97-1425�
OF
-��-��-��
iESOLUTION
I,NT PAUL, MlyAlf
Council File $ 97-/y
ordinance #
Green Sheet # 50263
0
33
Presented By
1
2
3
4
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Re£erred To Committee: Date
RESOLVED: That ap icatio , ID $15989, for a Sunday On-Sale Liquor, Restaurant (B) and
Liquor On-Sa e-C Licenses by Bella St. Paul, Inc. DBA Bella St. Paul (Dean
Altier, President) at 33 7th Place W., be and the same is hereby approved
with the following conditions:
O a r�r+.z
1) Business will not open until Fire pproval is given.
2) Business will not open until Environmental Health approval is given.
3) Business must present proof of dram shop coverage to the Office of
License and Inspections prior to opening.
Requested by Department of:
Off�ce of License Tnsnections and
Environmental Protection
Bye l /�vLI..OMM.2> �T �"�M�
Form Approved by City Attorney
BY� ` //i/>�i,.,�-/7, � , a/ � .
Adoption Certified by Council Secretary Approved by Mayor for Submission to
}� Council
B Y � c�, �' • 1 — � rv—� ^-ns�
� / g
Approved by Mayor: Date � Z� Z�i ( r? �
By:
Adopted by Council: Date �5 . 3� ��_"�
N° 50263
9�-��rzs
DEFLRTMENLDFFICEACOUNQL � DATE INRIA7ED � � —�
LIEP GREEN SHEE
CONTACT PERSON B VHONE INITIAVpATE INITIAVDATE
�DEAkRTMENTDlREGTOR aClNCOUNClp
Christiae A. Rozek - 266-9108 NUNBERFOR ❑CINATfORNEV �pTYCLERK
MUST BE ON COUNCIL AGENDq BV (DATE) POUTING O BUOGET DIRECTO � FIN. 8 AAGT SEqVIC DIR.
�' /-, �!'7 OPDEfl O MAVOH (OR ASSISTANn O
earin : �� �-«� +
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION PE�UESTED:
Bel1a St. Paul, Inc. DBA Bel.la St. Paul (Dean Altier, President) requests
Council approval of their application for a Sunday On-Sale Liquor, Restaurant (B) and
Liquor-On-Sale -C Licenses at 33 7th Place W. (ID 4115989)
RECOMMENDATIONS: ApWave (A) or Rel� (A) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING �UESTlONS:
_ PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �� Has this person/firm ever worked untler a contract for this department�
_ CIB COMMITTEE _ YES NO
_ S7ACF 2. Has this personttirm ever been a city employee�
— YES NO
_ DISiRiGiCOURT — 3. Does this person/firm possess a skill not normally possessetl by any current ciTy emptoyee?
SUPPORTS WHICH COUNCIL OBJECTIVE� VES NO
Explein all yes enswers on saparate sheet and enach to green sheet
INITATING PROBLEM. ISSUE, OPPORTUNITV (Who. Whe1, When. Where.Why).
'i�?c:� :�����E �;S`ii':i1A"
€���' � `� 1997
ADVANTAGES IF APPROVED:
OISADYANTAGES IFAPPROVED:
DISADVANTAGES IF NOTAPPROVED
TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
Ft1NDIWG SObRCE ACTIYI7Y N@MBER
FINANCIAL INFORFnAT10N. (EXPLIIN)
7- a�
SAIHt
PAVi
�
eeee
_ � ;�
CITY OF SAINT PA1
�ct of License, Inspections
and Environmental Rotution
ax; sc a� sc s,�m �o
Sz,-u• Pz=.� V��p sslo2
(61?)16S9�J fssC6t])I66-o114
�� � r
--
•
_ i r fr fr
Compan}' Nzme: %3 +� Lt /� SF} / N i �,g U�- {/ n! e,
Co`poration / Partnuslvp / So]e Proprictorship
If business is incorporated, give date of incorporation: i �/O S/�f'
T
Doing Business As: ¢ �a � tif p a�.� Business Phone: o� �/- �] ¢/ ° J Z
Business Address: �� U1 '�� �!{ C e�
Strcet Addmss City State Zip
Belu�een what cross streets is the business located? S'�' •`P,¢ �'/--t � 71'k �� 4+sL VJhich side of the street? �� r�/
Are the premises now occupied? /�/ t7 What T}�pe of Basiness�
Mail To Address: '
s� .aea,rss
c�Ty
s�c� ztp
Applicant Infonnauon: _ -.- _
NameandTitle: ��� ����- 1� /-t Z- %�t�Cl�- j�rtk.SsDti'.i
Fust Y&ddle (Maidrn) Last Title
Home Address: _ ��Li ,� e o� f� S r% S% �r�U L /�[ � 5 '`S/O Z
craK aRU csty st�c� z�p
DateofBirth: 7 o S3 PlaceofBirth: V�`^! /�1 S e� HomePhone: �0(2 '�71�a �/S/
Have you ever been com�icted of any fetony, crime or ��iolation of any city ordinance other than RafiSc? YES NO �
Date oY arrest: Whera?
