97-384Council File � �2- 3d'�}
Presented
Referred
�1������°��`
� 9 . 4� S. u: . S.-,
RESOLUTION
i
z
3
RESOLVED: That application (ID #12288) for an Auto Repair Garage License by M& M Auto
Repair DBA M& M Auto Repair (Anthony Mendez, Partner) at 1200 7ackson Street be
and the same is hereby approved.
4
5 Requested by Department of:
6 Yea Nays Abaent
7 BS k� �
9 — �6eeri� Meet�.. _� Office of License Ins�ections and
10 Me a� ✓ Environmental Protection
11 Re tma� ✓
12 Thune
14 Bostrom �� �//
15 gp _ �.�_ �'"'.�t,�- f J:_"5N'✓
16 Adopted by Council: Date �
17
18 Adoption Certified by Council Secretary Form Approved by City Attorney
19
22 BY ��� � By: ` Zv „�- � �cc�/ix.P/l
23 Approved by Mayor: Date �/J� /`� �
24
25 �� � � Approved by Mayor for Submission to
26 By. C._- Council
27
Bye
Ordinance #
Green Sheet # �� ��
DEPARTMENT/OFFICE
LIEPjLice
CONTACT PEiISON S f
Chzistine
266-9108
T07AL # OF 51GNATURE PAGES
a� -�a�y
GREEN SHEET N_ 35389
INITIAVDATE INIT7AVDATE —
DEPARTMENT DIREGTOR � CITY CAUNCIL
arrnnaaNer Q crrrc�a�c
BUOCET DIflECTOR � PIN. & MGT. SERVICES OIq.
MAYOR (OR ASSISTANn �
(CLIP AlL IOCATIONS FOR SIGNATURE)
M& M Auto Repair DBA M& M Auto Repair is requesting Council approval of its application
for an Auto Repair Garage License located at 1200 Jackson Street (ID 1�12288)
_ PLANNING CAhUAlSS1�N _ C
_ CIB COMMITTEE _ _
_ STAFF _ _
_ DISTRICT COURT _ _
SUPPORTS WHICH COUNCIL OBJEC'fIVE?
PERSONAL SERYICE CONTHACTS MUST ANSWEH TXE FOLLOWING pUESTiONS:
1. Has Nis person/Firm ever worked under a conVact for this department? �
VES NO
2. Has this perso�rm ever been a ciry employee?
YES NO
3. Does this personflirm possess a skill not normally possessad by any current city employee?
YES NO
Explain all yas answers on separate sheet antl attach to gresn sheet
INITIATING PROBLEM, 75Sf1E, OPPORTUNIT! (WFw, Whal. WhM,1Nhe�e, Why):
����������
DcC 23 19�6
p i�
� i r h . a.:
Councii Research Genter
�A�-�� � � �ss7
TOiAL AMOUNT OF TRANSACTION
COST/REVENUE BUDGETED (CIRCLE ONE)
YES NO
FUNDIRG SOURCE ACTIVITV NUMBER
FINANCIAL INFOiiMAT10N: (EXPLAIN) '
Greensheet # 35389 L.I.E.P. REVIEW CHECKLIST Date: 12/9/96 /�� •�d'y
In Tracker? npp'n Received / npp'n arocessed
License lD # 1228$ LiCense Type: an Auto Repair GaraQe
CompBny Name: M& M Auto Repair DBA: same
Business Addresss: 1200 3ackson Street Business Phone: 489-0807
Contact Name/Address: Anthonv Mendez, 1521 6th St. 106 Ffome Pfione: 778-2418
Date to Council Research: /,�
Public Hearing Date: � � � � � � � �i � Labels Ordered: �tf'/
Notice Sent to Applicant: District Council #:
e�� , �a r,b
Notice Sent to Public: Ward #: O�
Department/ Date inspections Commerrts
City Attorney
I•��`��- a�t'. •
Environmental
Health
t�.A�
Fire
� - �' °t�'' C� K` '
License Site Pien aeceived:_
Lease Received:
��a7 �?7 �3 /�
Police
�•�• g�` ��K
Zoning
a I2f�`�7 � � �
�
CLASS III
LIC�NSE APPLICATIO�
CITY OF SAL\'T P.�UZ
05ia of Limr.se, L^c�tio,s
aid Em�iro:n P;o;ec:ion
5: R?er 5i Svie 3J]
iirhd.l:ic � t��m
(El?) }2�9°J fss (613) L',5-Sl:/
��_ 3�y
THIS APPLICATIOV IS SliBTECTTO REVIE�'✓ BY TI� PLbLIC
PLEASE t`YPE OR PRLZT L'� L�K
T��e of License{<) +��� a��lied for:
Co:.,�any::��: � �'+- r I G�rc�.-'fb
Ce;�,ation(Pz�� hiplSole
� 2
212
�
If business is ince;�erzted. gi��e date ef in:o;poration:
Deino Busioecs As: P,v�o+'1 er�i J� �Cp/-�� �- Business Phone: �12
Hesiaess Address. I Z�� .�('���oN 5`[ ST �!a u. t� � I� L 'J S 7 i'�
Scct.4ddrus � Ciry �-� Sute Zip
Be� een �;tat aess streeu is tUe busioess la ated? f�� `"-�+�c1<So� t�� R'bich side of Lhe street? ST
:3re the premises now occupied? �� �t'bat T�pe of Business? Cl�+2Y���� A iA'�o 5[CLE�,
�1�i ro .�adrz�s: 1 Zc� �„��C�'.x�c.i S i- �-r, �i�, u r..- �'1r�( .r � i I'7
Sv�t Address ��� Cicy � . S:z[e Zip
.4nplicaatInform2tion: Q.�:.1TIav� l,�pS£�.(a 1�ktitD��° r�il�r�lEf - " , ..
\arne andTitle: 1-�Ai �i.kl.arV 9 l.4 �i'�r� '- 'QA�¢� - ,
n.�se �.Siddle � (�.* �3e � L2tt Ti;7t
,+"'�ENDE�' �S'�.1 �� S'r�AUL� I"�� �5�EC0 .
He�eAddress:r-�,a��.t= 50� G�nn.rtyza� �� �� i �So�#Z
., ' t��r.��EZC�t,Ad�es� C'1Etanszs S� .'�i3;�U,1'1n.� c'lE� IDE i
q 'z^°:'-�$
DzteofBinh:c-�.�..v�= � •�-eo� PlaceofBinh:�7AwaJ-5�i�-�t.t�l�itiC�1A�"S HomePhane:nnw,.i-tl3te
Ha�•e you e�er been con��icled of zny fe3ony, cria� oc GtioIstion of any city ordinance othec than taffic?
D�;e of a�est:��4T��t �
Ch;rse �
� Conti''sction:
Sentencz:
YL.S x i�Q
Lisi che names aod residences of three persons of good noral chazacter, Iit•ing a•ithin the Twin Cides Meao Area, not related to tbe
applicaot or fmancially interested in the premises ot business, u ho may be referred to az to tbe applicanCs chuacter.
�AME
ADDRESS
PHO\B
221-\ q!
� Li t—��Pa�l2✓.2.� z 7� I � lGk1.-� I ra f�-T �Df � M(�} -�� J tJ 1 �n0[�
�,_� �, S,-,�1 2 9'71 r'1 c I'� ,�,-1�-c •'JZ� r �-v�m�s-,� nr�l 55 i oL? �'7 �7 ?3 0l
List licenses ��hich you c_un hold for�rly be3d, o� may bave zn interest in:
(�YQ1�.1Cr .
Have any of the above named licenses ever been revoked? _ YES � ti'O If }'es, list zhe dates aod reasor� fo. revocation:
Are you going to operate ihis business personally? � YFS ____ A`O If not, u•bo will operate it?
�
Firn :�amc
Middle
(.Maidrn) Lasl
Hor,x Addrrss: So-ea �zme " � . Ciry State ,
Daic ot B'uth
Phone:�umSez
Are ��ou _oin� to hzcz a manager or Z«ist<,i{ in Lhi� besinecs? _�k�ES ^� �O If the nana�er is not Lhe <� �y the opzr�:ar, ple� --
co�lete che followina i,.formatio�:
F; ct \�r.ie
�c:'�Add S.
G�
Stzte Zp
Pleze list }�our e�le; �nt histe;y fet the precious fi�'e (�) ;eaz �rio3:
Be�iness/Er;v�)c�,—,knt Address
n4�.o�-.i= .
�.-�,- t � ���t�� �� 9 . la � „ �. — .�.0 _ - to
�� rzic.� rtiN�1E�� �'�a� �`70 y 1-� � rrr�.5i 4�.AU�l�
_:_,si�rzs /��-tran6�; �t u�i�erzs��/+�;�E sTP��- 19'�S-9'-� —
r�t���.1,7�'�,.�-�'--,' "�4��
Lict ali othet eifice,s
OFFICER
\A.\SE
t�l o �� �
'.;fc:_e L�tixl t'`itiden) I,�tt
tt�e co[poratien:
TITLE - - HO'�iE
(Office Hetd) ADDRESS
�. 1-4yn-���rtl- S i-
� r .a:.u� �-1-
HO'��
PHO�
U� t `J �I5 - `I
g�;c��S
P�IO\
DATE OF
BIRTH
If r b ` esiness is a p��ership, ple��e incl�de the fotfow'ine iyo�tion foreach pa-tner (�ce additional pa__es if nuess��'):
l�tvT�o,�� _- �a �Et�(l..�Z- �-�-Lo(o
�cce �ase ?�fid3le L (^..:uden) Lzs[ �ate of Bc,�xh
1�Z1 C��`` �-ra.� � S� I��.x� i` 11� ��loco �78Z-�1�
?ie::KAddress: S^^.'�:z-�e . . Ci.y ctyce Zap .n�nt?.uc:uer
: RS[!�i..TIC
Ho:net,ddress: Scea'�zme
Mld�q'SJ�PI
Dz:e ef birh
PhOie \umY.s
(;.tz;den)
cty
A� �-�-��
� , �� o: a;.-�t
� r.� 5�d�`2. �3c��c
- $S1C T.IjI .bSO:K?�112:15PS
h�''�FSOTA'I.AX IDE.'�'Tff�ICA'IIOti \`[i:.�IDII2 - Rusua�t to the Lzws of A�finnesota, 1984, Chaptec 502, Article 8, Secdon 2(270.72)
(I'ax C7earance; Issuaae of Licenses), licensing autborives z*e required to pro�•ide to the State of ?�3innesota Commissioner of Revenue,
. tUe !vli�esota business taz identific2tion number and tUe so:ial security numSer of each license appGcaat
tncL^r the :Jf'innesota Govemment Daza Pracdces Act and th� Federai Pri��acy.4ct of 1974, we are required to adrice you of tbe foUou7ng
regazding t6e use of the VLinnesota Tu Idenufication I�'um3er:
- This informarion may be used w deny t6e issuance or reoew�al of your license in the eveni you ov.�e ?.4innesota sales, employei s
w•ithholding oc motor vehide ezcise tazes;
- Upon receieing this iaformatioa, rhe liceasing authority will supply it only to tbe?vIinnesota Depatsent of Revenue. Aowevet,
under the Federal Ezchange of InformaA oa Agreement, the Depaztment of Re�•enue may supply this information to the Intemal
Revenue Sen'ice.
