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97-241Council File #�� J d y` � s l� t^3 � %l � � 4 i `�'�i :t'sa?S��f�3€a ordinance # Green Sheet # �� RESOLUTION CITY OF SAINT PAUL, MINNESOTA Presented By Referred To Committee: Date 1 2 3 4 5 6 7 8 9 lo 11 2. Food service to the public shall not bean without prior approval from food inspectors of LIEP, including an initial inspection before any change of equipment or remodeling. 12 13 Requested by Department of: 14 �Yea�i Nays Absent 15 B a — i/ 16 Bostrom Offic of License Insgections and 17 HaYris —� 18 Me ar � Env�ronmental Protection 19 Re tman 20 Thune n 21 Maver BY d/ ��7x/'� .��J 23 -M�y9'1 !� 24 Adopted by Council: Date 25 26 Adoption Certified by Council Secxetary z � Forn Approved by City Attorney 28 30 BY• �� / BY' ___�� V 31 Approved by Mayor: Date c`�� CS )' 32 ��,�� 33 Approved by Mayor for Submission to 34 By: Council 35 RESOLVED: ThaY application (ID #35114) for a Liquor On Sale-C, Sunday On Sale Liquor, Restaurant-B, Entertainment-A, and Cigazette License by Elanel Inc. DBA Governor's Fine Food (Louis Lentsch, President) at 959 Arcade Street be and the same is hereby approved with the following condition: 1. The use of the lot at 808 Case for off-sireet paddng is discontinued until appropriate variances aze granted by the Boazd of Zoning Appeals (BZA) and the site plan for the pazldng layout is approved by the Office of License, Inspections and Environmental Protection (LIEP). By' ��-ay� DEPAfiTMENT/OFFICE/COUNCIL DATE INRIATED GREEN SHEE N_ 3 5 3 0 3 LIEP/Licensing -- - " CqNTACTPEflSON&PHONE �DEPAflTMEMDIflECfOR �CffYCAUNCIL �NRIAVDATE Christine Rozek, 266-9108 A�IGN �CITYATfOPNEV �CRVCIEFK NUYBERFOR MUST BE ON COUNCIL AGENDA BV (DA7E) q�� BUDGET DIRECTOfl � FIN. 8 MGT. SERVICES DIR. ORDER Mqypq (OR PSSISTAD[i) For hearin : � � TOTAL # OF SIGNATURE PACaES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REOUESTED: Elemel Inc. DBA Governot`s Fine Eood requests Council approval of its application for a Liquor On Sale-C, Sunday On Sale Liquor, Restaurant-B, Entertainment-A, and Cigarette License located at 959 Arcade Street (ID �135114). RECOMMENDATiONS: Approva (A) w Hejea (R) pERSONAI SERYICE CONTRACTS MUST ANSWER THE FOILOWl1lG OUESTIOSIS: _ PLqNNING COMMISSION _ CNIL SEHVICE CAMMISSION 1. Has this personffirm ever worked under a contract for this department? - _ CIB CoMMIT7EE _ YES NO �� — 2. Has this perso�rtn ever been a ciry employee? YES NO , o15THICf CAUFiT _ 3. Does this perso�rm possess a skill not normally possessed by any Wrtent city emplqree? SUPPOfiT3 WHICH COUNCIL O&IECTIVE? YES NO Explain ali yes answers on separete sheet anE attaeh to green sheet INITIATING PROBLEM, ISSUE, OPPoRTUNITY (Who. What, When. Where. Why): ADVANTAGESIFAPPROVED: � DISADVANTAGES IF APPROVED: � C�unc� ��v-� ,_� €��.�� Mii�� S 1��7 �,_ - - ,� DISADVANTAGES IF NOTAPPpOVED: TO7AL AMOUNT OF TRANSACT�ON $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUNDING SOURCE ACTIVITY NUMBER FINANCIAL INFORMATION: (EXPLAIN) �. � ,'�. . . _ CLASS III LICENSE APPLICATION THIS APPLICATION IS SUBJECT TO REVIEW BY Tf� PUBLIC PLEASE TYPE OR PRINl' IN INK ao Y Type of License(s) being applied for: CITY OF SAINT PAUL off,«oru«�,t�«.u� � �� u�� u,� �� _ay� (61�]66909J fu(61�1669 —�r�9�!'Ll-{� o+' - a�J S� << � /60 �e4-� c /z�SS � s . CompanyName: �L�{�'lEl, �1JC• Coepontion / PaMaahip / Sole Proprietonhip _ If business is incorpora�te ave date of incotporation: DoingBusinessAs: U011�i—/2f�b1?� NlI�E Busines Address: seL«c na�„ csty s�m z�P Between what cross streets is the bu located? ��ll fl �f/'�I 5" Which side of the street7 ^} � Are the premises now occupied? l ES What Type of Business? �FST.4uQtV.�� ,Q.�I � ��1 S�fLE Lll,SLt 6� Mail To Address: sacn naa�. c�ry sws z�p Applicant Informatio Nazne and Tide: S,{�, 7 S �t}r/ csC r��-1 �E/(J TSG �RFS • Furt hj'iddic (Maiden) Lut Title Home Address: s�c naaR� c;ry DateofBirth: PlaceofBirth: �T� �UL._ HomePt Have you ever been convicted of any felony, crime or violation of any city ordinance other than �affic7 YES Date of arrest: Chuge: _ Conviction: Sentence: NO Zip List the names and xesidences of three persons of good moral chazacter, living within the Twin Cities Metro Area, not related to the applicant or &nancially interested in the premises or business, who may be referred to as to the applicanYs character: NAME ADDRESS PHONE Jc-Fi= _� �/sca-rc-� ��/d /an�ii/��TV�}u G�l< (�.��/( I'Yl/KE CoSrC-c.c! �S"r5 Qv�sPo��r �� l,�aoD�unw �(`'T� nW� l�,nu�F I,Jrro� l�9�'i l3G ina �r:n r�� ' /_45n may have an interest in: Have any of the above nazned licenses ever Wherel Business Phone: �'7�S q �Q� YES /Z __ NO If ves, list the dates and reasons for revocation: 12/18/96 U Are you goiag to operate this business perxmally7 _� YES NO If not, who will operate it7 ��_ a�� FustNeme bLdAclvRial (Meidcn) Lat DafeofB'uth HomeAdd+ess: StreetName CiTy Swe Zip PhoneNumber !ue you going to Lave amauaga or assistant in this business? YES _� NO ff the managa is not the same as the operator, please complete the following information: Fvst Namc Homc Addrev: Street Nme 2vfiddle (Ma�den) City Please list your employment lustory for the previous five (5) year period: �usinessBm�loyment Address I.ait Sr,r^ Da[e ofBvth Z�P Phone Ivumber /9?