Chazge:
Conviction: Sentence:
Lis[ the names and residences of three persons of good moral character, living �zthin the �win Cities Metro Area, not relaterl to the applicant
or financially interested in the premises or business, who may be referred to as to the applicznt's character:
NAME ADDRESS PHONE
_ G—� 1 0 � � .,.� s o � 3 `f -? / Cz ��� ° r-5 S�` FK � � c� �3 0� -�i `3 a `/ G L
�L�
cLass zzz
LICENSE APPLICATION
a !
t - ! �$
TfTIS APPLICATION IS SLBJFCT TO REVIrW BY THE PUBLIC
PLEASE TYPE OR PRII�'T IN INK
� N S� c.� -'72i- C L<< vt_.6a+ 7
l ��r€�.1 !G'Z_ �C77CGJ 7 hl' :St
Lf'4J �ZZ
List licenses which you ciurenfly holc� formerly hel� or may have an interest in: /
� 57 A-CI / C. 1 [rJ u 7l2. f � w1 1�1 O �/� C @%�� ��� ( r �/�! e L R
Ha��e any of the a6o��e named licenses ever been revoked? YES _� NO If yes, list the dates and reasons for revocation:
�` i
i 2/18/97
Are you going to operate this business personally?
First �zme
Yfiddle
fiome Addnxs: Strccc \amc
�s
(.lSEfC:nJ
Cih•
A,-e you going to have a mz.�er or assistant in this business? YES
pleasse complete the follo«�ing i*iformation:
Fus[`�ame
Home Addrtls: Strut \ame
'.liddlelnitisl (Viaidrn)
?rSiddlc
Please list your employmeet history fos the previous five (5) } eaz peried:
Business/Em�lo�7nenf Address
F� �, R ��,N
97-iy2s
NO If not, �i�ho u�iil operate it?
�� Dete oFBinh
State Zip Phonc\umba
�O If the manager is not thz sazne as the oper2tor,
Lzst
Sfste
S 1(5 L Cc� S i- . f'%
List a11 other officers of the corporacion:
OFFICER TITLE HOME HOME BUSiNESS DATE OF
NAME (Office Held) ADDRESS PHONE PHONE BIIZTH
`D���� /d-c-� ��� , j'�kS����irL7zG � �ooic..S;�ST�� � �7j 2Ya�' 7
If business is a partnership, please include the following information for each partner {use adclitional pages if necessary):
Fint;vamc
HomeAddreu: Sireei:�'ame
Fint?�amc
Home Add�ess; Strect I:ame
City
Las[
Stefe Zip
I.ast
Stete Zip
Da.c af Birth
Zip Phone 2�`umba
��vt � ��N S.�/v.
Phone \�umber
Datc of $irth
Phone t�'umbe�
MINNESOTA TAX 1DENTIFICATION NUMBER - Pursuant to the Laws of Minnesot� 1984, Chapter 502, Article 8, Section 2(270.72)
(Tax Clearauce; Issuance of Licenses), licensing authorities are required to provide to the Stete 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 Pricacy Act of 1974, we are required to advise you oPthe following
regarding the use of the Minnesota Ta�c Idrntification Number:
- This infonnation may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employei s
withholding or motor vehicle excise ta�ces;
- Upon receiving this infoimation, the licensing authority will supply it only to the Minnesota Department of Revenue. However,
under the Federal Exchange of Information Agreement, the Department of Revrnue may supply ttris information to the Internal
Revenue Service.
Minnesota TaX IdentificationNumbers (Sales & Use Tax Number) may be obtained firom the State of Minnesota, Business Records Department,
10 River Pazk Plaza (612-296-6181).
so�iai s�u�iry Numb�r: 5 b 3— n���p � Nfim�esota Tax Identification Number:
Ciri
(Nasidenj
City
:vliddle Initial
_ If a Minnesota TaY Identificatfon Number is not required for the business being operated, indicate so by placing an "X" in the box.