Minnesota Taz Ideatification Numben (Sales & Use Tzz �umber) may be obtained from the State of ?v1'innesota, Busioess 12uorcLs
Department, 10 River Pazk Plaza (612-296-6181 .
��1.r.��Z= �t�-9�-zz33
SocialSecurity;�'umber. t'Ist�r�— ��6 g�°'T9��
Minnesota Taz IdenuficaGon r�umber. Z`1 2 - ��� 3
If a.'vlinnesota Taz Identificstio¢ :�umber is not requ'ued for the bvsiaess being opented, indicau so by plazing zn "X" in the
box.
Are ��ou goine to hz� e a mana�er or zssi<t�nt in i}iis business? _�'ES x XO lf the manager is not the s�me � 4ae opzr�r, ple�e .
complete the follok•ing informatioo:
,��'�.�
F;�t tiune �;idve IrJu€1 t�:�den) L�.a Dzu of Birh
'r'c�ndd�s Sc:�t�zr.K Ci�• SLte Zip P3ea:�uTY.s
Plezce list your e�lo}vxnt histeq� fer the prerious fi�'e (�) ;'ezr perio3: � �
B u sinecSlEm�lo�tnent
t
�-lL� 5���l1c_t ��t�1T�
CA, 2 .z�c+ct" ti�1�1ESr�s�a �
S�i�.2s � i J E� �,tn.� i
���!�G+Zc 'p4L� `J� �
Address
P�� i g
,�. y�<<�.-�,
List all other effice:s of the cotporatiea:
OFFICER TITLE - _
\A14E (Office Held)
►.lo��'
HO>g BliSI\`ESS D4TE OF
PHO�'E P�IO� BIR7H
HO'��
ADDRESS
If besness is a Fa�er6ip, pleue inc)ade tbe follow•ing i, °o:mzGon for ea:b pa-mer (use additional page� if nuessa�•):
�- � �v � rao�.iy' �l, t �f.rC�Z 1 �1- Co cn
: rst `�a;x �9Sid:lle L`.iti�l ('�:tiden) Lut Datt of BL�A�
��� �.�-µ. �,-��� S �. ►"�.�..�� MtJ s�>«o 'i�ig2�f
?ie:z address: S�.'ti€.-ie
fL'S[ �2RIC
ITJ::2I
Ci,y
('�Sziden)
96
YA..lL-
Zip Pk,e:x
M
Dzte
Ho:mAddras: Scea!:xme - Ciry —�-- Stxtt Zip Pboac hvmSer
A�":CESOTA T.AX IDE.`�'T4SCATiO\ :�L'!dIDER - Pursu�t to the Izws of ?.'Gnnesota, 1984. Cliapter 502, Anicle 8, Secuon 2(270.72)
(Ia Clearance; Issuan:.e of Licenses), licensiflg autborities ue requ'ued to pro�•ide to t6e State of ?vlinnaota Commissionex of Revenue,
tbe ?vlinnesota business taz idenrification number and the so:ial suuriry number of each license applicaat
Under tbe ?v&nnecota Govetnmeat Data Practices Act and tlr. Federal Privacy Act of 1974, we aze required to advise you of u} e follo�nng
regazding tbe use of the ;.Tnnesou 7zz Idenrificavon A'umber:
- T6is infoimarion may be used to deny tbe issuance or renev.•al of ;•our license in tbe event you oa�e DSinnesota sales, employer s
w•ithboldingormotorvehicleezcise -w,es;
-13pon reuicing this infoimation, tl�e Bcensing authority will supply it onty to the Minnesota Depaz�nt of Revenue. How�ever,
uMiec tbe Federal Exchange of Informa6on Agexment, t6e Depait�nt of Revenue may supply chis information to the Intemal
Reeenue Sen•ice. �
Minnesota Taz Identification A'umbers (Sales & Use Tzz \'umber) may be obtained from the Stau of ATinnesota, Business Records
Department, ]0 River Park Pla7a (612-296-5181 .
r-ti�r�,��z: �7 t - 9�- zz3�
SociaiSecuriryNumber. r_J'tt�--n�= 9`1S-gC�'"Zg2� _
Minnesota Taz Idenrification T'umber. ��1 2- � 3 ��
_ If a Mianesota Tax Identification T'umbet is not required fot the business being operated, indicate so by pluing zn "X" in�
fP_S7
C>E$TIFICA'IIO\ OF �'�'ORK£RS' C0�3PF.tiSATION CQ\�RAGE PtRSi:A.�Z TO A4L\hcSOTA ST�TI�T£ 176.1e2
I hereby ceru`y ivat I, oi my companv, atn in cempliance w;;S tbe v.•orkers cer., in<_urance co�•es�ge requi�es�n's of :�4in�esota
Stamte 176.182, culxli.ision 2. I�:so understind t6at pro�isioa of ;21ce inforr.r:een in this cectification constitu�es su�ci�nt grounds for
zdver�e ac�ea z�tinst zt licen<es held, iaclu�:ng revoca�e� �d <usQensioa ef s�id licences. � q �,/
larzr_ af Insc—��ce Comp�:�y: � ( � �1 �7
Policy \umb;r: Co�'er�e frem to
I hace ¢o em ioyees co� ered undec a'orkers' covn�nsa!ie� =.:=urance �_ '
A\Y F:ILSIFIC9TI0'i� OR A.\SS��RS GI�'E'i OR'�iATERL4L SL�B?�IITTED
�i'II,L RESL7.T L� DE\Z�L OF THIS .�PPLf CATI0:3
�
I hereby sta's tbat I hz��e ansu•ered dl of the prueding ques�o�s, and tbat the iafer�tion contained herein is uue and ce,�ect to toz Er_st
'' of my 3:novriedee and belief. I bereby state fiucfier that I bzl e re: eiced no mone}� oc other consideration, 6y w�ay of ]oan, �`t, conffibution,
or ol�erwise, o:hec tban already disclosed in the a�plicaaon n•3uch I berew�ith submined. I also understand this premise m: y be inspected
by police, rue, healt6 znd ocher ciq� o:;�cials at zny anri zll :�s n;en the b;;s:ne<s is ia ope,atioa.
���'c:1�
✓j�
---- Sitia:se (F
1�.-5-
fez �!I applications) Date
*"�ote: If this a�plication is Foo�l_iquor re14t,d. pieue co�.act a City of Szint Pa�,il Iiealtb Inspector, Steti�e Olson (266-4139), to re��iew
ptaas.
If any substantial chaoges to swcnu� are_anticip��, please contact a City of Saint Paul PIan Ezaminer at 2664��7 w apply for
building.permiu.
If tLere are any changes to tbe pa*king lot, floor spe: e., or for new operz5oas, please contact a Cit}°of Saint Paul Zoaing Inspe: tor
az 265-9��08.
AddiAonal application requiremenfs, please attach:
A detailed description of the design, Iocation and square footage of the premises fo be licensed (rite p2an).
77�e follotiring data should be on the site pIan (preferahly on an S 1!2" x Il" or 81/2" z 14" paper):
- I�'ame, address, and phone number.
- Tbe scaie should be stafed snch as 1" = 20'. ^\ s6ould be indicated foward the top.
• Piacement of all pertinent features of the interior of the lice[��ed facility such u seating areu, �itchens, offices, repair
area, parh�ng, rest moms, etc
- Sf a request is for an addifion or ezpansion of the licensed facilitp, indicate both the current area and the proposed
ezpansion.
A cop}• of your )ease agreement or proof of o�snership of the property.
FOR SPECIFIC APPLICATION REQLZREhiENTS, PLEASE SEE REVERSE >>>>
Tfappl}ingfor, ��� ����] �-� . _ K.
Czbzret adu2G ple�e actac� uzitten proof that ezca enplo} ee is at ]eut 13 years o3d
ConrersztienlRap par)or 2du]t plez�e anacb M_�cen prcwf thzt each e�lo; ee is at lez�t 18 }�e�s old.
Entertzinment, ple�e sps-i:`y cl�sc A, B, oi C L:e�se; ebtain �*�d zr.ach sirna,wes of approvzl from 409c cf �eer nei�6bers
ei'�fn 350 :ezt of the est�bl;<_hz:�nt. This licec>z zett be �pplied fer ia conjunction w'ith a Liquor, \�'ine,'�3�[ Oa Sae er
RentaUD�ce Ha11 license.