� _►� :• •� � r��1 � • il: '! � i �� List all other officers of the cocporation: OFFICER TITLE HOME HOME BUSINESS DATE OF NAME (Office Held) ADDRESS PH02�3E PHONE BIFtTH � OU1< l�-1 L��.�r:ct� �P �- S"c- <-1Srd E��C� �7�� 77l 26t4 S- �-�7 If business is a psr�erslup, please include the following infoimation for each parmer (use additional pages if necessary): Fnx Tame Home Addrns: Stroet N�e Fits[ Name HomeAdd[cw: StroetName Middle (Maidrn) C(Ty (Maidrn) CiTy Last state Z�p Last Stete Zit Date of B'vth �one Number Date ofB'vth honc Numbcr MINNESOTA TAX IDENTIFICATION NUMBER - Pursuani to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tac Clearance; Issuance of Licenses), licensing authorities aze required to provide to the State of Minnesota Coaunissioner of Revenue, the Minnesota business tax iden�cation number and the social security number of each license applicant. Under the Minnesoffi Govemment Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the following regazding the use of the Minnesota Tax Iden�cation Number: - This information may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholding or motor vehicle excise ta�ces; - Upon receiving this informarion, the licensing authority will supply it only to the Minnesota Depacunent of Revenue. However, under the Federal Exchange of Infoimation Agreement, the DeparUnent of Revenue may supply this information to the Intemal Revenue Service. Mmnesota Tax Identification Nianbeis (Sales & Use Tax N�unber) may be obtained from the State of Minnesota, Business Records Departmrnt, 10 River Park Plaza (612-296-6181). Social Security Number: �7O �� G7 / Minnesota Ta� Identification Number: :� I I LS� �� _ If a Minnesota Tax Idrntification Number is not required for the business being operated, indicate so by placing an "X" in the box. 12/18/96 'v , . - .:ERTIFICATION OF WORKERS' COMPENSATION COVERAGE PURSUANf TO MINNESOTA STANTE 176.182 I hereby cectify that I, or my compa¢y, am m complia�ce with the workecs' compensation insurance coverage requiremenu of Mimiesota Starute 176.182, subdivisian 2. I aLw Lmderstmmd that provision of feLse mfoimation in tbis certification constitutes sufficient gounds for adverse action against all licenses beld, including revocation and suspension of said licenses. Name of Insurance Company: Policy Number: `" Coverage from to I have no employees covered under workers' compensation insurance (INITIALS) �'� l ��,� -�- ANY FAISIEICATION OF ANSWERS GIVEN OR MATERIAL Si3BM1TTED R'ILL RESULT AV DENLAL OF TFIIS APPLICATION I hereby state that I have answered all of the preceding questions, and that the infonnation contained herein is true and correct to the best of my lmowledge and belief. I hereby state fiuther that I have received no money or other consideralion, by way of loan, gift, contribution, or othenvise, other than already disclosed in the application which I herewith submitted I also undastand ttus preause may be inspected by police, fire, health and other ciry officials at any and all times when the business is in operation. �—� Signature (REQUIRED for all applications) W e will accept payment by cash, check (made payabie to City of Saint Paul) or cmdit card (MIC or V isa). IFPAYING BY CREDIT CARD PLEASE COMPLETE THE FOLLOWING INFORMATION: � MasterCazd � Visa EXPIl2ATION DATE: ACCOUNT NUMBER: ❑�/�❑ ❑�0❑ ❑00❑ ❑��❑ ❑C7�❑ of Card Holder(reauired for all charees) Date **Note: If this application is Food/Liquor related, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review plans. If any substantial changes to struchue aze anticipated, please contact a City of Saint Paul Plan Exazniner at 266-9007 to apply for building permits. If there are any changes to the parking lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at 266-9008. All applications require the following documents. Please attach these documents w•hen submitting your appGcation: 1. A detailed description of the design, location and squaze footage of the pretnises 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): - Name, address, and phone number. - The scale should be stated such as I"= 20'. ^N should be indicated toward the top. - Placement of all pertinent features of the interior of the licensed facility such as seating azeas, kitchens, offices, repair area, pazking, res[ rooms, ete. - If a request is for an addilion or expansion of the licensed facility, indicate both the current azea and the proposed eapansion. 