchens, offices, repair `,.- area, parking, rest rooms, etc. , 8 _ If a request is for an addition or expansion of the licensed facility, indicate 6oth the current area and the proposed c. of your lease agreement or proof of o�rnership of the property. �"-` °r�CIFIC APPLICATION REQUIREMENTS� PLEASE SEE REVERSE >>>> y': _ • �F ? CLASS III LICENSE APPLICAT'ION CITY OF SANT PAtiL OBice of License, Inspections 2nd Environmental Protection i_'6 Sc Paa h SuSte i00 Szinc 4avl, Minncsou SS102 ( :a <6L)?F&9t14 . _ "_�"""_'___ _..'___'" "_ — _ _ __ __._ — J� THIS APPLICATIO:�T IS SUBJECT TO REVIEVd BY THE PliBLIC PLEASE TYPE OR PR3NT IN Ii�TK 7+ T;�pe of License(s) being applied for: ' I I(.�.1,� �.S�Y�n4'� — W t/1 � CompanyName: b.7U (i�OY�Q � 1 Corporation / Partners ip / So]e Proprietorship If business is incorporated, give date of incorporation: _ 1� r 5 Doing Business As: }�L�N � I� BusinessAddress: �a� t�Q Dl1C` `�' YQ1.Ld- Business Phone: (0 7� � U� / !}') n � S I 1 �f Sveet Address City State Zip Bet�aeen �vhat cross streets is the business located? mcn d€ Tt'a-r� �ar t.Q Which side of the street? N� Are the premises now occupied? n L� R'hat T}pe of Business? Mail To Address: Street AddreSs Applicant Information: rTame and Title: �'�� ` Fint Middle Ciry State Zip ,�,(�LCU'2 c I,ast Title Home Address: f`7t%O 1 `-'1C 1161N 'Y i C i L� y �.VU � Y+'I �LtO � E'il ( 1�! � ✓ _ Sveet Address Ciry Staie Zip Date of Birth: b 0 � Place of Birth: I �Q O —� �— Home Phone: Have you ever been convicted of any felony, crime ox violation of any city ordinance other than traffic? YES _ NO � Date of arrest: Char�e: _ Conviction: Where? Sentence: List the names and residences of three persons of good moral character, ]iving within the Tw�in Cities Metro Area, not related to the applicant or financially interested in the premises or business, who may be referred to as to the applicant's character: NAME ADDRESS List licenses whlch you currently hold, formerly held, or may have an interest in: (�rif�.Y� 1nf,�nv .— S�ncDnl�11P_ PHONE Have any of the above named licenses ever been revoked? _ YES � NO If yes, ]ist the dates and reasons for revocation: ATe you goin� to operate this business personally? � YES _ NO If not, who will operate it? Frst A`ame Middle (M2iden) Home Address: Stren Name City Lazt State Date of Birth Zip - Phone Number '. _ .:,,� >,M . � . . Are you goin� to have a mana�er or assistant in this businecs? � YES _ h0 If the manager is not the same as the oper�t�� p]ease complete the followin�,information: i F/ j l �_ Name Home Address: Street Name Initial (\1�iden) � ,�'� f'Y�n S51 ciate Zip Phone Number Citv �__Yleasa.list--yeur--€r�gley�em foY"Jse previous fve (5} }'ear period: Business(Emnlovment nAddress ��i1 I Y'1 b S .�-1 � 1 (�i� �-F- � � I � 1 E I� (1 , ��r-,��C�:»,�t� (�n;��tvrn� t��'nE -------- List all other officers of the corporation: OFFICER TITLE HOME HOME BUSINESS DATE OF NAME (Office He1d) ADDRESS PHONE PHONE BIRTH ��'l] PJ�1� �l.,f�+u1'1F1,1� B'('2.S IHao� rtilou>�r"�N�' ��i��3Q33� �� l•�7U0 j 4��01 � �o�� Jit_�(�"Z �� 233�r �1�,�� F��U2�i6---o7�Z �i�R� I�t,�(�Z� �f'-'fY'2�S `�'3�p F;zc��e �l¢y s�-IS� y-�l� �Z�6 1a� If business is a partnership, please include the followin� information for each partner (use additional pa�es if necessary): First Name Home Address: Sveet 2.