Firezrms, plezse attach a ler�er u ith the followi_� informa[ion: st�te if seIIine oc only repairinQ, Federzl Fue��:u Liczn<e
?�um'`zr, n t+z ef Arur..d Sen ices dischzrge (Hone �S':e, GeneraI, Bad Cenduct, tndesirable, Dishoaorable, ar oo �ic�r}' sen'ice.
(�OTE: Establish�nt must be cemmerciaily ze�cd} -_
Game room, ptezu pro�•ide. �ue follou�ing infor�oa: nz� of �c.`,�ine znd list pace. (:�'OTE: A Peol Hall l;'cent i< requued
if chere z:e �,ypool tzbles in the establishmenC)
Healtb/Sgorfs clab adult, pleue attach written g.�f tUat euh e�1o;:z is at ]east 18 yeazs old.
Liquor ofL�on sa1e refer to zr.a:hed liquor appLcs�on. -"'
LocG opening ser�ices. ple<<e aCach a list of all c�plo}'ees (v. ich ho� 2ddress 2ad Yelep�one nuiaber} u�ho �'ill `��e doin� tbe
locb oYZnia= sen�ice; attach S l0 Surety Bon3 .
'�fassege centeq piease atcac� a detailed descripdea of ebe sen�ices beias pro��id:d.
�f�szge center adult. pleze zttacb u�rirten preef ::at each emnloyee is at ]e2st IS years eld.
'�Szs�ne prac6tioner, ple2�e zra:h a copy of Ier�; for appro��al fromHe�leh; pra�f of insur2nce co��erase of 51,O1a.0�A� za_h
�ener� lizb:lip� and professienal liability x•ith the City of Saint Paul n-we,d as zn additinnzl inscred, as�d a?0 d�;' notice of
czncellauaa; a letter from.; �.0 empioyer to veri,`y' e�lo}�nt w•ich a license msszoe center.
'�iotorcccle dealer, plez�e in.lude State of ?.4innew:z IY_aler :�um�r.
'�e� motor cehicIe dealer, please inct�de Stace of �linnesota IY_ater:iumSer.
Par�iag IoUramp, please include tbe number of ga.-'sing spaces, and ztta,:L p12ns coataining a geaeral description of t',�e security
prorided at rhe lot/ramp, a_site pian sbowing 'a-:t'ew�ays of the propose3 lo[ and the legal description of tbe pro�erty (this
requirement necessary only if no site pIan is cunendy on file). Attach a cover letter dexribing your plzns to co�?;y w'ith the
li�ting and pzinting require�nu.
Pa� please attach 55,000.00 Surety Boa�
Semnd hand dealer-motor Fehicle, ptease include State of ?�Rinnesota Dezler �omber.
Second hxnd dealer-moWr rehicle parts, pleue 4: a:� SS,OO�.00I SvreEy Bon3
Steam roomlbath hoase adult, piease attach �ziaen proof t2�at each emp]oyee is az lezst 18 yeazs o13
Theatet adult, please attach wzineo proof thac ezch employee is ai lezst 18 yeazs old.
If appl}ing for, �� � �o��� ' . . -. ' • . - . "
Cabaret adu3t, p]edce anach s proof tbat ea:3 emplo; ee is at leza 13 pears old � L �
Com ersa.ionJRap parlor zdult plez�e artach w'^�en proof thzt e:+ch em; lo;ee is zt ]ez�t 18 yeus old.
Entertzinment, pleae sp°�i,`y d2ss A, B, or C li:cnce; obtain 2nd zrach si`natures of appro�•�l from 909c of }°ear nei�.`,�
�it�'sa 350 f�t of the esta�lis�nt Ttus lice�e must be �pplie3 fec ia coajuncuon u•ith a Liquor, \Vine, ?,i�t On S�
Rental.�D�ce Hall license.
Firezrms, pleue attach a lztter v.�ith ttie followi*_e infonnation: stau ifi �ellin� or on]y repzirina, Federal Fi:e�� Liczn�e
Iium�zr, nr+z of Am�ed Sen'ices dischzrge (Hone-<�le, Gener�l, Bad Ce�duct, tndesirable, Disbonorable, or no mi?it�' se��ice.
(\OTE: Est�blishv�nt must be cemmerciaily zened) . -,
Game room, pleue provide the follou•ing infor�en: nzme of m3chine x�d list price. (:�OTE: A Peel Hall licens, is reqv'ued
if the;e �;e 2,ypool tables in tbe establishment)
Healeh/Sportr ctub adult, plezse attach w�ritten p.� �f tha[ eazh emllo;;x is st Jeut ] 8 yeazs old
Liquor ofUon sa1e. refer to �rached liquor applicz�on. '" `
L.ock apening ser�ices. ple�e attach a list of all e:.:�lopees (w'ith 6onz ad3ress and telep'�one nu;a'xr) u•ho W�iil bz doing the
lo:k erzr�ia_ sen'ice; attach SI0,0�0 SuretyBon3
\iassa;e center, pleaze sttach a detailed descrip�an of the ser��ices beiae pio`•ided.
\1a<sage center adult. plez e attach written pro.f - �at eac6 employee is at lezst 18 yeazs o7d.
'�Sas oe practitioner. plrz�e z^a:L a copy of ]ee:: for zpprot•al frem Iie�ih; proof of insurance co��erege of SI,O��A��A� ea=6
�ene: �]izSlip� and professioaal liabiliry x•ith u e Ciry of Saint Pzul caned az zn ad3itienzl insered, and a.0 da;' noti: e of
cancellztioa: a)ener from yo:u employer to veri5' e�lo;ment N�ith a license msszae center.
�fotorcrcle dealer, plez�e in.lude State of b'tinnesoa Dealer:�amSer.
'�eK motor sehicle deater, plrzse include State of �,innesota IYalet \umber.
�
Parlang IoVratnp, please in:lude the number of pa-k.ing spaces, and atta:b pians containing a general d�scription of :�e secuzity
pro�•ided at the lotlramp, a site plan showing d:;�ew•a}�s of tbe proposed lot znd the legal desc[igrion of the pro�rty (this
ree,uire�nt necessary only if ao site plan is curtea8y on file). Atta:L a cover ]etter dexribing your plans to co�Iy ��ith the
lightine a�d pzinting requuemenu. .
Pa�cnbroker, please attacb �5,00�.00 Surety Bon�
Second hand deaJer-motor cehide, please inclucL State of ?�Tinnesota Dezler \Umber.
Second }cand dealer-motor Fehide parts, pleZe auacb SS,OOa.Q� S+uety Bon3
Steam room/bath house adult, pleau attach x�ri:un pzoof that eacb employee is at least 18 yeazs o]d
Theater adu3t, piease attach uzinen proof tbat eub employee is at lezct 18 years old.
�
Council File � �2- 3d'�}
Presented
Referred
�1������°��`
� 9 . 4� S. u: . S.-,
RESOLUTION
i
z
3
RESOLVED: That application (ID #12288) for an Auto Repair Garage License by M& M Auto
Repair DBA M& M Auto Repair (Anthony Mendez, Partner) at 1200 7ackson Street be
and the same is hereby approved.
4
5 Requested by Department of:
6 Yea Nays Abaent
7 BS k� �
9 — �6eeri� Meet�.. _� Office of License Ins�ections and
10 Me a� ✓ Environmental Protection
11 Re tma� ✓
12 Thune
14 Bostrom �� �//
15 gp _ �.�_ �'"'.�t,�- f J:_"5N'✓
16 Adopted by Council: Date �
17
18 Adoption Certified by Council Secretary Form Approved by City Attorney
19
2o BY �' `�'—� � By: `�/ Zv�,u�- � �cc�%_
22
23 Approved by Mayor: Date � J� /`� �
24
25 �� � � Approved by Mayor for Submission to
26 By. C._- Council
27
Bye
Ordinance #
Green Sheet # �� ��
DEPARTMENT/OFFICE
LIEPjLice
CONTACT PEiISON S f
Chzistine
266-9108
T07AL # OF 51GNATURE PAGES
a� -�a�y
GREEN SHEET N_ 35389
INITIAVDATE INIT7AVDATE —
DEPARTMENT DIREGTOR � CITY CAUNCIL
arrnnaaNer Q crrrc�a�c
BUOCET DIflECTOR � PIN. & MGT. SERVICES OIq.
MAYOR (OR ASSISTANn �
(CLIP AlL IOCATIONS FOR SIGNATURE)
M& M Auto Repair DBA M& M Auto Repair is requesting Council approval of its application
for an Auto Repair Garage License located at 1200 Jackson Street (ID 1�12288)
_ PLANNING CAhUAlSS1�N _ C
_ CIB COMMITTEE _ _
_ STAFF _ _
_ DISTRICT COURT _ _
SUPPORTS WHICH COUNCIL OBJEC'fIVE?