2. A copy of your lease agreement or proof of ownership of the properiy. SPECIFIC LICENSE APPLICATIONS REQUIRE ADDTFIONAL INFORMATION. PLEASE SEE REVERSE FOR DETAII.S >>>> 12/18/96 � if apply�ing for, Cabaret adult, please attach written proof that each employee is at least 18 years old �` �� Conversation/Rap parlor adult, please attach written proof that each employce is at least 18 years old Entertainment, please specity class A, B, or C license; obtain and attach signatures of approval from 90% of your neighbors within 350 feet ofthe establis�ment This license mus[ be applied for in conjunction with a Liquor, Wine, Malt On Sale or ReniallDance Hall license. Firn��„+a, please attach a letta with the following infoimation: state if selling or only repairing, Federal Fireazms License Number, type of Azme.d Services discfiarge (Honorable, General, Bad Conduct, Undesirable; Dishonorafiie; orno military suvice. (NOT'E: Establishment must be commercially zoned.) Game room, please provide the following infomiation: name of mactune and list price. (NOTE: A Pool Hall licease is required if there are any pool tables in the establishment) HeattWSports club adult, please attach written proof that each employee is at least 18 years old Liquor off/on sale, refer to attached liquor application. T..ock opening services, please attach a list of all employeu (with home eddress and telephone number) who will be doing the lock opening service; attach $10,000 Surety Bond. Massage center, please attach a detailed descriprion of the services being provided. Massage center adult, please attach written proof that each employee is at least 18 yeazs old. Massage practitioner, please attach a copy of letter for approval from Health; proof of insurance coverage of $1,000,000.00 each general liability and profusional liability with the City of Saint Paul named as an additional insured, and a 30 day notice of cancellation; a letter &om your employer to veiify employment with a license massage center. Motonycle dealer, please include State of Minnesota Dealer Number. New motor vehicle dealer, please include State of Minnesota Dealer Number. Yaridag bUramp, please include ihe n�anber of pa�ng s�aces, and attach plans containuig a general description of the seciuiry provided at the IoUrunp, a site pl� showing driveways ofthe proposed lot and the legal description of the properiy (this requiremrnt necessary only if no site plan is cucrently on file). Attach a cover letter describing your plans to comply with the lighting and painting requirements. Pawnbroker, please attach $5,000.00 Surety Bond. Second hand dealer-motor vehicle, please include Sffite ofMinnesota Dealer Number. Second hand dealer-motor vehicle parts, please attach $5,000.00 Surety Bond. Sfeam room/bath house adult, please attach written proof tLat each emptoyee is at least 18 years old. Theater adult, please attach written proof that each employee is at least 18 years old. 12/18/96 Greensneet # 35303 L.I.E.P. REVIEW CHECKLIST Date: z/27/97 / In Tracker? apP'n Received / App'n Processed ��a� � License ID # 35114 License Type: Liq. On Sale-C Sundav On Sale L•iq.. ReGta„ranr-R Company Name: Elemel Inc. Entertainment- and Cigarette , Bq: Governor s Fine Food Business Addresss: 959 Arcade Street Business Phone: 778-9408 Contact Name/Address: Louis Lentsch, 2680 Hazelwood. Home Phone: 770-1825 Maplewood, MN 55109 �„� �q�9�a 4 r0i� Date to Councif Research: Public Hearing Notice Sent to Applicant: Labels Ordered: 3/3/97 DisVict Council #: __ � Notice Sent to Ward Department/ Date Inspections Comments City Attorney �•�• `��' O� K - Environmental Health Fire License Sice Pian aeceived:_ Lease Raceivea: Police `� �� ' Zoning Council File #�� J d y` � s l� t^3 � %l � � 4 i `�'�i :t'sa?S��f�3€a ordinance # Green Sheet # �� RESOLUTION CITY OF SAINT PAUL, MINNESOTA Presented By Referred To Committee: Date 1 2 3 4 5 6 7 8 9 lo 11 2. Food service to the public shall not bean without prior approval from food inspectors of LIEP, including an initial inspection before any change of equipment or remodeling. 12 13 Requested by Department of: 14 �Yea�i Nays Absent 15 B a — i/ 16 Bostrom Offic of License Insgections and 17 HaYris —� 18 Me ar � Env�ronmental Protection 19 Re tman 20 Thune n 21 Maver BY d/ ��7x/'� .��J 23 -M�y9'1 !� 24 Adopted by Council: Date 25 26 Adoption Certified by Council Secxetary z � Forn Approved by City Attorney 28 30 BY• �� / BY' ___�� V 31 Approved by Mayor: Date c`�� CS )' 32 ��,�� 33 Approved by Mayor for Submission to 34 By: Council 35 RESOLVED: ThaY application (ID #35114) for a Liquor On Sale-C, Sunday On Sale Liquor, Restaurant-B, Entertainment-A, and Cigazette License by Elanel Inc. DBA Governor's Fine Food (Louis Lentsch, President) at 959 Arcade Street be and the same is hereby approved with the following condition: 1. The use of the lot at 808 Case for off-sireet paddng is discontinued until appropriate variances aze granted by the Boazd of Zoning Appeals (BZA) and the site plan for the pazldng layout is approved by the Office of License, Inspections and Environmental Protection (LIEP). By' ��-ay� DEPAfiTMENT/OFFICE/COUNCIL DATE INRIATED GREEN SHEE N_ 3 5 3 0 3 LIEP/Licensing -- - " CqNTACTPEflSON&PHONE �DEPAflTMEMDIflECfOR �CffYCAUNCIL �NRIAVDATE Christine Rozek, 266-9108 A�IGN �CITYATfOPNEV �CRVCIEFK NUYBERFOR