�
� , ' 2/18/47
9�-iyu
CERTIFICATION OF WORKERS' CO?v1PENSATION CO VERAGE PURSUAi3I TO ;vIINNESOTA STATUTE 176.182
I hereby ceRifi' that I, or my company, azn in compliance ��ith the �3 s' compensation insurance covera�e requirements of Minnesota Statute
176.182, subdi�isirn 2. I also understand thatp;o�ision offase information in this cetufication constitutes s�zfficient grounds for adverse action
against all licznses field, including revocetion a,�d suspension of said ticenses.
I�'ame of Insurance Company:
(a t`'1 4 ✓L i e .8 �t
� S u �t .e •v �n
� ��
Policy\umbe:: Corerygefrom < i 7 to ���"
I have no emplo}'e� s cot�ered under u-orkers compzns2Tion insuznce (I2�ZTIALS)
ANY FALSIFICATION OF AI�SVVERS GIVEN OR MATERIAL SUBMTI"TED
WII.L RESULT IN DENI�IL OF THIS APPLICATION
I hereby state that i have ansv,�ered a11 of the preceding questions, and thaT The information contained herein is true and correct to the best of
my lmowledge and belief. I hereby staYe fiuther thai I have received no money or other consideration, by w�ay of loan, gift, conhibution, or
otherwise, other than already disclosa3 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 busin��eration.
�
We will accepY pay�mettt by cash, check (made parable !o City of Saint P&uIJ or credit card (M/C or Visa).
IFPAYINGBYCREDITGIRDPLEASECOh1PLETETHEFOLL03f7NGINFORMATION: �?vlasterC�rd � Visa
EXPIRATION DATE:
� � � �
ACCOUNT NUMBER:
� � � � � � � � � � � � � � � � I
�u
Date
**Note: ff this application is Food/Liquor related, plezse contact a City of Sainf Patil Health Inspecior, Steve Olson (266-9139), to ravieu�
plans.
If any substantial changes to structure are anticipated, please contact a City of Saint Paul Plan Examiner at 266-9007 to app]y for
building pemuts.
Ifthere aze any changes to the paz lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at
266-9008.
AII appfications mquim the following documents. Please attach t6ese documents n�hen submitting }our application:
I. A detailed description of the design, locaUon and square footage of the premises to be licensed (site plan).
The following data should be on the site plan (preferab�y on an 8 1/2" x 11" or 8 1!2" � 14" paper):
- Nazne, address, and phone number.
- The scale should be stated such as 1' = 20'. ^N should be indicated towazd the top.
- Placement of all pertinent features of the interior of the licensed faciliiy such as seating areas, kiYChens, offices, repair area,
parking, rest rooms, etc.
- ff a request is for an addition or expansion of the licznsed facIlity, indicate both the current azea and the proposed eapansion-
2. A copy of your lease agreement or proof of ow nership of the praperty.
SPECIFIC LICENSE APPLTCATIONS REQUIl2E ADDTTIONAL IlITFORMATION.
PLEASE SEE REVERSE FOR DETAII,S >>>>
;'��
�'18/97
�
OF
-��-��-��
iESOLUTION
I,NT PAUL, MlyAlf
Council File $ 97-/y
ordinance #
Green Sheet # 50263
0
33
Presented By
1
2
3
4
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Re£erred To Committee: Date
RESOLVED: That ap icatio , ID $15989, for a Sunday On-Sale Liquor, Restaurant (B) and
Liquor On-Sa e-C Licenses by Bella St. Paul, Inc. DBA Bella St. Paul (Dean
Altier, President) at 33 7th Place W., be and the same is hereby approved
with the following conditions:
O a r�r+.z
1) Business will not open until Fire pproval is given.
2) Business will not open until Environmental Health approval is given.
3) Business must present proof of dram shop coverage to the Office of
License and Inspections prior to opening.
Requested by Department of:
Off�ce of License Tnsnections and
Environmental Protection
Bye l /�vLI..OMM.2> �T �"�M�
Form Approved by City Attorney
BY� ` //i/>�i,.,�-/7, � , a/ � .
Adoption Certified by Council Secretary Approved by Mayor for Submission to
}� Council
B Y � c�, �' • 1 — � rv—� ^-ns�
� / g
Approved by Mayor: Date � Z� Z�i ( r? �
By:
Adopted by Council: Date �5 . 3� ��_"�
N° 50263
9�-��rzs
DEFLRTMENLDFFICEACOUNQL � DATE INRIA7ED � � —�
LIEP GREEN SHEE
CONTACT PERSON B VHONE INITIAVpATE INITIAVDATE
�DEAkRTMENTDlREGTOR aClNCOUNClp
Christiae A. Rozek - 266-9108 NUNBERFOR ❑CINATfORNEV �pTYCLERK
MUST BE ON COUNCIL AGENDq BV (DATE) POUTING O BUOGET DIRECTO � FIN. 8 AAGT SEqVIC DIR.