PERSONAL SERYICE CONTHACTS MUST ANSWEH TXE FOLLOWING pUESTiONS:
1. Has Nis person/Firm ever worked under a conVact for this department? �
VES NO
2. Has this perso�rm ever been a ciry employee?
YES NO
3. Does this personflirm possess a skill not normally possessad by any current city employee?
YES NO
Explain all yas answers on separate sheet antl attach to gresn sheet
INITIATING PROBLEM, 75Sf1E, OPPORTUNIT! (WFw, Whal. WhM,1Nhe�e, Why):
����������
DcC 23 19�6
p i�
� i r h . a.:
Councii Research Genter
�A�-�� � � �ss7
TOiAL AMOUNT OF TRANSACTION
COST/REVENUE BUDGETED (CIRCLE ONE)
YES NO
FUNDIRG SOURCE ACTIVITV NUMBER
FINANCIAL INFOiiMAT10N: (EXPLAIN) '
Greensheet # 35389 L.I.E.P. REVIEW CHECKLIST Date: 12/9/96 /�� •�d'y
In Tracker? npp'n Received / npp'n arocessed
License lD # 1228$ LiCense Type: an Auto Repair GaraQe
CompBny Name: M& M Auto Repair DBA: same
Business Addresss: 1200 3ackson Street Business Phone: 489-0807
Contact Name/Address: Anthonv Mendez, 1521 6th St. 106 Ffome Pfione: 778-2418
Date to Council Research: /,�
Public Hearing Date: � � � � � � � �i � Labels Ordered: �tf'/
Notice Sent to Applicant: District Council #:
e�� , �a r,b
Notice Sent to Public: Ward #: O�
Department/ Date inspections Commerrts
City Attorney
I•��`��- a�t'. •
Environmental
Health
t�.A�
Fire
� - �' °t�'' C� K` '
License Site Pien aeceived:_
Lease Received:
��a7 �?7 �3 /�
Police
�•�• g�` ��K
Zoning
a I2f�`�7 � � �
�
CLASS III
LIC�NSE APPLICATIO�
CITY OF SAL\'T P.�UZ
05ia of Limr.se, L^c�tio,s
aid Em�iro:n P;o;ec:ion
5: R?er 5i Svie 3J]
iirhd.l:ic � t��m
(El?) }2�9°J fss (613) L',5-Sl:/
��_ 3�y
THIS APPLICATIOV IS SliBTECTTO REVIE�'✓ BY TI� PLbLIC
PLEASE t`YPE OR PRLZT L'� L�K
T��e of License{<) +��� a��lied for:
Co:.,�any::��: � �'+- r I G�rc�.-'fb
Ce;�,ation(Pz�� hiplSole
� 2
212
�
If business is ince;�erzted. gi��e date ef in:o;poration:
Deino Busioecs As: P,v�o+'1 er�i J� �Cp/-�� �- Business Phone: �12
Hesiaess Address. I Z�� .�('���oN 5`[ ST �!a u. t� � I� L 'J S 7 i'�
Scct.4ddrus � Ciry �-� Sute Zip
Be� een �;tat aess streeu is tUe busioess la ated? f�� `"-�+�c1<So� t�� R'bich side of Lhe street? ST
:3re the premises now occupied? �� �t'bat T�pe of Business? Cl�+2Y���� A iA'�o 5[CLE�,
�1�i ro .�adrz�s: 1 Zc� �„��C�'.x�c.i S i- �-r, �i�, u r..- �'1r�( .r � i I'7
Sv�t Address ��� Cicy � . S:z[e Zip
.4nplicaatInform2tion: Q.�:.1TIav� l,�pS£�.(a 1�ktitD��° r�il�r�lEf - " , ..
\arne andTitle: 1-�Ai �i.kl.arV 9 l.4 �i'�r� '- 'QA�¢� - ,
n.�se �.Siddle � (�.* �3e � L2tt Ti;7t
,+"'�ENDE�' �S'�.1 �� S'r�AUL� I"�� �5�EC0 .
He�eAddress:r-�,a��.t= 50� G�nn.rtyza� �� �� i �So�#Z
., ' t��r.��EZC�t,Ad�es� C'1Etanszs S� .'�i3;�U,1'1n.� c'lE� IDE i
q 'z^°:'-�$
DzteofBinh:c-�.�..v�= � •�-eo� PlaceofBinh:�7AwaJ-5�i�-�t.t�l�itiC�1A�"S HomePhane:nnw,.i-tl3te
Ha�•e you e�er been con��icled of zny fe3ony, cria� oc GtioIstion of any city ordinance othec than taffic?
D�;e of a�est:��4T��t �
Ch;rse �
� Conti''sction:
Sentencz:
YL.S x i�Q
Lisi che names aod residences of three persons of good noral chazacter, Iit•ing a•ithin the Twin Cides Meao Area, not related to tbe
applicaot or fmancially interested in the premises ot business, u ho may be referred to az to tbe applicanCs chuacter.
�AME
ADDRESS
PHO\B
221-\ q!
� Li t—��Pa�l2✓.2.� z 7� I � lGk1.-� I ra f�-T �Df � M(�} -�� J tJ 1 �n0[�
�,_� �, S,-,�1 2 9'71 r'1 c I'� ,�,-1�-c •'JZ� r �-v�m�s-,� nr�l 55 i oL? �'7 �7 ?3 0l
List licenses ��hich you c_un hold for�rly be3d, o� may bave zn interest in:
(�YQ1�.1Cr .
Have any of the above named licenses ever been revoked? _ YES � ti'O If }'es, list zhe dates aod reasor� fo. revocation:
Are you going to operate ihis business personally? � YFS ____ A`O If not, u•bo will operate it?
�
Firn :�amc
Middle
(.Maidrn) Lasl
Hor,x Addrrss: So-ea �zme " � . Ciry State ,
Daic ot B'uth
Phone:�umSez
Are ��ou _oin� to hzcz a manager or Z«ist<,i{ in Lhi� besinecs? _�k�ES ^� �O If the nana�er is not Lhe <� �y the opzr�:ar, ple� --
co�lete che followina i,.formatio�:
F; ct \�r.ie
�c:'�Add S.
G�
Stzte Zp
Pleze list }�our e�le; �nt histe;y fet the precious fi�'e (�) ;eaz �rio3:
Be�iness/Er;v�)c�,—,knt Address
n4�.o�-.i= .
�.-�,- t � ���t�� �� 9 . la � „ �. — .�.0 _ - to
�� rzic.� rtiN�1E�� �'�a� �`70 y 1-� � rrr�.5i 4�.AU�l�
_:_,si�rzs /��-tran6�; �t u�i�erzs��/+�;�E sTP��- 19'�S-9'-� —
r�t���.1,7�'�,.�-�'--,' "�4��
Lict ali othet eifice,s
OFFICER
\A.\SE
t�l o �� �
'.;fc:_e L�tixl t'`itiden) I,�tt
tt�e co[poratien:
TITLE - - HO'�iE
(Office Hetd) ADDRESS
�. 1-4yn-���rtl- S i-
� r .a:.u� �-1-
HO'��
PHO�
U� t `J �I5 - `I
g�;c��S
P�IO\
DATE OF
BIRTH
If r b ` esiness is a p��ership, ple��e incl�de the fotfow'ine iyo�tion foreach pa-tner (�ce additional pa__es if nuess��'):
l�tvT�o,�� _- �a �Et�(l..�Z- �-�-Lo(o
�cce �ase ?�fid3le L (^..:uden) Lzs[ �ate of Bc,�xh
1�Z1 C��`` �-ra.� � S� I��.x� i` 11� ��loco �78Z-�1�
?ie::KAddress: S^^.'�:z-�e . . Ci.y ctyce Zap .n�nt?.uc:uer
: RS[!�i..TIC
Ho:net,ddress: Scea'�zme
Mld�q'SJ�PI
Dz:e ef birh
PhOie \umY.s
(;.tz;den)
cty
A� �-�-��
� , �� o: a;.-�t
� r.� 5�d�`2. �3c��c
- $S1C T.IjI .bSO:K?�112:15PS
h�''�FSOTA'I.AX IDE.'�'Tff�ICA'IIOti \`[i:.�IDII2 - Rusua�t to the Lzws of A�finnesota, 1984, Chaptec 502, Article 8, Secdon 2(270.72)
(I'ax C7earance; Issuaae of Licenses), licensing autborives z*e required to pro�•ide to the State of ?�3innesota Commissioner of Revenue,
. tUe !vli�esota business taz identific2tion number and tUe so:ial security numSer of each license appGcaat
tncL^r the :Jf'innesota Govemment Daza Pracdces Act and th� Federai Pri��acy.4ct of 1974, we are required to adrice you of tbe foUou7ng
regazding t6e use of the VLinnesota Tu Idenufication I�'um3er:
- This informarion may be used w deny t6e issuance or reoew�al of your license in the eveni you ov.�e ?.4innesota sales, employei s
w•ithholding oc motor vehide ezcise tazes;
- Upon receieing this iaformatioa, rhe liceasing authority will supply it only to tbe?vIinnesota Depatsent of Revenue. Aowevet,
under the Federal Ezchange of InformaA oa Agreement, the Depaztment of Re�•enue may supply this information to the Intemal
Revenue Sen'ice.
Minnesota Taz Ideatification Numben (Sales & Use Tzz �umber) may be obtained from the State of ?v1'innesota, Busioess 12uorcLs
Department, 10 River Pazk Plaza (612-296-6181 .
��1.r.��Z= �t�-9�-zz33
SocialSecurity;�'umber. t'Ist�r�— ��6 g�°'T9��
Minnesota Taz IdenuficaGon r�umber. Z`1 2 - ��� 3
If a.'vlinnesota Taz Identificstio¢ :�umber is not requ'ued for the bvsiaess being opented, indicau so by plazing zn "X" in the
box.