MUST BE ON COUNCIL AGENDA BV (DA7E) q�� BUDGET DIRECTOfl � FIN. 8 MGT. SERVICES DIR. ORDER Mqypq (OR PSSISTAD[i) For hearin : � � TOTAL # OF SIGNATURE PACaES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REOUESTED: Elemel Inc. DBA Governot`s Fine Eood requests Council approval of its application for a Liquor On Sale-C, Sunday On Sale Liquor, Restaurant-B, Entertainment-A, and Cigarette License located at 959 Arcade Street (ID �135114). RECOMMENDATiONS: Approva (A) w Hejea (R) pERSONAI SERYICE CONTRACTS MUST ANSWER THE FOILOWl1lG OUESTIOSIS: _ PLqNNING COMMISSION _ CNIL SEHVICE CAMMISSION 1. Has this personffirm ever worked under a contract for this department? - _ CIB CoMMIT7EE _ YES NO �� — 2. Has this perso�rtn ever been a ciry employee? YES NO , o15THICf CAUFiT _ 3. Does this perso�rm possess a skill not normally possessed by any Wrtent city emplqree? SUPPOfiT3 WHICH COUNCIL O&IECTIVE? YES NO Explain ali yes answers on separete sheet anE attaeh to green sheet INITIATING PROBLEM, ISSUE, OPPoRTUNITY (Who. What, When. Where. Why): ADVANTAGESIFAPPROVED: � DISADVANTAGES IF APPROVED: � C�unc� ��v-� ,_� €��.�� Mii�� S 1��7 �,_ - - ,� DISADVANTAGES IF NOTAPPpOVED: TO7AL AMOUNT OF TRANSACT�ON $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUNDING SOURCE ACTIVITY NUMBER FINANCIAL INFORMATION: (EXPLAIN) �. � ,'�. . . _ CLASS III LICENSE APPLICATION THIS APPLICATION IS SUBJECT TO REVIEW BY Tf� PUBLIC PLEASE TYPE OR PRINl' IN INK ao Y Type of License(s) being applied for: CITY OF SAINT PAUL off,«oru«�,t�«.u� � �� u�� u,� �� _ay� (61�]66909J fu(61�1669 —�r�9�!'Ll-{� o+' - a�J S� << � /60 �e4-� c /z�SS � s . CompanyName: �L�{�'lEl, �1JC• Coepontion / PaMaahip / Sole Proprietonhip _ If business is incorpora�te ave date of incotporation: DoingBusinessAs: U011�i—/2f�b1?� NlI�E Busines Address: seL«c na�„ csty s�m z�P Between what cross streets is the bu located? ��ll fl �f/'�I 5" Which side of the street7 ^} � Are the premises now occupied? l ES What Type of Business? �FST.4uQtV.�� ,Q.�I � ��1 S�fLE Lll,SLt 6� Mail To Address: sacn naa�. c�ry sws z�p Applicant Informatio Nazne and Tide: S,{�, 7 S �t}r/ csC r��-1 �E/(J TSG �RFS • Furt hj'iddic (Maiden) Lut Title Home Address: s�c naaR� c;ry DateofBirth: PlaceofBirth: �T� �UL._ HomePt Have you ever been convicted of any felony, crime or violation of any city ordinance other than �affic7 YES Date of arrest: Chuge: _ Conviction: Sentence: NO Zip List the names and xesidences of three persons of good moral chazacter, living within the Twin Cities Metro Area, not related to the applicant or &nancially interested in the premises or business, who may be referred to as to the applicanYs character: NAME ADDRESS PHONE Jc-Fi= _� �/sca-rc-� ��/d /an�ii/��TV�}u G�l< (�.��/( I'Yl/KE CoSrC-c.c! �S"r5 Qv�sPo��r �� l,�aoD�unw �(`'T� nW� l�,nu�F I,Jrro� l�9�'i l3G ina �r:n r�� ' /_45n may have an interest in: Have any of the above nazned licenses ever Wherel Business Phone: �'7�S q �Q� YES /Z __ NO If ves, list the dates and reasons for revocation: 12/18/96 U Are you goiag to operate this business perxmally7 _� YES NO If not, who will operate it7 ��_ a�� FustNeme bLdAclvRial (Meidcn) Lat DafeofB'uth HomeAdd+ess: StreetName CiTy Swe Zip PhoneNumber !ue you going to Lave amauaga or assistant in this business? YES _� NO ff the managa is not the same as the operator, please complete the following information: Fvst Namc Homc Addrev: Street Nme 2vfiddle (Ma�den) City Please list your employment lustory for the previous five (5) year period: �usinessBm�loyment Address I.ait Sr,r^ Da[e ofBvth Z�P Phone Ivumber /9?� _►� :• •� � r��1 � • il: '! � i �� List all other officers of the cocporation: OFFICER TITLE HOME HOME BUSINESS DATE OF NAME (Office Held) ADDRESS PH02�3E PHONE BIFtTH � OU1< l�-1 L��.�r:ct� �P �- S"c- <-1Srd E��C� �7�� 77l 26t4 S- �-�7 If business is a psr�erslup, please include the following infoimation for each parmer (use additional pages if necessary): Fnx Tame Home Addrns: Stroet N�e Fits[ Name HomeAdd[cw: StroetName Middle (Maidrn) C(Ty (Maidrn) CiTy Last state Z�p Last Stete Zit Date of B'vth �one Number Date ofB'vth honc Numbcr MINNESOTA TAX IDENTIFICATION NUMBER - Pursuani to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tac Clearance; Issuance of Licenses), licensing authorities aze required to provide to the State of Minnesota Coaunissioner of Revenue, the Minnesota business tax iden�cation number and the social security number of each license applicant. Under the Minnesoffi Govemment Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the following regazding the use of the Minnesota Tax Iden�cation Number: - This information may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholding or motor vehicle excise ta�ces; - Upon receiving this informarion, the licensing authority will supply it only to the Minnesota Depacunent of Revenue. However, under the Federal Exchange of Infoimation Agreement, the DeparUnent of Revenue may supply this information to the Intemal Revenue Service. Mmnesota