�' /-, �!'7 OPDEfl O MAVOH (OR ASSISTANn O
earin : �� �-«� +
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION PE�UESTED:
Bel1a St. Paul, Inc. DBA Bel.la St. Paul (Dean Altier, President) requests
Council approval of their application for a Sunday On-Sale Liquor, Restaurant (B) and
Liquor-On-Sale -C Licenses at 33 7th Place W. (ID 4115989)
RECOMMENDATIONS: ApWave (A) or Rel� (A) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING �UESTlONS:
_ PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �� Has this person/firm ever worked untler a contract for this department�
_ CIB COMMITTEE _ YES NO
_ S7ACF 2. Has this personttirm ever been a city employee�
— YES NO
_ DISiRiGiCOURT — 3. Does this person/firm possess a skill not normally possessetl by any current ciTy emptoyee?
SUPPORTS WHICH COUNCIL OBJECTIVE� VES NO
Explein all yes enswers on saparate sheet and enach to green sheet
INITATING PROBLEM. ISSUE, OPPORTUNITV (Who. Whe1, When. Where.Why).
'i�?c:� :�����E �;S`ii':i1A"
€���' � `� 1997
ADVANTAGES IF APPROVED:
OISADYANTAGES IFAPPROVED:
DISADVANTAGES IF NOTAPPROVED
TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
Ft1NDIWG SObRCE ACTIYI7Y N@MBER
FINANCIAL INFORFnAT10N. (EXPLIIN)
7- a�
SAIHt
PAVi
�
eeee
_ � ;�
CITY OF SAINT PA1
�ct of License, Inspections
and Environmental Rotution
ax; sc a� sc s,�m �o
Sz,-u• Pz=.� V��p sslo2
(61?)16S9�J fssC6t])I66-o114
�� � r
--
•
_ i r fr fr
Compan}' Nzme: %3 +� Lt /� SF} / N i �,g U�- {/ n! e,
Co`poration / Partnuslvp / So]e Proprictorship
If business is incorporated, give date of incorporation: i �/O S/�f'
T
Doing Business As: ¢ �a � tif p a�.� Business Phone: o� �/- �] ¢/ ° J Z
Business Address: �� U1 '�� �!{ C e�
Strcet Addmss City State Zip
Belu�een what cross streets is the business located? S'�' •`P,¢ �'/--t � 71'k �� 4+sL VJhich side of the street? �� r�/
Are the premises now occupied? /�/ t7 What T}�pe of Basiness�
Mail To Address: '
s� .aea,rss
c�Ty
s�c� ztp
Applicant Infonnauon: _ -.- _
NameandTitle: ��� ����- 1� /-t Z- %�t�Cl�- j�rtk.SsDti'.i
Fust Y&ddle (Maidrn) Last Title
Home Address: _ ��Li ,� e o� f� S r% S% �r�U L /�[ � 5 '`S/O Z
craK aRU csty st�c� z�p
DateofBirth: 7 o S3 PlaceofBirth: V�`^! /�1 S e� HomePhone: �0(2 '�71�a �/S/
Have you ever been com�icted of any fetony, crime or ��iolation of any city ordinance other than RafiSc? YES NO �
Date oY arrest: Whera?
Chazge:
Conviction: Sentence:
Lis[ the names and residences of three persons of good moral character, living �zthin the �win Cities Metro Area, not relaterl to the applicant
or financially interested in the premises or business, who may be referred to as to the applicznt's character:
NAME ADDRESS PHONE
_ G—� 1 0 � � .,.� s o � 3 `f -? / Cz ��� ° r-5 S�` FK � � c� �3 0� -�i `3 a `/ G L
�L�
cLass zzz
LICENSE APPLICATION
a !
t - ! �$
TfTIS APPLICATION IS SLBJFCT TO REVIrW BY THE PUBLIC
PLEASE TYPE OR PRII�'T IN INK
� N S� c.� -'72i- C L<< vt_.6a+ 7
l ��r€�.1 !G'Z_ �C77CGJ 7 hl' :St
Lf'4J �ZZ
List licenses which you ciurenfly holc� formerly hel� or may have an interest in: /
� 57 A-CI / C. 1 [rJ u 7l2. f � w1 1�1 O �/� C @%�� ��� ( r �/�! e L R
Ha��e any of the a6o��e named licenses ever been revoked? YES _� NO If yes, list the dates and reasons for revocation:
�` i
i 2/18/97
Are you going to operate this business personally?