Are ��ou goine to hz� e a mana�er or zssi<t�nt in i}iis business? _�'ES x XO lf the manager is not the s�me � 4ae opzr�r, ple�e .
complete the follok•ing informatioo:
,��'�.�
F;�t tiune �;idve IrJu€1 t�:�den) L�.a Dzu of Birh
'r'c�ndd�s Sc:�t�zr.K Ci�• SLte Zip P3ea:�uTY.s
Plezce list your e�lo}vxnt histeq� fer the prerious fi�'e (�) ;'ezr perio3: � �
B u sinecSlEm�lo�tnent
t
�-lL� 5���l1c_t ��t�1T�
CA, 2 .z�c+ct" ti�1�1ESr�s�a �
S�i�.2s � i J E� �,tn.� i
���!�G+Zc 'p4L� `J� �
Address
P�� i g
,�. y�<<�.-�,
List all other effice:s of the cotporatiea:
OFFICER TITLE - _
\A14E (Office Held)
►.lo��'
HO>g BliSI\`ESS D4TE OF
PHO�'E P�IO� BIR7H
HO'��
ADDRESS
If besness is a Fa�er6ip, pleue inc)ade tbe follow•ing i, °o:mzGon for ea:b pa-mer (use additional page� if nuessa�•):
�- � �v � rao�.iy' �l, t �f.rC�Z 1 �1- Co cn
: rst `�a;x �9Sid:lle L`.iti�l ('�:tiden) Lut Datt of BL�A�
��� �.�-µ. �,-��� S �. ►"�.�..�� MtJ s�>«o 'i�ig2�f
?ie:z address: S�.'ti€.-ie
fL'S[ �2RIC
ITJ::2I
Ci,y
('�Sziden)
96
YA..lL-
Zip Pk,e:x
M
Dzte
Ho:mAddras: Scea!:xme - Ciry —�-- Stxtt Zip Pboac hvmSer
A�":CESOTA T.AX IDE.`�'T4SCATiO\ :�L'!dIDER - Pursu�t to the Izws of ?.'Gnnesota, 1984. Cliapter 502, Anicle 8, Secuon 2(270.72)
(Ia Clearance; Issuan:.e of Licenses), licensiflg autborities ue requ'ued to pro�•ide to t6e State of ?vlinnaota Commissionex of Revenue,
tbe ?vlinnesota business taz idenrification number and the so:ial suuriry number of each license applicaat
Under tbe ?v&nnecota Govetnmeat Data Practices Act and tlr. Federal Privacy Act of 1974, we aze required to advise you of u} e follo�nng
regazding tbe use of the ;.Tnnesou 7zz Idenrificavon A'umber:
- T6is infoimarion may be used to deny tbe issuance or renev.•al of ;•our license in tbe event you oa�e DSinnesota sales, employer s
w•ithboldingormotorvehicleezcise -w,es;
-13pon reuicing this infoimation, tl�e Bcensing authority will supply it onty to the Minnesota Depaz�nt of Revenue. How�ever,
uMiec tbe Federal Exchange of Informa6on Agexment, t6e Depait�nt of Revenue may supply chis information to the Intemal
Reeenue Sen•ice. �
Minnesota Taz Identification A'umbers (Sales & Use Tzz \'umber) may be obtained from the Stau of ATinnesota, Business Records
Department, ]0 River Park Pla7a (612-296-5181 .
r-ti�r�,��z: �7 t - 9�- zz3�
SociaiSecuriryNumber. r_J'tt�--n�= 9`1S-gC�'"Zg2� _
Minnesota Taz Idenrification T'umber. ��1 2- � 3 ��
_ If a Mianesota Tax Identification T'umbet is not required fot the business being operated, indicate so by pluing zn "X" in�
fP_S7
C>E$TIFICA'IIO\ OF �'�'ORK£RS' C0�3PF.tiSATION CQ\�RAGE PtRSi:A.�Z TO A4L\hcSOTA ST�TI�T£ 176.1e2
I hereby ceru`y ivat I, oi my companv, atn in cempliance w;;S tbe v.•orkers cer., in<_urance co�•es�ge requi�es�n's of :�4in�esota
Stamte 176.182, culxli.ision 2. I�:so understind t6at pro�isioa of ;21ce inforr.r:een in this cectification constitu�es su�ci�nt grounds for
zdver�e ac�ea z�tinst zt licen<es held, iaclu�:ng revoca�e� �d <usQensioa ef s�id licences. � q �,/
larzr_ af Insc—��ce Comp�:�y: � ( � �1 �7
Policy \umb;r: Co�'er�e frem to
I hace ¢o em ioyees co� ered undec a'orkers' covn�nsa!ie� =.:=urance �_ '
A\Y F:ILSIFIC9TI0'i� OR A.\SS��RS GI�'E'i OR'�iATERL4L SL�B?�IITTED
�i'II,L RESL7.T L� DE\Z�L OF THIS .�PPLf CATI0:3
�
I hereby sta's tbat I hz��e ansu•ered dl of the prueding ques�o�s, and tbat the iafer�tion contained herein is uue and ce,�ect to toz Er_st
'' of my 3:novriedee and belief. I bereby state fiucfier that I bzl e re: eiced no mone}� oc other consideration, 6y w�ay of ]oan, �`t, conffibution,
or ol�erwise, o:hec tban already disclosed in the a�plicaaon n•3uch I berew�ith submined. I also understand this premise m: y be inspected
by police, rue, healt6 znd ocher ciq� o:;�cials at zny anri zll :�s n;en the b;;s:ne<s is ia ope,atioa.
���'c:1�
✓j�
---- Sitia:se (F
1�.-5-
fez �!I applications) Date
*"�ote: If this a�plication is Foo�l_iquor re14t,d. pieue co�.act a City of Szint Pa�,il Iiealtb Inspector, Steti�e Olson (266-4139), to re��iew
ptaas.
If any substantial chaoges to swcnu� are_anticip��, please contact a City of Saint Paul PIan Ezaminer at 2664��7 w apply for
building.permiu.
If tLere are any changes to tbe pa*king lot, floor spe: e., or for new operz5oas, please contact a Cit}°of Saint Paul Zoaing Inspe: tor
az 265-9��08.
AddiAonal application requiremenfs, please attach:
A detailed description of the design, Iocation and square footage of the premises fo be licensed (rite p2an).
77�e follotiring data should be on the site pIan (preferahly on an S 1!2" x Il" or 81/2" z 14" paper):
- I�'ame, address, and phone number.
- Tbe scaie should be stafed snch as 1" = 20'. ^\ s6ould be indicated foward the top.
• Piacement of all pertinent features of the interior of the lice[��ed facility such u seating areu, �itchens, offices, repair
area, parh�ng, rest moms, etc
- Sf a request is for an addifion or ezpansion of the licensed facilitp, indicate both the current area and the proposed
ezpansion.
A cop}• of your )ease agreement or proof of o�snership of the property.
FOR SPECIFIC APPLICATION REQLZREhiENTS, PLEASE SEE REVERSE >>>>
Tfappl}ingfor, ��� ����] �-� . _ K.
Czbzret adu2G ple�e actac� uzitten proof that ezca enplo} ee is at ]eut 13 years o3d
ConrersztienlRap par)or 2du]t plez�e anacb M_�cen prcwf thzt each e�lo; ee is at lez�t 18 }�e�s old.
Entertzinment, ple�e sps-i:`y cl�sc A, B, oi C L:e�se; ebtain �*�d zr.ach sirna,wes of approvzl from 409c cf �eer nei�6bers
ei'�fn 350 :ezt of the est�bl;<_hz:�nt. This licec>z zett be �pplied fer ia conjunction w'ith a Liquor, \�'ine,'�3�[ Oa Sae er
RentaUD�ce Ha11 license.
Firezrms, plezse attach a ler�er u ith the followi_� informa[ion: st�te if seIIine oc only repairinQ, Federzl Fue��:u Liczn<e
?�um'`zr, n t+z ef Arur..d Sen ices dischzrge (Hone �S':e, GeneraI, Bad Cenduct, tndesirable, Dishoaorable, ar oo �ic�r}' sen'ice.
(�OTE: Establish�nt must be cemmerciaily ze�cd} -_
Game room, ptezu pro�•ide. �ue follou�ing infor�oa: nz� of �c.`,�ine znd list pace. (:�'OTE: A Peol Hall l;'cent i< requued
if chere z:e �,ypool tzbles in the establishmenC)
Healtb/Sgorfs clab adult, pleue attach written g.�f tUat euh e�1o;:z is at ]east 18 yeazs old.
Liquor ofL�on sa1e refer to zr.a:hed liquor appLcs�on. -"'
LocG opening ser�ices. ple<<e aCach a list of all c�plo}'ees (v. ich ho� 2ddress 2ad Yelep�one nuiaber} u�ho �'ill `��e doin� tbe
locb oYZnia= sen�ice; attach S l0 Surety Bon3 .
'�fassege centeq piease atcac� a detailed descripdea of ebe sen�ices beias pro��id:d.
�f�szge center adult. pleze zttacb u�rirten preef ::at each emnloyee is at ]e2st IS years eld.
'�Szs�ne prac6tioner, ple2�e zra:h a copy of Ier�; for appro��al fromHe�leh; pra�f of insur2nce co��erase of 51,O1a.0�A� za_h
�ener� lizb:lip� and professienal liability x•ith the City of Saint Paul n-we,d as zn additinnzl inscred, as�d a?0 d�;' notice of
czncellauaa; a letter from.; �.0 empioyer to veri,`y' e�lo}�nt w•ich a license msszoe center.
'�iotorcccle dealer, plez�e in.lude State of ?.4innew:z IY_aler :�um�r.
'�e� motor cehicIe dealer, please inct�de Stace of �linnesota IY_ater:iumSer.
Par�iag IoUramp, please include tbe number of ga.-'sing spaces, and ztta,:L p12ns coataining a geaeral description of t',�e security
prorided at rhe lot/ramp, a_site pian sbowing 'a-:t'ew�ays of the propose3 lo[ and the legal description of tbe pro�erty (this
requirement necessary only if no site pIan is cunendy on file). Attach a cover letter dexribing your plzns to co�?;y w'ith the
li�ting and pzinting require�nu.
Pa� please attach 55,000.00 Surety Boa�
Semnd hand dealer-motor Fehicle, ptease include State of ?�Rinnesota Dezler �omber.
Second hxnd dealer-moWr rehicle parts, pleue 4: a:� SS,OO�.00I SvreEy Bon3
Steam roomlbath hoase adult, piease attach �ziaen proof t2�at each emp]oyee is az lezst 18 yeazs o13
Theatet adult, please attach wzineo proof thac ezch employee is ai lezst 18 yeazs old.
If appl}ing for, �� � �o��� ' . . -. ' • . - . "
Cabaret adu3t, p]edce anach s proof tbat ea:3 emplo; ee is at leza 13 pears old � L �
Com ersa.ionJRap parlor zdult plez�e artach w'^�en proof thzt e:+ch em; lo;ee is zt ]ez�t 18 yeus old.
