97-1362Council File #` g 7 - /.3��
Ordinance #
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--�
Presented By �
Referred To �-
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
Green Sheet � 37924
�
Committee: Date
RESOLVED: That application, ID �31934, for an Entertainment - C1ass A License by Deb=a
Johnson DBA Sports Break {Debra Johnson, Owner) at 1199 Rice Street, be and
the same is hereby approved.
Requested by Department of:
Adoption Certified by Council Secretary
BY� �a_ c�-: �..r�,'�.a��—_
C t
Approved by Mayor: Da�te 1� Iza�41
By : � �
Office of License Ins�ections and
/ E�n , vironmental Protection
BY- \ � � '"'S�/�-�
Form Approved by City Att ey
By: � JJ
Approved by ayor for Submission to
Council
By:
Adopted by Council: Date � \, �
y � - i,3��.
DEPAHiGENTNFFICEACOUNCIL DATE INITIATED � � .J L �
LIEP GREEN SHEE
CONTACTPERSON 8 PHONE �NITIAVDATE INffIALNATE
ODEPARTh1ENTDIRECTOR �CITYCOUNCIL
Christine A. Rozek — 266-9108 N Y RFOR ❑CIT'ATfORNEY OCITYCLEFK
MUST BE ON CpUNCIL AGENOp BY (OATE) pp�p� �@qDGE[ OfRECTOR � FIN. 8 MGT. SERVfGES DIR.
H23T1Il : � I OflOEH � MpyOR (OR ASSISTANn �
TOTAL # OF SIGNA7URE PAGES (CLIP All LOCATIONS FOR SIGNATURE)
ACTION REQUESTED;
Debra Johnson DBA Sports Break requests Council approval of the application for
an Entertainment - Class A License, ID 4i31934, (Debra Johnson - Ovmer) at 1199 Rice Street.
RECOMMENDA71oNS: Approve (a) or Rejact (R) pERSONAL SERVICE CON7RACTS MUST ANSWEfl THE FOLLOWING QUESTIONS:
_ PLANNING COMMISSION _ GIVIL SERVICE COMMISSION �- Has this person/Firm ever worketl under a coMract tor this department?
_ CIB CAMMITTEE _ YES NO
_ STAFF 2. Has this personRirm ever been a city employee?
— YES NO
_ D�S7iiIC7 GOURi _ 3. Does this ersorVfirm ossess a skill not normall �
p p y possessed by any current ciry employee.
SUPPORTS WHICH CAUNCIL O&IECTIVE? YES NO
Expfain all yas answers on saparate sheet and attach to green sheet
INITIATING PROBLEM, ISSUE, OPPfi1RTUNITV (Who, Whet, When. Where, Why�:
ADVANTAGES IF APPRpVED:
��€�:?;'.% .
��k � ! i�jr.
DISA�VANTAGES IF APPROVED:
DISADVANTAGES IF NOTAPPROVE�. � �
70TAL AMOUNT OF THANSACTION S COST/AEVENUE BUDGE7ED (CIRCLE ONE) YES ND
FUNDIIdG SOURCE ACTNITY NUMBER
FINANCIALINFORASATION (E%PLAIN)
�7-i3��-
31934
RECEIPT
FOR
LTCIIVSE APPI,ICATION
Applicant#: 31934
DIDRA JOHNSON
SPORTS BRFI�IC
1199 RICE ST
ST. PAUL M[�iT 55117
phone: (612)489-�483
License
� - � � ia�
City of Saint Paul
Office of License, Sns�ctions
And Environmental Protection
350 St. Peter St. Suite 300
Saint Paul, Minnesota 55102
Date of Application : 08/27/97
License effective fran 10/31/97 to 10/31/98
Tota1 Fee
State Tax ID#: 2212975
Pai.d by: Cf�'CK ($15.00 charge for all retusned checks)
5-27-97--NEED COt}NCSL APPROVAL--LK--LIC
Units Fee
1 $217.00
$217.00
Your license to do business will be mailed upon receipt of r� approvals.
If you have any questions regardinq your license, please call
---------------------------------------------------------------------
CEEtTIFICATION OF WORI�25' COMPE�rSATION COVERAGE PERSUP.NT TO N�VNESQTA STATU7� 176.182
I hereby certify that I, or my ca*n�any, am in campliance with the workers` ca[g�n.sation
in�urance coverage requirements of Minnesota statute 176.182, sul�clivision 2.
I also understand that provision of false information in this certification constitutes
sufficient grounds for adverse action against a11 licenses held, including revocation
and suspension if said licenses.
Name of Snsurance Ccanpany :
Coverage from :
to
Policy Nlsnber :
I have no employees crovered under workers' com�nsation insurance.