`ame First Name HOme Addre55: Sveei t�ame Middle Initial Middle Initial (Afaiden) C+ry Ciry Lan State Last State Dace of Binh Zip Phone Number Date of Birth Zip Phone Number MINNESOTA TAX IDENTIFICATION Nt72vIBElt - Pursuant to the Laws of Minnesota, 1484, Chapter 502, Article 8, Section 2 (27Q.72) (Tax Clearance; Issuance of Licenses), licensin� autborities are required to provide to the State of Minnesota Commissioner of Revenue, the Minnesota business tax identification number and the social security number of each license applicant. Under the Minnesota Govemment Data Practices Act and the Federal Privacy Aci of 1974, we are required to advise you of the following re�ardin� the use of the Minnesota Tax Identification Number: - This information may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholdin� or motor vehicle excise taxes; - Upon receiving this information, the licensing authoriry will supply it only to the Minnesota Aeparhnent of Revenue. However, under the Federai Exchange of Information Agreement, the Departrnent of Revenue may supply this information to the Intemal Revenue Service. Minnesota Ta�c Identification Numbers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records Department, 10 River Park Plaza (b12-296-6181). Sociai Security Number:3� " � � g Mi�esota Tax Identification Num6er: �a /�� v _ If a Minnesota Tax Identification 23umber is not required for the business being operated, indicate so by gtacing an "X" in the box. � r ' ,'�u.�t�ia.�,�,..��;r ... -.._�. ,.., .cq.':_�_,.. �ERTIFICATION OF WORKEAS' COMPENSATIODI C�VERAGE PURSUANT TO MTI�TI�'ESOTA S'CATUTE 176.182 `�� I hereby certify that I, or my company, am in compliance with the workers' compensation insurance coverage requirements of Nlinnesota Statute 1 i6.182, subdivision 2. I also understand thzt provision of false information in this certification constitutes sufficient �rounds for adverse action against all licenses he3d, includin� revocation and suspension of said licenses. Name of Insurance Company: 1W1l:UU.�LU T Ptl� PolicyA�umber: (OQ —��.��_ -; I have no emnlozeescauesedunr�eF-r�mkers' ctimoensai G�� o}•erage from to ANY FALSIFICATION OF ANSR'ERS GIVEN OR MATERIAL SUBD4ITTED WILL RESULT IN DEtiIAL OF THIS APPLICATION I hereby state that I have answ�ered all of the preceding questions, and that the information contained herein is true and correct to the best of my };no�i ledge and belief. I hereby state further thzt I have received no money or other consideration, by way of loan, gift, contribution, ot otherwise, other than already disclosed in the application which I herewith submitted. I also understand this premise may be inspected by police, fire, health and other city officials at any and all times when the businets is in operation. **Note: If this application is FoodlLiquor related, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9739), to review plans. If any substantial changes to structure are anticipated please contaci a City of Saint Pau] Plan Examiner at 266-9007 to apply for building permits. If there are any chan�es to the parking lot, floor space, or for new operations, please contact a City of Saint Pau1 Zoning Inspector at 266-9008. Additional appiication requirements, please attach: A defailed description of the design, location and square footage of the premises to be licensed (site plan). The following data should be on the site plan (preferably on an 8 1/2" x 11" or 8 1/2" x 14" paper): - n'ame, address, and phone numher. - The scate should be stated such as 1" = 20'. ^N shoutd be indicated toward the top. - Placementof all pertinentfeatures of the interior of the licensed facility such as seating areas, kitc6ens, ofrces, repair area, parking, rest rooms, etc. - If a request is for an addition or expansion of the licensed facility, indicate both the current area and the proposed expansion. A copy of your lease agreement or pioof of ownership of the property. FOR SPECIRTC APPLICATION REQUIREMENTS, PLEASE SEE REVERSE >>>> _ ��.,�: . __�,. , � y� �:,��