Entertzinment, pleae sp°�i,`y d2ss A, B, or C li:cnce; obtain 2nd zrach si`natures of appro�•�l from 909c of }°ear nei�.`,�
�it�'sa 350 f�t of the esta�lis�nt Ttus lice�e must be �pplie3 fec ia coajuncuon u•ith a Liquor, \Vine, ?,i�t On S�
Rental.�D�ce Hall license.
Firezrms, pleue attach a lztter v.�ith ttie followi*_e infonnation: stau ifi �ellin� or on]y repzirina, Federal Fi:e�� Liczn�e
Iium�zr, nr+z of Am�ed Sen'ices dischzrge (Hone-<�le, Gener�l, Bad Ce�duct, tndesirable, Disbonorable, or no mi?it�' se��ice.
(\OTE: Est�blishv�nt must be cemmerciaily zened) . -,
Game room, pleue provide the follou•ing infor�en: nzme of m3chine x�d list price. (:�OTE: A Peel Hall licens, is reqv'ued
if the;e �;e 2,ypool tables in tbe establishment)
Healeh/Sportr ctub adult, plezse attach w�ritten p.� �f tha[ eazh emllo;;x is st Jeut ] 8 yeazs old
Liquor ofUon sa1e. refer to �rached liquor applicz�on. '" `
L.ock apening ser�ices. ple�e attach a list of all e:.:�lopees (w'ith 6onz ad3ress and telep'�one nu;a'xr) u•ho W�iil bz doing the
lo:k erzr�ia_ sen'ice; attach SI0,0�0 SuretyBon3
\iassa;e center, pleaze sttach a detailed descrip�an of the ser��ices beiae pio`•ided.
\1a<sage center adult. plez e attach written pro.f - �at eac6 employee is at lezst 18 yeazs o7d.
'�Sas oe practitioner. plrz�e z^a:L a copy of ]ee:: for zpprot•al frem Iie�ih; proof of insurance co��erege of SI,O��A��A� ea=6
�ene: �]izSlip� and professioaal liabiliry x•ith u e Ciry of Saint Pzul caned az zn ad3itienzl insered, and a.0 da;' noti: e of
cancellztioa: a)ener from yo:u employer to veri5' e�lo;ment N�ith a license msszae center.
�fotorcrcle dealer, plez�e in.lude State of b'tinnesoa Dealer:�amSer.
'�eK motor sehicle deater, plrzse include State of �,innesota IYalet \umber.
�
Parlang IoVratnp, please in:lude the number of pa-k.ing spaces, and atta:b pians containing a general d�scription of :�e secuzity
pro�•ided at the lotlramp, a site plan showing d:;�ew•a}�s of tbe proposed lot znd the legal desc[igrion of the pro�rty (this
ree,uire�nt necessary only if ao site plan is curtea8y on file). Atta:L a cover ]etter dexribing your plans to co�Iy ��ith the
lightine a�d pzinting requuemenu. .
Pa�cnbroker, please attacb �5,00�.00 Surety Bon�
Second hand deaJer-motor cehide, please inclucL State of ?�Tinnesota Dezler \Umber.
Second }cand dealer-motor Fehide parts, pleZe auacb SS,OOa.Q� S+uety Bon3
Steam room/bath house adult, pleau attach x�ri:un pzoof that eacb employee is at least 18 yeazs o]d
Theater adu3t, piease attach uzinen proof tbat eub employee is at lezct 18 years old.
�
Council File � �2- 3d'�}
Presented
Referred
�1������°��`
� 9 . 4� S. u: . S.-,
RESOLUTION
i
z
3
RESOLVED: That application (ID #12288) for an Auto Repair Garage License by M& M Auto
Repair DBA M& M Auto Repair (Anthony Mendez, Partner) at 1200 7ackson Street be
and the same is hereby approved.
4
5 Requested by Department of:
6 Yea Nays Abaent
7 BS k� �
9 — �6eeri� Meet�.. _� Office of License Ins�ections and
10 Me a� ✓ Environmental Protection
11 Re tma� ✓
12 Thune
14 Bostrom �� �//
15 gp _ �.�_ �'"'.�t,�- f J:_"5N'✓
16 Adopted by Council: Date �
17
18 Adoption Certified by Council Secretary Form Approved by City Attorney
19
2o BY �' `�'—� � By: `�/ Zv�,u�- � �cc�%_
22
23 Approved by Mayor: Date � J� /`� �
24
25 �� � � Approved by Mayor for Submission to
26 By. C._- Council
27
Bye
Ordinance #
Green Sheet # �� ��
DEPARTMENT/OFFICE
LIEPjLice
CONTACT PEiISON S f
Chzistine
266-9108
T07AL # OF 51GNATURE PAGES
a� -�a�y
GREEN SHEET N_ 35389
INITIAVDATE INIT7AVDATE —
DEPARTMENT DIREGTOR � CITY CAUNCIL
arrnnaaNer Q crrrc�a�c
BUOCET DIflECTOR � PIN. & MGT. SERVICES OIq.
MAYOR (OR ASSISTANn �
(CLIP AlL IOCATIONS FOR SIGNATURE)
M& M Auto Repair DBA M& M Auto Repair is requesting Council approval of its application
for an Auto Repair Garage License located at 1200 Jackson Street (ID 1�12288)
_ PLANNING CAhUAlSS1�N _ C
_ CIB COMMITTEE _ _
_ STAFF _ _
_ DISTRICT COURT _ _
SUPPORTS WHICH COUNCIL OBJEC'fIVE?
PERSONAL SERYICE CONTHACTS MUST ANSWEH TXE FOLLOWING pUESTiONS:
1. Has Nis person/Firm ever worked under a conVact for this department? �
VES NO
2. Has this perso�rm ever been a ciry employee?
YES NO
3. Does this personflirm possess a skill not normally possessad by any current city employee?
YES NO
Explain all yas answers on separate sheet antl attach to gresn sheet
INITIATING PROBLEM, 75Sf1E, OPPORTUNIT! (WFw, Whal. WhM,1Nhe�e, Why):
����������
DcC 23 19�6
p i�
� i r h . a.:
Councii Research Genter
�A�-�� � � �ss7
TOiAL AMOUNT OF TRANSACTION
COST/REVENUE BUDGETED (CIRCLE ONE)
YES NO
FUNDIRG SOURCE ACTIVITV NUMBER
FINANCIAL INFOiiMAT10N: (EXPLAIN) '
Greensheet # 35389 L.I.E.P. REVIEW CHECKLIST Date: 12/9/96 /�� •�d'y
In Tracker? npp'n Received / npp'n arocessed
License lD # 1228$ LiCense Type: an Auto Repair GaraQe
CompBny Name: M& M Auto Repair DBA: same
Business Addresss: 1200 3ackson Street Business Phone: 489-0807
Contact Name/Address: Anthonv Mendez, 1521 6th St. 106 Ffome Pfione: 778-2418
Date to Council Research: /,�
Public Hearing Date: � � � � � � � �i � Labels Ordered: �tf'/
Notice Sent to Applicant: District Council #:
e�� , �a r,b
Notice Sent to Public: Ward #: O�
Department/ Date inspections Commerrts
City Attorney
I•��`��- a�t'. •
Environmental
Health
t�.A�
Fire
� - �' °t�'' C� K` '
License Site Pien aeceived:_
Lease Received:
��a7 �?7 �3 /�
Police
�•�• g�` ��K
Zoning
a I2f�`�7 � � �
�
CLASS III
LIC�NSE APPLICATIO�
CITY OF SAL\'T P.�UZ
05ia of Limr.se, L^c�tio,s
aid Em�iro:n P;o;ec:ion
5: R?er 5i Svie 3J]
iirhd.l:ic � t��m
(El?) }2�9°J fss (613) L',5-Sl:/
��_ 3�y
THIS APPLICATIOV IS SliBTECTTO REVIE�'✓ BY TI� PLbLIC
PLEASE t`YPE OR PRLZT L'� L�K
T��e of License{<) +��� a��lied for:
Co:.,�any::��: � �'+- r I G�rc�.-'fb
Ce;�,ation(Pz�� hiplSole
� 2
212
�
If business is ince;�erzted. gi��e date ef in:o;poration:
Deino Busioecs As: P,v�o+'1 er�i J� �Cp/-�� �- Business Phone: �12
Hesiaess Address. I Z�� .�('���oN 5`[ ST �!a u. t� � I� L 'J S 7 i'�
Scct.4ddrus � Ciry �-� Sute Zip
Be� een �;tat aess streeu is tUe busioess la ated? f�� `"-�+�c1<So� t�� R'bich side of Lhe street? ST
:3re the premises now occupied? �� �t'bat T�pe of Business? Cl�+2Y���� A iA'�o 5[CLE�,
�1�i ro .�adrz�s: 1 Zc� �„��C�'.x�c.i S i- �-r, �i�, u r..- �'1r�( .r � i I'7
Sv�t Address ��� Cicy � . S:z[e Zip
.4nplicaatInform2tion: Q.�:.1TIav� l,�pS£�.(a 1�ktitD��° r�il�r�lEf - " , ..
\arne andTitle: 1-�Ai �i.kl.arV 9 l.4 �i'�r� '- 'QA�¢� - ,
n.�se �.Siddle � (�.* �3e � L2tt Ti;7t
,+"'�ENDE�' �S'�.1 �� S'r�AUL� I"�� �5�EC0 .
He�eAddress:r-�,a��.t= 50� G�nn.rtyza� �� �� i �So�#Z
., ' t��r.��EZC�t,Ad�es� C'1Etanszs S� .'�i3;�U,1'1n.� c'lE� IDE i
q 'z^°:'-�$
DzteofBinh:c-�.�..v�= � •�-eo� PlaceofBinh:�7AwaJ-5�i�-�t.t�l�itiC�1A�"S HomePhane:nnw,.i-tl3te
Ha�•e you e�er been con��icled of zny fe3ony, cria� oc GtioIstion of any city ordinance othec than taffic?