First �zme
Yfiddle
fiome Addnxs: Strccc \amc
�s
(.lSEfC:nJ
Cih•
A,-e you going to have a mz.�er or assistant in this business? YES
pleasse complete the follo«�ing i*iformation:
Fus[`�ame
Home Addrtls: Strut \ame
'.liddlelnitisl (Viaidrn)
?rSiddlc
Please list your employmeet history fos the previous five (5) } eaz peried:
Business/Em�lo�7nenf Address
F� �, R ��,N
97-iy2s
NO If not, �i�ho u�iil operate it?
�� Dete oFBinh
State Zip Phonc\umba
�O If the manager is not thz sazne as the oper2tor,
Lzst
Sfste
S 1(5 L Cc� S i- . f'%
List a11 other officers of the corporacion:
OFFICER TITLE HOME HOME BUSiNESS DATE OF
NAME (Office Held) ADDRESS PHONE PHONE BIIZTH
`D���� /d-c-� ��� , j'�kS����irL7zG � �ooic..S;�ST�� � �7j 2Ya�' 7
If business is a partnership, please include the following information for each partner {use adclitional pages if necessary):
Fint;vamc
HomeAddreu: Sireei:�'ame
Fint?�amc
Home Add�ess; Strect I:ame
City
Las[
Stefe Zip
I.ast
Stete Zip
Da.c af Birth
Zip Phone 2�`umba
��vt � ��N S.�/v.
Phone \�umber
Datc of $irth
Phone t�'umbe�
MINNESOTA TAX 1DENTIFICATION NUMBER - Pursuant to the Laws of Minnesot� 1984, Chapter 502, Article 8, Section 2(270.72)
(Tax Clearauce; Issuance of Licenses), licensing authorities are required to provide to the Stete 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 Pricacy Act of 1974, we are required to advise you oPthe following
regarding the use of the Minnesota Ta�c Idrntification Number:
- This infonnation may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employei s
withholding or motor vehicle excise ta�ces;
- Upon receiving this infoimation, the licensing authority will supply it only to the Minnesota Department of Revenue. However,
under the Federal Exchange of Information Agreement, the Department of Revrnue may supply ttris information to the Internal
Revenue Service.
Minnesota TaX IdentificationNumbers (Sales & Use Tax Number) may be obtained firom the State of Minnesota, Business Records Department,
10 River Pazk Plaza (612-296-6181).
so�iai s�u�iry Numb�r: 5 b 3— n���p � Nfim�esota Tax Identification Number:
Ciri
(Nasidenj
City
:vliddle Initial
_ If a Minnesota TaY Identificatfon Number is not required for the business being operated, indicate so by placing an "X" in the box.
�
� , ' 2/18/47
9�-iyu
CERTIFICATION OF WORKERS' CO?v1PENSATION CO VERAGE PURSUAi3I TO ;vIINNESOTA STATUTE 176.182
I hereby ceRifi' that I, or my company, azn in compliance ��ith the �3 s' compensation insurance covera�e requirements of Minnesota Statute
176.182, subdi�isirn 2. I also understand thatp;o�ision offase information in this cetufication constitutes s�zfficient grounds for adverse action
against all licznses field, including revocetion a,�d suspension of said ticenses.
I�'ame of Insurance Company:
(a t`'1 4 ✓L i e .8 �t
� S u �t .e •v �n
� ��
Policy\umbe:: Corerygefrom < i 7 to ���"
I have no emplo}'e� s cot�ered under u-orkers compzns2Tion insuznce (I2�ZTIALS)
ANY FALSIFICATION OF AI�SVVERS GIVEN OR MATERIAL SUBMTI"TED
WII.L RESULT IN DENI�IL OF THIS APPLICATION
I hereby state that i have ansv,�ered a11 of the preceding questions, and thaT The information contained herein is true and correct to the best of
my lmowledge and belief. I hereby staYe fiuther thai I have received no money or other consideration, by w�ay of loan, gift, conhibution, or
otherwise, other than already disclosa3 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 busin��eration.
�
We will accepY pay�mettt by cash, check (made parable !o City of Saint P&uIJ or credit card (M/C or Visa).