Tax Identification Nianbeis (Sales & Use Tax N�unber) may be obtained from the State of Minnesota, Business Records Departmrnt, 10 River Park Plaza (612-296-6181). Social Security Number: �7O �� G7 / Minnesota Ta� Identification Number: :� I I LS� �� _ If a Minnesota Tax Idrntification Number is not required for the business being operated, indicate so by placing an "X" in the box. 12/18/96 'v , . - .:ERTIFICATION OF WORKERS' COMPENSATION COVERAGE PURSUANf TO MINNESOTA STANTE 176.182 I hereby cectify that I, or my compa¢y, am m complia�ce with the workecs' compensation insurance coverage requiremenu of Mimiesota Starute 176.182, subdivisian 2. I aLw Lmderstmmd that provision of feLse mfoimation in tbis certification constitutes sufficient gounds for adverse action against all licenses beld, including revocation and suspension of said licenses. Name of Insurance Company: Policy Number: `" Coverage from to I have no employees covered under workers' compensation insurance (INITIALS) �'� l ��,� -�- ANY FAISIEICATION OF ANSWERS GIVEN OR MATERIAL Si3BM1TTED R'ILL RESULT AV DENLAL OF TFIIS APPLICATION I hereby state that I have answered all of the preceding questions, and that the infonnation contained herein is true and correct to the best of my lmowledge and belief. I hereby state fiuther that I have received no money or other consideralion, by way of loan, gift, contribution, or othenvise, other than already disclosed in the application which I herewith submitted I also undastand ttus preause may be inspected by police, fire, health and other ciry officials at any and all times when the business is in operation. �—� Signature (REQUIRED for all applications) W e will accept payment by cash, check (made payabie to City of Saint Paul) or cmdit card (MIC or V isa). IFPAYING BY CREDIT CARD PLEASE COMPLETE THE FOLLOWING INFORMATION: � MasterCazd � Visa EXPIl2ATION DATE: ACCOUNT NUMBER: ❑�/�❑ ❑�0❑ ❑00❑ ❑��❑ ❑C7�❑ of Card Holder(reauired for all charees) Date **Note: If this application is Food/Liquor related, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review plans. If any substantial changes to struchue aze anticipated, please contact a City of Saint Paul Plan Exazniner at 266-9007 to apply for building permits. If there are any changes to the parking lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at 266-9008. All applications require the following documents. Please attach these documents w•hen submitting your appGcation: 1. A detailed description of the design, location and squaze footage of the pretnises 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): - Name, address, and phone number. - The scale should be stated such as I"= 20'. ^N should be indicated toward the top. - Placement of all pertinent features of the interior of the licensed facility such as seating azeas, kitchens, offices, repair area, pazking, res[ rooms, ete. - If a request is for an addilion or expansion of the licensed facility, indicate both the current azea and the proposed eapansion. 2. A copy of your lease agreement or proof of ownership of the properiy. SPECIFIC LICENSE APPLICATIONS REQUIRE ADDTFIONAL INFORMATION. PLEASE SEE REVERSE FOR DETAII.S >>>> 12/18/96 � if apply�ing for, Cabaret adult, please attach written proof that each employee is at least 18 years old �` �� Conversation/Rap parlor adult, please attach written proof that each employce is at least 18 years old Entertainment, please specity class A, B, or C license; obtain and attach signatures of approval from 90% of your neighbors within 350 feet ofthe establis�ment This license mus[ be applied for in conjunction with a Liquor, Wine, Malt On Sale or ReniallDance Hall license. Firn��„+a, please attach a letta with the following infoimation: state if selling or only repairing, Federal Fireazms License Number, type of Azme.d Services discfiarge (Honorable, General, Bad Conduct, Undesirable; Dishonorafiie; orno military suvice. (NOT'E: Establishment must be commercially zoned.) Game room, please provide the following infomiation: name of mactune and list price. (NOTE: A Pool Hall licease is required if there are any pool tables in the establishment) HeattWSports club adult, please attach written proof that each employee is at least 18 years old Liquor off/on sale, refer to attached liquor application. T..ock opening services, please attach a list of all employeu (with home eddress and telephone number) who will be doing the lock opening service; attach $10,000 Surety Bond. Massage center, please attach a detailed descriprion of the services being provided. Massage center adult, please attach written proof that each employee is at least 18 yeazs old. Massage practitioner, please attach a copy of letter for approval from Health; proof of insurance coverage of $1,000,000.00 each general liability and profusional liability with the City of Saint Paul named as an additional insured, and a 30 day notice of cancellation; a letter &om your employer to veiify employment with a license massage center. Motonycle