=nC Business Name Date
Council File #` g 7 - /.3��
Ordinance #
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
--�
Presented By �
Referred To �-
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
Green Sheet � 37924
�
Committee: Date
RESOLVED: That application, ID �31934, for an Entertainment - C1ass A License by Deb=a
Johnson DBA Sports Break {Debra Johnson, Owner) at 1199 Rice Street, be and
the same is hereby approved.
Requested by Department of:
Adoption Certified by Council Secretary
BY� �a_ c�-: �..r�,'�.a��—_
C t
Approved by Mayor: Da�te 1� Iza�41
By : � �
Office of License Ins�ections and
/ E�n , vironmental Protection
BY- \ � � '"'S�/�-�
Form Approved by City Att ey
By: � JJ
Approved by ayor for Submission to
Council
By:
Adopted by Council: Date � \, �
y � - i,3��.
DEPAHiGENTNFFICEACOUNCIL DATE INITIATED � � .J L �
LIEP GREEN SHEE
CONTACTPERSON 8 PHONE �NITIAVDATE INffIALNATE
ODEPARTh1ENTDIRECTOR �CITYCOUNCIL
Christine A. Rozek — 266-9108 N Y RFOR ❑CIT'ATfORNEY OCITYCLEFK
MUST BE ON CpUNCIL AGENOp BY (OATE) pp�p� �@qDGE[ OfRECTOR � FIN. 8 MGT. SERVfGES DIR.
H23T1Il : � I OflOEH � MpyOR (OR ASSISTANn �
TOTAL # OF SIGNA7URE PAGES (CLIP All LOCATIONS FOR SIGNATURE)
ACTION REQUESTED;
Debra Johnson DBA Sports Break requests Council approval of the application for
an Entertainment - Class A License, ID 4i31934, (Debra Johnson - Ovmer) at 1199 Rice Street.
RECOMMENDA71oNS: Approve (a) or Rejact (R) pERSONAL SERVICE CON7RACTS MUST ANSWEfl THE FOLLOWING QUESTIONS:
_ PLANNING COMMISSION _ GIVIL SERVICE COMMISSION �- Has this person/Firm ever worketl under a coMract tor this department?
_ CIB CAMMITTEE _ YES NO
_ STAFF 2. Has this personRirm ever been a city employee?
— YES NO
_ D�S7iiIC7 GOURi _ 3. Does this ersorVfirm ossess a skill not normall �
p p y possessed by any current ciry employee.
SUPPORTS WHICH CAUNCIL O&IECTIVE? YES NO
Expfain all yas answers on saparate sheet and attach to green sheet
INITIATING PROBLEM, ISSUE, OPPfi1RTUNITV (Who, Whet, When. Where, Why�:
ADVANTAGES IF APPRpVED:
��€�:?;'.% .
��k � ! i�jr.
DISA�VANTAGES IF APPROVED:
DISADVANTAGES IF NOTAPPROVE�. � �
70TAL AMOUNT OF THANSACTION S COST/AEVENUE BUDGE7ED (CIRCLE ONE) YES ND
FUNDIIdG SOURCE ACTNITY NUMBER
FINANCIALINFORASATION (E%PLAIN)
�7-i3��-
31934
RECEIPT
FOR
LTCIIVSE APPI,ICATION
Applicant#: 31934
DIDRA JOHNSON
SPORTS BRFI�IC
1199 RICE ST
ST. PAUL M[�iT 55117
phone: (612)489-�483
License
� - � � ia�
City of Saint Paul
Office of License, Sns�ctions
And Environmental Protection
350 St. Peter St. Suite 300
Saint Paul, Minnesota 55102
Date of Application : 08/27/97
License effective fran 10/31/97 to 10/31/98
Tota1 Fee
State Tax ID#: 2212975
Pai.d by: Cf�'CK ($15.00 charge for all retusned checks)
5-27-97--NEED COt}NCSL APPROVAL--LK--LIC
Units Fee
1 $217.00
$217.00
Your license to do business will be mailed upon receipt of r� approvals.
If you have any questions regardinq your license, please call
---------------------------------------------------------------------
CEEtTIFICATION OF WORI�25' COMPE�rSATION COVERAGE PERSUP.NT TO N�VNESQTA STATU7� 176.182
I hereby certify that I, or my ca*n�any, am in campliance with the workers` ca[g�n.sation
in�urance coverage requirements of Minnesota statute 176.182, sul�clivision 2.
I also understand that provision of false information in this certification constitutes
sufficient grounds for adverse action against a11 licenses held, including revocation
and suspension if said licenses.
Name of Snsurance Ccanpany :
Coverage from :
to
Policy Nlsnber :
I have no employees crovered under workers' com�nsation insurance.