D�;e of a�est:��4T��t �
Ch;rse �
� Conti''sction:
Sentencz:
YL.S x i�Q
Lisi che names aod residences of three persons of good noral chazacter, Iit•ing a•ithin the Twin Cides Meao Area, not related to tbe
applicaot or fmancially interested in the premises ot business, u ho may be referred to az to tbe applicanCs chuacter.
�AME
ADDRESS
PHO\B
221-\ q!
� Li t—��Pa�l2✓.2.� z 7� I � lGk1.-� I ra f�-T �Df � M(�} -�� J tJ 1 �n0[�
�,_� �, S,-,�1 2 9'71 r'1 c I'� ,�,-1�-c •'JZ� r �-v�m�s-,� nr�l 55 i oL? �'7 �7 ?3 0l
List licenses ��hich you c_un hold for�rly be3d, o� may bave zn interest in:
(�YQ1�.1Cr .
Have any of the above named licenses ever been revoked? _ YES � ti'O If }'es, list zhe dates aod reasor� fo. revocation:
Are you going to operate ihis business personally? � YFS ____ A`O If not, u•bo will operate it?
�
Firn :�amc
Middle
(.Maidrn) Lasl
Hor,x Addrrss: So-ea �zme " � . Ciry State ,
Daic ot B'uth
Phone:�umSez
Are ��ou _oin� to hzcz a manager or Z«ist<,i{ in Lhi� besinecs? _�k�ES ^� �O If the nana�er is not Lhe <� �y the opzr�:ar, ple� --
co�lete che followina i,.formatio�:
F; ct \�r.ie
�c:'�Add S.
G�
Stzte Zp
Pleze list }�our e�le; �nt histe;y fet the precious fi�'e (�) ;eaz �rio3:
Be�iness/Er;v�)c�,—,knt Address
n4�.o�-.i= .
�.-�,- t � ���t�� �� 9 . la � „ �. — .�.0 _ - to
�� rzic.� rtiN�1E�� �'�a� �`70 y 1-� � rrr�.5i 4�.AU�l�
_:_,si�rzs /��-tran6�; �t u�i�erzs��/+�;�E sTP��- 19'�S-9'-� —
r�t���.1,7�'�,.�-�'--,' "�4��
Lict ali othet eifice,s
OFFICER
\A.\SE
t�l o �� �
'.;fc:_e L�tixl t'`itiden) I,�tt
tt�e co[poratien:
TITLE - - HO'�iE
(Office Hetd) ADDRESS
�. 1-4yn-���rtl- S i-
� r .a:.u� �-1-
HO'��
PHO�
U� t `J �I5 - `I
g�;c��S
P�IO\
DATE OF
BIRTH
If r b ` esiness is a p��ership, ple��e incl�de the fotfow'ine iyo�tion foreach pa-tner (�ce additional pa__es if nuess��'):
l�tvT�o,�� _- �a �Et�(l..�Z- �-�-Lo(o
�cce �ase ?�fid3le L (^..:uden) Lzs[ �ate of Bc,�xh
1�Z1 C��`` �-ra.� � S� I��.x� i` 11� ��loco �78Z-�1�
?ie::KAddress: S^^.'�:z-�e . . Ci.y ctyce Zap .n�nt?.uc:uer
: RS[!�i..TIC
Ho:net,ddress: Scea'�zme
Mld�q'SJ�PI
Dz:e ef birh
PhOie \umY.s
(;.tz;den)
cty
A� �-�-��
� , �� o: a;.-�t
� r.� 5�d�`2. �3c��c
- $S1C T.IjI .bSO:K?�112:15PS
h�''�FSOTA'I.AX IDE.'�'Tff�ICA'IIOti \`[i:.�IDII2 - Rusua�t to the Lzws of A�finnesota, 1984, Chaptec 502, Article 8, Secdon 2(270.72)
(I'ax C7earance; Issuaae of Licenses), licensing autborives z*e required to pro�•ide to the State of ?�3innesota Commissioner of Revenue,
. tUe !vli�esota business taz identific2tion number and tUe so:ial security numSer of each license appGcaat
tncL^r the :Jf'innesota Govemment Daza Pracdces Act and th� Federai Pri��acy.4ct of 1974, we are required to adrice you of tbe foUou7ng
regazding t6e use of the VLinnesota Tu Idenufication I�'um3er:
- This informarion may be used w deny t6e issuance or reoew�al of your license in the eveni you ov.�e ?.4innesota sales, employei s
w•ithholding oc motor vehide ezcise tazes;
- Upon receieing this iaformatioa, rhe liceasing authority will supply it only to tbe?vIinnesota Depatsent of Revenue. Aowevet,
under the Federal Ezchange of InformaA oa Agreement, the Depaztment of Re�•enue may supply this information to the Intemal
Revenue Sen'ice.
Minnesota Taz Ideatification Numben (Sales & Use Tzz �umber) may be obtained from the State of ?v1'innesota, Busioess 12uorcLs
Department, 10 River Pazk Plaza (612-296-6181 .
��1.r.��Z= �t�-9�-zz33
SocialSecurity;�'umber. t'Ist�r�— ��6 g�°'T9��
Minnesota Taz IdenuficaGon r�umber. Z`1 2 - ��� 3
If a.'vlinnesota Taz Identificstio¢ :�umber is not requ'ued for the bvsiaess being opented, indicau so by plazing zn "X" in the
box.
Are ��ou goine to hz� e a mana�er or zssi<t�nt in i}iis business? _�'ES x XO lf the manager is not the s�me � 4ae opzr�r, ple�e .
complete the follok•ing informatioo:
,��'�.�
F;�t tiune �;idve IrJu€1 t�:�den) L�.a Dzu of Birh
'r'c�ndd�s Sc:�t�zr.K Ci�• SLte Zip P3ea:�uTY.s
Plezce list your e�lo}vxnt histeq� fer the prerious fi�'e (�) ;'ezr perio3: � �
B u sinecSlEm�lo�tnent
t
�-lL� 5���l1c_t ��t�1T�
CA, 2 .z�c+ct" ti�1�1ESr�s�a �
S�i�.2s � i J E� �,tn.� i
���!�G+Zc 'p4L� `J� �
Address
P�� i g
,�. y�<<�.-�,
List all other effice:s of the cotporatiea:
OFFICER TITLE - _
\A14E (Office Held)
►.lo��'
HO>g BliSI\`ESS D4TE OF
PHO�'E P�IO� BIR7H
HO'��
ADDRESS
If besness is a Fa�er6ip, pleue inc)ade tbe follow•ing i, °o:mzGon for ea:b pa-mer (use additional page� if nuessa�•):
�- � �v � rao�.iy' �l, t �f.rC�Z 1 �1- Co cn
: rst `�a;x �9Sid:lle L`.iti�l ('�:tiden) Lut Datt of BL�A�
��� �.�-µ. �,-��� S �. ►"�.�..�� MtJ s�>«o 'i�ig2�f
?ie:z address: S�.'ti€.-ie
fL'S[ �2RIC
ITJ::2I
Ci,y
('�Sziden)
96
YA..lL-
Zip Pk,e:x
M
Dzte
Ho:mAddras: Scea!:xme - Ciry —�-- Stxtt Zip Pboac hvmSer
A�":CESOTA T.AX IDE.`�'T4SCATiO\ :�L'!dIDER - Pursu�t to the Izws of ?.'Gnnesota, 1984. Cliapter 502, Anicle 8, Secuon 2(270.72)
(Ia Clearance; Issuan:.e of Licenses), licensiflg autborities ue requ'ued to pro�•ide to t6e State of ?vlinnaota Commissionex of Revenue,
tbe ?vlinnesota business taz idenrification number and the so:ial suuriry number of each license applicaat
Under tbe ?v&nnecota Govetnmeat Data Practices Act and tlr. Federal Privacy Act of 1974, we aze required to advise you of u} e follo�nng
regazding tbe use of the ;.Tnnesou 7zz Idenrificavon A'umber:
- T6is infoimarion may be used to deny tbe issuance or renev.•al of ;•our license in tbe event you oa�e DSinnesota sales, employer s
w•ithboldingormotorvehicleezcise -w,es;
-13pon reuicing this infoimation, tl�e Bcensing authority will supply it onty to the Minnesota Depaz�nt of Revenue. How�ever,
uMiec tbe Federal Exchange of Informa6on Agexment, t6e Depait�nt of Revenue may supply chis information to the Intemal
Reeenue Sen•ice. �
Minnesota Taz Identification A'umbers (Sales & Use Tzz \'umber) may be obtained from the Stau of ATinnesota, Business Records
Department, ]0 River Park Pla7a (612-296-5181 .
r-ti�r�,��z: �7 t - 9�- zz3�
SociaiSecuriryNumber. r_J'tt�--n�= 9`1S-gC�'"Zg2� _
Minnesota Taz Idenrification T'umber. ��1 2- � 3 ��
_ If a Mianesota Tax Identification T'umbet is not required fot the business being operated, indicate so by pluing zn "X" in�
fP_S7
C>E$TIFICA'IIO\ OF �'�'ORK£RS' C0�3PF.tiSATION CQ\�RAGE PtRSi:A.�Z TO A4L\hcSOTA ST�TI�T£ 176.1e2
I hereby ceru`y ivat I, oi my companv, atn in cempliance w;;S tbe v.•orkers cer., in<_urance co�•es�ge requi�es�n's of :�4in�esota
Stamte 176.182, culxli.ision 2. I�:so understind t6at pro�isioa of ;21ce inforr.r:een in this cectification constitu�es su�ci�nt grounds for
zdver�e ac�ea z�tinst zt licen<es held, iaclu�:ng revoca�e� �d <usQensioa ef s�id licences. � q �,/
larzr_ af Insc—��ce Comp�:�y: � ( � �1 �7
Policy \umb;r: Co�'er�e frem to
I hace ¢o em ioyees co� ered undec a'orkers' covn�nsa!ie� =.:=urance �_ '
A\Y F:ILSIFIC9TI0'i� OR A.\SS��RS GI�'E'i OR'�iATERL4L SL�B?�IITTED
�i'II,L RESL7.T L� DE\Z�L OF THIS .�PPLf CATI0:3
�
I hereby sta's tbat I hz��e ansu•ered dl of the prueding ques�o�s, and tbat the iafer�tion contained herein is uue and ce,�ect to toz Er_st
'' of my 3:novriedee and belief. I bereby state fiucfier that I bzl e re: eiced no mone}� oc other consideration, 6y w�ay of ]oan, �`t, conffibution,
or ol�erwise, o:hec tban already disclosed in the a�plicaaon n•3uch I berew�ith submined. I also understand this premise m: y be inspected
by police, rue, healt6 znd ocher ciq� o:;�cials at zny anri zll :�s n;en the b;;s:ne<s is ia ope,atioa.