dealer, please include State of Minnesota Dealer Number. New motor vehicle dealer, please include State of Minnesota Dealer Number. Yaridag bUramp, please include ihe n�anber of pa�ng s�aces, and attach plans containuig a general description of the seciuiry provided at the IoUrunp, a site pl� showing driveways ofthe proposed lot and the legal description of the properiy (this requiremrnt necessary only if no site plan is cucrently on file). Attach a cover letter describing your plans to comply with the lighting and painting requirements. Pawnbroker, please attach $5,000.00 Surety Bond. Second hand dealer-motor vehicle, please include Sffite ofMinnesota Dealer Number. Second hand dealer-motor vehicle parts, please attach $5,000.00 Surety Bond. Sfeam room/bath house adult, please attach written proof tLat each emptoyee is at least 18 years old. Theater adult, please attach written proof that each employee is at least 18 years old. 12/18/96 Greensneet # 35303 L.I.E.P. REVIEW CHECKLIST Date: z/27/97 / In Tracker? apP'n Received / App'n Processed ��a� � License ID # 35114 License Type: Liq. On Sale-C Sundav On Sale L•iq.. ReGta„ranr-R Company Name: Elemel Inc. Entertainment- and Cigarette , Bq: Governor s Fine Food Business Addresss: 959 Arcade Street Business Phone: 778-9408 Contact Name/Address: Louis Lentsch, 2680 Hazelwood. Home Phone: 770-1825 Maplewood, MN 55109 �„� �q�9�a 4 r0i� Date to Councif Research: Public Hearing Notice Sent to Applicant: Labels Ordered: 3/3/97 DisVict Council #: __ � Notice Sent to Ward Department/ Date Inspections Comments City Attorney �•�• `��' O� K - Environmental Health Fire License Sice Pian aeceived:_ Lease Raceivea: Police `� �� ' Zoning Council File #�� J d y` � s l� t^3 � %l � � 4 i `�'�i :t'sa?S��f�3€a ordinance # Green Sheet # �� RESOLUTION CITY OF SAINT PAUL, MINNESOTA Presented By Referred To Committee: Date 1 2 3 4 5 6 7 8 9 lo 11 2. Food service to the public shall not bean without prior approval from food inspectors of LIEP, including an initial inspection before any change of equipment or remodeling. 12 13 Requested by Department of: 14 �Yea�i Nays Absent 15 B a — i/ 16 Bostrom Offic of License Insgections and 17 HaYris —� 18 Me ar � Env�ronmental Protection 19 Re tman 20 Thune n 21 Maver BY d/ ��7x/'� .��J 23 -M�y9'1 !� 24 Adopted by Council: Date 25 26 Adoption Certified by Council Secxetary z � Forn Approved by City Attorney 28 30 BY• �� / BY' ___�� V 31 Approved by Mayor: Date c`�� CS )' 32 ��,�� 33 Approved by Mayor for Submission to 34 By: Council 35 RESOLVED: ThaY application (ID #35114) for a Liquor On Sale-C, Sunday On Sale Liquor, Restaurant-B, Entertainment-A, and Cigazette License by Elanel Inc. DBA Governor's Fine Food (Louis Lentsch, President) at 959 Arcade Street be and the same is hereby approved with the following condition: 1. The use of the lot at 808 Case for off-sireet paddng is discontinued until appropriate variances aze granted by the Boazd of Zoning Appeals (BZA) and the site plan for the pazldng layout is approved by the Office of License, Inspections and Environmental Protection (LIEP). By' ��-ay� DEPAfiTMENT/OFFICE/COUNCIL DATE INRIATED GREEN SHEE N_ 3 5 3 0 3 LIEP/Licensing -- - " CqNTACTPEflSON&PHONE �DEPAflTMEMDIflECfOR �CffYCAUNCIL �NRIAVDATE Christine Rozek, 266-9108 A�IGN �CITYATfOPNEV �CRVCIEFK NUYBERFOR MUST BE ON COUNCIL AGENDA BV (DA7E) q�� BUDGET DIRECTOfl � FIN. 8 MGT. SERVICES DIR. ORDER Mqypq (OR PSSISTAD[i) For hearin : � � TOTAL # OF SIGNATURE PACaES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REOUESTED: Elemel Inc. DBA Governot`s Fine Eood requests Council approval of its application for a Liquor On Sale-C, Sunday On Sale Liquor, Restaurant-B, Entertainment-A, and Cigarette License located at 959 Arcade Street (ID �135114). RECOMMENDATiONS: Approva (A) w Hejea (R) pERSONAI SERYICE CONTRACTS MUST ANSWER THE FOILOWl1lG OUESTIOSIS: _ PLqNNING COMMISSION _ CNIL SEHVICE CAMMISSION 1. Has this personffirm ever worked under a contract for this department? - _ CIB CoMMIT7EE _ YES NO �� — 2. Has this perso�rtn ever been a ciry employee? YES NO , o15THICf CAUFiT _ 3. Does this perso�rm possess a skill not normally possessed by any Wrtent city emplqree? SUPPOfiT3 WHICH COUNCIL O&IECTIVE? YES NO Explain ali yes answers on separete sheet anE attaeh to green sheet INITIATING PROBLEM, ISSUE, OPPoRTUNITY (Who. What, When. Where. Why): ADVANTAGESIFAPPROVED: � DISADVANTAGES IF APPROVED: � C�unc� ��v-� ,_� €��.�� Mii�� S 1��7 �,_ - - ,� DISADVANTAGES IF NOTAPPpOVED: TO7AL AMOUNT OF TRANSACT�ON $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUNDING SOURCE ACTIVITY NUMBER FINANCIAL INFORMATION: (EXPLAIN) �. � ,'�. . . _ CLASS III LICENSE APPLICATION THIS APPLICATION IS SUBJECT TO REVIEW BY Tf� PUBLIC PLEASE TYPE OR PRINl' IN INK ao Y Type of License(s) being applied for: CITY OF SAINT PAUL off,«oru«�,t�«.u� � �� u�� u,� �� _ay� (61�]66909J fu(61�1669 —�r�9�!'Ll-{� o+' - a�J S� << � /60 �e4-� c /z�SS � s . CompanyName: �L�{�'lEl, �1JC• Coepontion / PaMaahip / Sole Proprietonhip _ If business is incorpora�te ave date of incotporation: DoingBusinessAs: U011�i—/2f�b1?