IFPAYINGBYCREDITGIRDPLEASECOh1PLETETHEFOLL03f7NGINFORMATION: �?vlasterC�rd � Visa
EXPIRATION DATE:
� � � �
ACCOUNT NUMBER:
� � � � � � � � � � � � � � � � I
�u
Date
**Note: ff this application is Food/Liquor related, plezse contact a City of Sainf Patil Health Inspecior, Steve Olson (266-9139), to ravieu�
plans.
If any substantial changes to structure are anticipated, please contact a City of Saint Paul Plan Examiner at 266-9007 to app]y for
building pemuts.
Ifthere aze any changes to the paz lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at
266-9008.
AII appfications mquim the following documents. Please attach t6ese documents n�hen submitting }our application:
I. A detailed description of the design, locaUon and square footage of the premises to be licensed (site plan).
The following data should be on the site plan (preferab�y on an 8 1/2" x 11" or 8 1!2" � 14" paper):
- Nazne, address, and phone number.
- The scale should be stated such as 1' = 20'. ^N should be indicated towazd the top.
- Placement of all pertinent features of the interior of the licensed faciliiy such as seating areas, kiYChens, offices, repair area,
parking, rest rooms, etc.
- ff a request is for an addition or expansion of the licznsed facIlity, indicate both the current azea and the proposed eapansion-
2. A copy of your lease agreement or proof of ow nership of the praperty.
SPECIFIC LICENSE APPLTCATIONS REQUIl2E ADDTTIONAL IlITFORMATION.
PLEASE SEE REVERSE FOR DETAII,S >>>>
;'��
�'18/97
�
OF
-��-��-��
iESOLUTION
I,NT PAUL, MlyAlf
Council File $ 97-/y
ordinance #
Green Sheet # 50263
0
33
Presented By
1
2
3
4
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Re£erred To Committee: Date
RESOLVED: That ap icatio , ID $15989, for a Sunday On-Sale Liquor, Restaurant (B) and
Liquor On-Sa e-C Licenses by Bella St. Paul, Inc. DBA Bella St. Paul (Dean
Altier, President) at 33 7th Place W., be and the same is hereby approved
with the following conditions:
O a r�r+.z
1) Business will not open until Fire pproval is given.
2) Business will not open until Environmental Health approval is given.
3) Business must present proof of dram shop coverage to the Office of
License and Inspections prior to opening.
Requested by Department of:
Off�ce of License Tnsnections and
Environmental Protection
Bye l /�vLI..OMM.2> �T �"�M�
Form Approved by City Attorney
BY� ` //i/>�i,.,�-/7, � , a/ � .
Adoption Certified by Council Secretary Approved by Mayor for Submission to
}� Council
B Y � c�, �' • 1 — � rv—� ^-ns�
� / g
Approved by Mayor: Date � Z� Z�i ( r? �
By:
Adopted by Council: Date �5 . 3� ��_"�
N° 50263
9�-��rzs
DEFLRTMENLDFFICEACOUNQL � DATE INRIA7ED � � —�
LIEP GREEN SHEE
CONTACT PERSON B VHONE INITIAVpATE INITIAVDATE
�DEAkRTMENTDlREGTOR aClNCOUNClp
Christiae A. Rozek - 266-9108 NUNBERFOR ❑CINATfORNEV �pTYCLERK
MUST BE ON COUNCIL AGENDq BV (DATE) POUTING O BUOGET DIRECTO � FIN. 8 AAGT SEqVIC DIR.
�' /-, �!'7 OPDEfl O MAVOH (OR ASSISTANn O
earin : �� �-«� +
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION PE�UESTED:
Bel1a St. Paul, Inc. DBA Bel.la St. Paul (Dean Altier, President) requests
Council approval of their application for a Sunday On-Sale Liquor, Restaurant (B) and
Liquor-On-Sale -C Licenses at 33 7th Place W. (ID 4115989)
RECOMMENDATIONS: ApWave (A) or Rel� (A) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING �UESTlONS:
_ PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �� Has this person/firm ever worked untler a contract for this department�
_ CIB COMMITTEE _ YES NO
_ S7ACF 2. Has this personttirm ever been a city employee�
— YES NO
_ DISiRiGiCOURT — 3. Does this person/firm possess a skill not normally possessetl by any current ciTy emptoyee?
SUPPORTS WHICH COUNCIL OBJECTIVE� VES NO
Explein all yes enswers on saparate sheet and enach to green sheet
INITATING PROBLEM. ISSUE, OPPORTUNITV (Who. Whe1, When. Where.Why).