���'c:1�
✓j�
---- Sitia:se (F
1�.-5-
fez �!I applications) Date
*"�ote: If this a�plication is Foo�l_iquor re14t,d. pieue co�.act a City of Szint Pa�,il Iiealtb Inspector, Steti�e Olson (266-4139), to re��iew
ptaas.
If any substantial chaoges to swcnu� are_anticip��, please contact a City of Saint Paul PIan Ezaminer at 2664��7 w apply for
building.permiu.
If tLere are any changes to tbe pa*king lot, floor spe: e., or for new operz5oas, please contact a Cit}°of Saint Paul Zoaing Inspe: tor
az 265-9��08.
AddiAonal application requiremenfs, please attach:
A detailed description of the design, Iocation and square footage of the premises fo be licensed (rite p2an).
77�e follotiring data should be on the site pIan (preferahly on an S 1!2" x Il" or 81/2" z 14" paper):
- I�'ame, address, and phone number.
- Tbe scaie should be stafed snch as 1" = 20'. ^\ s6ould be indicated foward the top.
• Piacement of all pertinent features of the interior of the lice[��ed facility such u seating areu, �itchens, offices, repair
area, parh�ng, rest moms, etc
- Sf a request is for an addifion or ezpansion of the licensed facilitp, indicate both the current area and the proposed
ezpansion.
A cop}• of your )ease agreement or proof of o�snership of the property.
FOR SPECIFIC APPLICATION REQLZREhiENTS, PLEASE SEE REVERSE >>>>
Tfappl}ingfor, ��� ����] �-� . _ K.
Czbzret adu2G ple�e actac� uzitten proof that ezca enplo} ee is at ]eut 13 years o3d
ConrersztienlRap par)or 2du]t plez�e anacb M_�cen prcwf thzt each e�lo; ee is at lez�t 18 }�e�s old.
Entertzinment, ple�e sps-i:`y cl�sc A, B, oi C L:e�se; ebtain �*�d zr.ach sirna,wes of approvzl from 409c cf �eer nei�6bers
ei'�fn 350 :ezt of the est�bl;<_hz:�nt. This licec>z zett be �pplied fer ia conjunction w'ith a Liquor, \�'ine,'�3�[ Oa Sae er
RentaUD�ce Ha11 license.
Firezrms, plezse attach a ler�er u ith the followi_� informa[ion: st�te if seIIine oc only repairinQ, Federzl Fue��:u Liczn<e
?�um'`zr, n t+z ef Arur..d Sen ices dischzrge (Hone �S':e, GeneraI, Bad Cenduct, tndesirable, Dishoaorable, ar oo �ic�r}' sen'ice.
(�OTE: Establish�nt must be cemmerciaily ze�cd} -_
Game room, ptezu pro�•ide. �ue follou�ing infor�oa: nz� of �c.`,�ine znd list pace. (:�'OTE: A Peol Hall l;'cent i< requued
if chere z:e �,ypool tzbles in the establishmenC)
Healtb/Sgorfs clab adult, pleue attach written g.�f tUat euh e�1o;:z is at ]east 18 yeazs old.
Liquor ofL�on sa1e refer to zr.a:hed liquor appLcs�on. -"'
LocG opening ser�ices. ple<<e aCach a list of all c�plo}'ees (v. ich ho� 2ddress 2ad Yelep�one nuiaber} u�ho �'ill `��e doin� tbe
locb oYZnia= sen�ice; attach S l0 Surety Bon3 .
'�fassege centeq piease atcac� a detailed descripdea of ebe sen�ices beias pro��id:d.
�f�szge center adult. pleze zttacb u�rirten preef ::at each emnloyee is at ]e2st IS years eld.
'�Szs�ne prac6tioner, ple2�e zra:h a copy of Ier�; for appro��al fromHe�leh; pra�f of insur2nce co��erase of 51,O1a.0�A� za_h
�ener� lizb:lip� and professienal liability x•ith the City of Saint Paul n-we,d as zn additinnzl inscred, as�d a?0 d�;' notice of
czncellauaa; a letter from.; �.0 empioyer to veri,`y' e�lo}�nt w•ich a license msszoe center.
'�iotorcccle dealer, plez�e in.lude State of ?.4innew:z IY_aler :�um�r.
'�e� motor cehicIe dealer, please inct�de Stace of �linnesota IY_ater:iumSer.
Par�iag IoUramp, please include tbe number of ga.-'sing spaces, and ztta,:L p12ns coataining a geaeral description of t',�e security
prorided at rhe lot/ramp, a_site pian sbowing 'a-:t'ew�ays of the propose3 lo[ and the legal description of tbe pro�erty (this
requirement necessary only if no site pIan is cunendy on file). Attach a cover letter dexribing your plzns to co�?;y w'ith the
li�ting and pzinting require�nu.
Pa� please attach 55,000.00 Surety Boa�
Semnd hand dealer-motor Fehicle, ptease include State of ?�Rinnesota Dezler �omber.
Second hxnd dealer-moWr rehicle parts, pleue 4: a:� SS,OO�.00I SvreEy Bon3
Steam roomlbath hoase adult, piease attach �ziaen proof t2�at each emp]oyee is az lezst 18 yeazs o13
Theatet adult, please attach wzineo proof thac ezch employee is ai lezst 18 yeazs old.
If appl}ing for, �� � �o��� ' . . -. ' • . - . "
Cabaret adu3t, p]edce anach s proof tbat ea:3 emplo; ee is at leza 13 pears old � L �
Com ersa.ionJRap parlor zdult plez�e artach w'^�en proof thzt e:+ch em; lo;ee is zt ]ez�t 18 yeus old.
Entertzinment, pleae sp°�i,`y d2ss A, B, or C li:cnce; obtain 2nd zrach si`natures of appro�•�l from 909c of }°ear nei�.`,�
�it�'sa 350 f�t of the esta�lis�nt Ttus lice�e must be �pplie3 fec ia coajuncuon u•ith a Liquor, \Vine, ?,i�t On S�
Rental.�D�ce Hall license.
Firezrms, pleue attach a lztter v.�ith ttie followi*_e infonnation: stau ifi �ellin� or on]y repzirina, Federal Fi:e�� Liczn�e
Iium�zr, nr+z of Am�ed Sen'ices dischzrge (Hone-<�le, Gener�l, Bad Ce�duct, tndesirable, Disbonorable, or no mi?it�' se��ice.
(\OTE: Est�blishv�nt must be cemmerciaily zened) . -,
Game room, pleue provide the follou•ing infor�en: nzme of m3chine x�d list price. (:�OTE: A Peel Hall licens, is reqv'ued
if the;e �;e 2,ypool tables in tbe establishment)
Healeh/Sportr ctub adult, plezse attach w�ritten p.� �f tha[ eazh emllo;;x is st Jeut ] 8 yeazs old
Liquor ofUon sa1e. refer to �rached liquor applicz�on. '" `
L.ock apening ser�ices. ple�e attach a list of all e:.:�lopees (w'ith 6onz ad3ress and telep'�one nu;a'xr) u•ho W�iil bz doing the
lo:k erzr�ia_ sen'ice; attach SI0,0�0 SuretyBon3
\iassa;e center, pleaze sttach a detailed descrip�an of the ser��ices beiae pio`•ided.
\1a<sage center adult. plez e attach written pro.f - �at eac6 employee is at lezst 18 yeazs o7d.
'�Sas oe practitioner. plrz�e z^a:L a copy of ]ee:: for zpprot•al frem Iie�ih; proof of insurance co��erege of SI,O��A��A� ea=6
�ene: �]izSlip� and professioaal liabiliry x•ith u e Ciry of Saint Pzul caned az zn ad3itienzl insered, and a.0 da;' noti: e of
cancellztioa: a)ener from yo:u employer to veri5' e�lo;ment N�ith a license msszae center.
�fotorcrcle dealer, plez�e in.lude State of b'tinnesoa Dealer:�amSer.
'�eK motor sehicle deater, plrzse include State of �,innesota IYalet \umber.
�
Parlang IoVratnp, please in:lude the number of pa-k.ing spaces, and atta:b pians containing a general d�scription of :�e secuzity
pro�•ided at the lotlramp, a site plan showing d:;�ew•a}�s of tbe proposed lot znd the legal desc[igrion of the pro�rty (this
ree,uire�nt necessary only if ao site plan is curtea8y on file). Atta:L a cover ]etter dexribing your plans to co�Iy ��ith the
lightine a�d pzinting requuemenu. .
Pa�cnbroker, please attacb �5,00�.00 Surety Bon�
Second hand deaJer-motor cehide, please inclucL State of ?�Tinnesota Dezler \Umber.
Second }cand dealer-motor Fehide parts, pleZe auacb SS,OOa.Q� S+uety Bon3
Steam room/bath house adult, pleau attach x�ri:un pzoof that eacb employee is at least 18 yeazs o]d
Theater adu3t, piease attach uzinen proof tbat eub employee is at lezct 18 years old.