� NlI�E Busines Address: seL«c na�„ csty s�m z�P Between what cross streets is the bu located? ��ll fl �f/'�I 5" Which side of the street7 ^} � Are the premises now occupied? l ES What Type of Business? �FST.4uQtV.�� ,Q.�I � ��1 S�fLE Lll,SLt 6� Mail To Address: sacn naa�. c�ry sws z�p Applicant Informatio Nazne and Tide: S,{�, 7 S �t}r/ csC r��-1 �E/(J TSG �RFS • Furt hj'iddic (Maiden) Lut Title Home Address: s�c naaR� c;ry DateofBirth: PlaceofBirth: �T� �UL._ HomePt Have you ever been convicted of any felony, crime or violation of any city ordinance other than �affic7 YES Date of arrest: Chuge: _ Conviction: Sentence: NO Zip List the names and xesidences of three persons of good moral chazacter, living within the Twin Cities Metro Area, not related to the applicant or &nancially interested in the premises or business, who may be referred to as to the applicanYs character: NAME ADDRESS PHONE Jc-Fi= _� �/sca-rc-� ��/d /an�ii/��TV�}u G�l< (�.��/( I'Yl/KE CoSrC-c.c! �S"r5 Qv�sPo��r �� l,�aoD�unw �(`'T� nW� l�,nu�F I,Jrro� l�9�'i l3G ina �r:n r�� ' /_45n may have an interest in: Have any of the above nazned licenses ever Wherel Business Phone: �'7�S q �Q� YES /Z __ NO If ves, list the dates and reasons for revocation: 12/18/96 U Are you goiag to operate this business perxmally7 _� YES NO If not, who will operate it7 ��_ a�� FustNeme bLdAclvRial (Meidcn) Lat DafeofB'uth HomeAdd+ess: StreetName CiTy Swe Zip PhoneNumber !ue you going to Lave amauaga or assistant in this business? YES _� NO ff the managa is not the same as the operator, please complete the following information: Fvst Namc Homc Addrev: Street Nme 2vfiddle (Ma�den) City Please list your employment lustory for the previous five (5) year period: �usinessBm�loyment Address I.ait Sr,r^ Da[e ofBvth Z�P Phone Ivumber /9?� _►� :• •� � r��1 � • il: '! � i �� List all other officers of the cocporation: OFFICER TITLE HOME HOME BUSINESS DATE OF NAME (Office Held) ADDRESS PH02�3E PHONE BIFtTH � OU1< l�-1 L��.�r:ct� �P �- S"c- <-1Srd E��C� �7�� 77l 26t4 S- �-�7 If business is a psr�erslup, please include the following infoimation for each parmer (use additional pages if necessary): Fnx Tame Home Addrns: Stroet N�e Fits[ Name HomeAdd[cw: StroetName Middle (Maidrn) C(Ty (Maidrn) CiTy Last state Z�p Last Stete Zit Date of B'vth �one Number Date ofB'vth honc Numbcr MINNESOTA TAX IDENTIFICATION NUMBER - Pursuani to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tac Clearance; Issuance of Licenses), licensing authorities aze required to provide to the State of Minnesota Coaunissioner of Revenue, the Minnesota business tax iden�cation number and the social security number of each license applicant. Under the Minnesoffi Govemment Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the following regazding the use of the Minnesota Tax Iden�cation Number: - This information may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholding or motor vehicle excise ta�ces; - Upon receiving this informarion, the licensing authority will supply it only to the Minnesota Depacunent of Revenue. However, under the Federal Exchange of Infoimation Agreement, the DeparUnent of Revenue may supply this information to the Intemal Revenue Service. Mmnesota Tax Identification Nianbeis (Sales & Use Tax N�unber) may be obtained from the State of Minnesota, Business Records Departmrnt, 10 River Park Plaza (612-296-6181). Social Security Number: �7O �� G7 / Minnesota Ta� Identification Number: :� I I LS� �� _ If a Minnesota Tax Idrntification Number is not required for the business being operated, indicate so by placing an "X" in the box. 12/18/96 'v , . - .:ERTIFICATION OF WORKERS' COMPENSATION COVERAGE PURSUANf TO MINNESOTA STANTE 176.182 I hereby cectify that I, or my compa¢y, am m complia�ce with the workecs' compensation insurance coverage requiremenu of Mimiesota Starute 176.182, subdivisian 2. I aLw Lmderstmmd that provision of feLse mfoimation in tbis certification constitutes sufficient gounds for adverse action against all licenses beld, including revocation and suspension of said licenses. Name of Insurance Company: Policy Number: `" Coverage from to I have no employees covered under workers' compensation insurance (INITIALS) �'� l ��,� -�- ANY FAISIEICATION OF ANSWERS GIVEN OR MATERIAL Si3BM1TTED R'ILL RESULT AV DENLAL OF TFIIS APPLICATION I hereby state that I have answered all of the preceding questions, and that the infonnation contained herein is true and correct to the best of my lmowledge and belief. I hereby state fiuther that I have received no money or other consideralion, by way of loan, gift, contribution, or othenvise, other than already disclosed in the application which I herewith submitted I also undastand ttus preause may be inspected by police, fire, health and other ciry officials at any and all times when the business is in operation. �—� Signature (REQUIRED for all applications) W e will accept