'i�?c:� :�����E �;S`ii':i1A"
€���' � `� 1997
ADVANTAGES IF APPROVED:
OISADYANTAGES IFAPPROVED:
DISADVANTAGES IF NOTAPPROVED
TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
Ft1NDIWG SObRCE ACTIYI7Y N@MBER
FINANCIAL INFORFnAT10N. (EXPLIIN)
7- a�
SAIHt
PAVi
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eeee
_ � ;�
CITY OF SAINT PA1
�ct of License, Inspections
and Environmental Rotution
ax; sc a� sc s,�m �o
Sz,-u• Pz=.� V��p sslo2
(61?)16S9�J fssC6t])I66-o114
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_ i r fr fr
Compan}' Nzme: %3 +� Lt /� SF} / N i �,g U�- {/ n! e,
Co`poration / Partnuslvp / So]e Proprictorship
If business is incorporated, give date of incorporation: i �/O S/�f'
T
Doing Business As: ¢ �a � tif p a�.� Business Phone: o� �/- �] ¢/ ° J Z
Business Address: �� U1 '�� �!{ C e�
Strcet Addmss City State Zip
Belu�een what cross streets is the business located? S'�' •`P,¢ �'/--t � 71'k �� 4+sL VJhich side of the street? �� r�/
Are the premises now occupied? /�/ t7 What T}�pe of Basiness�
Mail To Address: '
s� .aea,rss
c�Ty
s�c� ztp
Applicant Infonnauon: _ -.- _
NameandTitle: ��� ����- 1� /-t Z- %�t�Cl�- j�rtk.SsDti'.i
Fust Y&ddle (Maidrn) Last Title
Home Address: _ ��Li ,� e o� f� S r% S% �r�U L /�[ � 5 '`S/O Z
craK aRU csty st�c� z�p
DateofBirth: 7 o S3 PlaceofBirth: V�`^! /�1 S e� HomePhone: �0(2 '�71�a �/S/
Have you ever been com�icted of any fetony, crime or ��iolation of any city ordinance other than RafiSc? YES NO �
Date oY arrest: Whera?
Chazge:
Conviction: Sentence:
Lis[ the names and residences of three persons of good moral character, living �zthin the �win Cities Metro Area, not relaterl to the applicant
or financially interested in the premises or business, who may be referred to as to the applicznt's character:
NAME ADDRESS PHONE
_ G—� 1 0 � � .,.� s o � 3 `f -? / Cz ��� ° r-5 S�` FK � � c� �3 0� -�i `3 a `/ G L
�L�
cLass zzz
LICENSE APPLICATION
a !
t - ! �$
TfTIS APPLICATION IS SLBJFCT TO REVIrW BY THE PUBLIC
PLEASE TYPE OR PRII�'T IN INK
� N S� c.� -'72i- C L<< vt_.6a+ 7
l ��r€�.1 !G'Z_ �C77CGJ 7 hl' :St
Lf'4J �ZZ
List licenses which you ciurenfly holc� formerly hel� or may have an interest in: /
� 57 A-CI / C. 1 [rJ u 7l2. f � w1 1�1 O �/� C @%�� ��� ( r �/�! e L R
Ha��e any of the a6o��e named licenses ever been revoked? YES _� NO If yes, list the dates and reasons for revocation:
�` i
i 2/18/97
Are you going to operate this business personally?
First �zme
Yfiddle
fiome Addnxs: Strccc \amc
�s
(.lSEfC:nJ
Cih•
A,-e you going to have a mz.�er or assistant in this business? YES
pleasse complete the follo«�ing i*iformation:
Fus[`�ame
Home Addrtls: Strut \ame
'.liddlelnitisl (Viaidrn)
?rSiddlc
Please list your employmeet history fos the previous five (5) } eaz peried:
Business/Em�lo�7nenf Address
F� �, R ��,N
97-iy2s
NO If not, �i�ho u�iil operate it?
�� Dete oFBinh
State Zip Phonc\umba
�O If the manager is not thz sazne as the oper2tor,
Lzst
Sfste
S 1(5 L Cc� S i- . f'%
List a11 other officers of the corporacion:
OFFICER TITLE HOME HOME BUSiNESS DATE OF
NAME (Office Held) ADDRESS PHONE PHONE BIIZTH
`D���� /d-c-� ��� , j'�kS����irL7zG � �ooic..S;�ST�� � �7j 2Ya�' 7
If business is a partnership, please include the following information for each partner {use adclitional pages if necessary):
Fint;vamc
HomeAddreu: Sireei:�'ame
Fint?�amc
Home Add�ess; Strect I:ame
City
Las[
Stefe Zip
I.ast
Stete Zip
Da.c af Birth
Zip Phone 2�`umba
��vt � ��N S.�/v.