=nC Business Name Date
Council File #` g 7 - /.3��
Ordinance #
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
--�
Presented By �
Referred To �-
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
Green Sheet � 37924
�
Committee: Date
RESOLVED: That application, ID �31934, for an Entertainment - C1ass A License by Deb=a
Johnson DBA Sports Break {Debra Johnson, Owner) at 1199 Rice Street, be and
the same is hereby approved.
Requested by Department of:
Adoption Certified by Council Secretary
BY� �a_ c�-: �..r�,'�.a��—_
C t
Approved by Mayor: Da�te 1� Iza�41
By : � �
Office of License Ins�ections and
/ E�n , vironmental Protection
BY- \ � � '"'S�/�-�
Form Approved by City Att ey
By: � JJ
Approved by ayor for Submission to
Council
By:
Adopted by Council: Date � \, �
y � - i,3��.
DEPAHiGENTNFFICEACOUNCIL DATE INITIATED � � .J L �
LIEP GREEN SHEE
CONTACTPERSON 8 PHONE �NITIAVDATE INffIALNATE
ODEPARTh1ENTDIRECTOR �CITYCOUNCIL
Christine A. Rozek — 266-9108 N Y RFOR ❑CIT'ATfORNEY OCITYCLEFK
MUST BE ON CpUNCIL AGENOp BY (OATE) pp�p� �@qDGE[ OfRECTOR � FIN. 8 MGT. SERVfGES DIR.
H23T1Il : � I OflOEH � MpyOR (OR ASSISTANn �
TOTAL # OF SIGNA7URE PAGES (CLIP All LOCATIONS FOR SIGNATURE)
ACTION REQUESTED;
Debra Johnson DBA Sports Break requests Council approval of the application for
an Entertainment - Class A License, ID 4i31934, (Debra Johnson - Ovmer) at 1199 Rice Street.
RECOMMENDA71oNS: Approve (a) or Rejact (R) pERSONAL SERVICE CON7RACTS MUST ANSWEfl THE FOLLOWING QUESTIONS:
_ PLANNING COMMISSION _ GIVIL SERVICE COMMISSION �- Has this person/Firm ever worketl under a coMract tor this department?
_ CIB CAMMITTEE _ YES NO
_ STAFF 2. Has this personRirm ever been a city employee?
— YES NO
_ D�S7iiIC7 GOURi _ 3. Does this ersorVfirm ossess a skill not normall �
p p y possessed by any current ciry employee.
SUPPORTS WHICH CAUNCIL O&IECTIVE? YES NO
Expfain all yas answers on saparate sheet and attach to green sheet
INITIATING PROBLEM, ISSUE, OPPfi1RTUNITV (Who, Whet, When. Where, Why�:
ADVANTAGES IF APPRpVED:
��€�:?;'.% .
��k � ! i�jr.
DISA�VANTAGES IF APPROVED:
DISADVANTAGES IF NOTAPPROVE�. � �
70TAL AMOUNT OF THANSACTION S COST/AEVENUE BUDGE7ED (CIRCLE ONE) YES ND
FUNDIIdG SOURCE ACTNITY NUMBER
FINANCIALINFORASATION (E%PLAIN)
�7-i3��-
31934
RECEIPT
FOR
LTCIIVSE APPI,ICATION
Applicant#: 31934
DIDRA JOHNSON
SPORTS BRFI�IC
1199 RICE ST
ST. PAUL M[�iT 55117
phone: (612)489-�483
License
� - � � ia�
City of Saint Paul
Office of License, Sns�ctions
And Environmental Protection
350 St. Peter St. Suite 300
Saint Paul, Minnesota 55102
Date of Application : 08/27/97
License effective fran 10/31/97 to 10/31/98
Tota1 Fee
State Tax ID#: 2212975
Pai.d by: Cf�'CK ($15.00 charge for all retusned checks)
5-27-97--NEED COt}NCSL APPROVAL--LK--LIC
Units Fee
1 $217.00
$217.00
Your license to do business will be mailed upon receipt of r� approvals.
If you have any questions regardinq your license, please call
---------------------------------------------------------------------
CEEtTIFICATION OF WORI�25' COMPE�rSATION COVERAGE PERSUP.NT TO N�VNESQTA STATU7� 176.182
I hereby certify that I, or my ca*n�any, am in campliance with the workers` ca[g�n.sation
in�urance coverage requirements of Minnesota statute 176.182, sul�clivision 2.
I also understand that provision of false information in this certification constitutes
sufficient grounds for adverse action against a11 licenses held, including revocation
and suspension if said licenses.
Name of Snsurance Ccanpany :
Coverage from :
to
Policy Nlsnber :
I have no employees crovered under workers' com�nsation insurance.
=nC Business Name Date