payment by cash, check (made payabie to City of Saint Paul) or cmdit card (MIC or V isa). IFPAYING BY CREDIT CARD PLEASE COMPLETE THE FOLLOWING INFORMATION: � MasterCazd � Visa EXPIl2ATION DATE: ACCOUNT NUMBER: ❑�/�❑ ❑�0❑ ❑00❑ ❑��❑ ❑C7�❑ of Card Holder(reauired for all charees) Date **Note: If this application is Food/Liquor related, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review plans. If any substantial changes to struchue aze anticipated, please contact a City of Saint Paul Plan Exazniner at 266-9007 to apply for building permits. If there are any changes to the parking lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at 266-9008. All applications require the following documents. Please attach these documents w•hen submitting your appGcation: 1. A detailed description of the design, location and squaze footage of the pretnises 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): - Name, address, and phone number. - The scale should be stated such as I"= 20'. ^N should be indicated toward the top. - Placement of all pertinent features of the interior of the licensed facility such as seating azeas, kitchens, offices, repair area, pazking, res[ rooms, ete. - If a request is for an addilion or expansion of the licensed facility, indicate both the current azea and the proposed eapansion. 2. A copy of your lease agreement or proof of ownership of the properiy. SPECIFIC LICENSE APPLICATIONS REQUIRE ADDTFIONAL INFORMATION. PLEASE SEE REVERSE FOR DETAII.S >>>> 12/18/96 � if apply�ing for, Cabaret adult, please attach written proof that each employee is at least 18 years old �` �� Conversation/Rap parlor adult, please attach written proof that each employce is at least 18 years old Entertainment, please specity class A, B, or C license; obtain and attach signatures of approval from 90% of your neighbors within 350 feet ofthe establis�ment This license mus[ be applied for in conjunction with a Liquor, Wine, Malt On Sale or ReniallDance Hall license. Firn��„+a, please attach a letta with the following infoimation: state if selling or only repairing, Federal Fireazms License Number, type of Azme.d Services discfiarge (Honorable, General, Bad Conduct, Undesirable; Dishonorafiie; orno military suvice. (NOT'E: Establishment must be commercially zoned.) Game room, please provide the following infomiation: name of mactune and list price. (NOTE: A Pool Hall licease is required if there are any pool tables in the establishment) HeattWSports club adult, please attach written proof that each employee is at least 18 years old Liquor off/on sale, refer to attached liquor application. T..ock opening services, please attach a list of all employeu (with home eddress and telephone number) who will be doing the lock opening service; attach $10,000 Surety Bond. Massage center, please attach a detailed descriprion of the services being provided. Massage center adult, please attach written proof that each employee is at least 18 yeazs old. Massage practitioner, please attach a copy of letter for approval from Health; proof of insurance coverage of $1,000,000.00 each general liability and profusional liability with the City of Saint Paul named as an additional insured, and a 30 day notice of cancellation; a letter &om your employer to veiify employment with a license massage center. Motonycle dealer, please include State of Minnesota Dealer Number. New motor vehicle dealer, please include State of Minnesota Dealer Number. Yaridag bUramp, please include ihe n�anber of pa�ng s�aces, and attach plans containuig a general description of the seciuiry provided at the IoUrunp, a site pl� showing driveways ofthe proposed lot and the legal description of the properiy (this requiremrnt necessary only if no site plan is cucrently on file). Attach a cover letter describing your plans to comply with the lighting and painting requirements. Pawnbroker, please attach $5,000.00 Surety Bond. Second hand dealer-motor vehicle, please include Sffite ofMinnesota Dealer Number. Second hand dealer-motor vehicle parts, please attach $5,000.00 Surety Bond. Sfeam room/bath house adult, please attach written proof tLat each emptoyee is at least 18 years old. Theater adult, please attach written proof that each employee is at least 18 years old. 12/18/96 Greensneet # 35303 L.I.E.P. REVIEW CHECKLIST Date: z/27/97 / In Tracker? apP'n Received / App'n Processed ��a� � License ID # 35114 License Type: Liq. On Sale-C Sundav On Sale L•iq.. ReGta„ranr-R Company Name: Elemel Inc. Entertainment- and Cigarette , Bq: Governor s Fine Food Business Addresss: 959 Arcade Street Business Phone: 778-9408 Contact Name/Address: Louis Lentsch, 2680 Hazelwood. Home Phone: 770-1825 Maplewood, MN 55109 �„� �q�9�a 4 r0i� Date to Councif Research: Public Hearing Notice Sent to Applicant: Labels Ordered: 3/3/97 DisVict Council #: __ � Notice Sent to Ward Department/ Date Inspections Comments City Attorney �•�• `��' O� K - Environmental Health Fire License Sice Pian aeceived:_ Lease Raceivea: Police `� �� ' Zoning