Phone \�umber
Datc of $irth
Phone t�'umbe�
MINNESOTA TAX 1DENTIFICATION NUMBER - Pursuant to the Laws of Minnesot� 1984, Chapter 502, Article 8, Section 2(270.72)
(Tax Clearauce; Issuance of Licenses), licensing authorities are required to provide to the Stete 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 Pricacy Act of 1974, we are required to advise you oPthe following
regarding the use of the Minnesota Ta�c Idrntification Number:
- This infonnation may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employei s
withholding or motor vehicle excise ta�ces;
- Upon receiving this infoimation, the licensing authority will supply it only to the Minnesota Department of Revenue. However,
under the Federal Exchange of Information Agreement, the Department of Revrnue may supply ttris information to the Internal
Revenue Service.
Minnesota TaX IdentificationNumbers (Sales & Use Tax Number) may be obtained firom the State of Minnesota, Business Records Department,
10 River Pazk Plaza (612-296-6181).
so�iai s�u�iry Numb�r: 5 b 3— n���p � Nfim�esota Tax Identification Number:
Ciri
(Nasidenj
City
:vliddle Initial
_ If a Minnesota TaY Identificatfon Number is not required for the business being operated, indicate so by placing an "X" in the box.
�
� , ' 2/18/47
9�-iyu
CERTIFICATION OF WORKERS' CO?v1PENSATION CO VERAGE PURSUAi3I TO ;vIINNESOTA STATUTE 176.182
I hereby ceRifi' that I, or my company, azn in compliance ��ith the �3 s' compensation insurance covera�e requirements of Minnesota Statute
176.182, subdi�isirn 2. I also understand thatp;o�ision offase information in this cetufication constitutes s�zfficient grounds for adverse action
against all licznses field, including revocetion a,�d suspension of said ticenses.
I�'ame of Insurance Company:
(a t`'1 4 ✓L i e .8 �t
� S u �t .e •v �n
� ��
Policy\umbe:: Corerygefrom < i 7 to ���"
I have no emplo}'e� s cot�ered under u-orkers compzns2Tion insuznce (I2�ZTIALS)
ANY FALSIFICATION OF AI�SVVERS GIVEN OR MATERIAL SUBMTI"TED
WII.L RESULT IN DENI�IL OF THIS APPLICATION
I hereby state that i have ansv,�ered a11 of the preceding questions, and thaT The information contained herein is true and correct to the best of
my lmowledge and belief. I hereby staYe fiuther thai I have received no money or other consideration, by w�ay of loan, gift, conhibution, or
otherwise, other than already disclosa3 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 busin��eration.
�
We will accepY pay�mettt by cash, check (made parable !o City of Saint P&uIJ or credit card (M/C or Visa).
IFPAYINGBYCREDITGIRDPLEASECOh1PLETETHEFOLL03f7NGINFORMATION: �?vlasterC�rd � Visa
EXPIRATION DATE:
� � � �
ACCOUNT NUMBER:
� � � � � � � � � � � � � � � � I
�u
Date
**Note: ff this application is Food/Liquor related, plezse contact a City of Sainf Patil Health Inspecior, Steve Olson (266-9139), to ravieu�
plans.
If any substantial changes to structure are anticipated, please contact a City of Saint Paul Plan Examiner at 266-9007 to app]y for
building pemuts.
Ifthere aze any changes to the paz lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at
266-9008.
AII appfications mquim the following documents. Please attach t6ese documents n�hen submitting }our application:
I. A detailed description of the design, locaUon and square footage of the premises to be licensed (site plan).
The following data should be on the site plan (preferab�y on an 8 1/2" x 11" or 8 1!2" � 14" paper):
- Nazne, address, and phone number.
- The scale should be stated such as 1' = 20'. ^N should be indicated towazd the top.
- Placement of all pertinent features of the interior of the licensed faciliiy such as seating areas, kiYChens, offices, repair area,
parking, rest rooms, etc.
- ff a request is for an addition or expansion of the licznsed facIlity, indicate both the current azea and the proposed eapansion-
2. A copy of your lease agreement or proof of ow nership of the praperty.
SPECIFIC LICENSE APPLTCATIONS REQUIl2E ADDTTIONAL IlITFORMATION.
PLEASE SEE REVERSE FOR DETAII,S >>>>
;'��
�'18/97