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97-627Council File # Q�Z� Ordinance # Green Sheet # �� r�;�,��^.�� s ; � �'_.: �.. �, .�� 1 2 3 4 5 6 � s 9 lo 11 12 13 14 15 16 17 18 19 20 21 22 3. 4. 5. All velucles pazked outdoors on the lot shall be completely assembled with no parts missing. Velucle salvage is not permitted. Pazking of vehicles that are awaiting repair or that have been repaired shall be prolubital in the public streets. Wheelstops shall be installed along the sidewalk on Hawkhorne Avenue, between the driveway and the alley, to prevent vehicles from driving on the sidewalk. The hours of operation shall be those stated by the applicant 8:00 a.m. to 8:00 p.m. Monday through Friday; 8:00 a.m. to 4:00 p.m. Sahuday; and closed Sunday. 23 24 Requeated by Department of: 25 Y� Na� Absent 26 B a� eTT 27 Bostrom o ice of License rnspections and 28 Hairzs 29 Meqa� — y7` Env+ronmental Protect<on 30 Morton �/' 31 T un� ✓' 32 Co� � 34 � � t.�;� � 35 Adopted by Council: Date qq� B Y' 36 37 Adoption Certified by Council Secretary 38 Form Approved by City Attorney 39 ` 40 By: c `t}- �E' — = ' �Y Cc� 41 I J �' . 42 Approved by Mayor: Date �( �/�/ �-- 43 44 Approved by Mayor for Submission to 45 By: � G council 46 Presented By Referred To Committee: Date RESOLVED: That application (ID #20459) for am Auw Body Repau Garage License by Ivlicheal Sullivan DBA Mike's Auto Services (Micheal Sullivan, Owner) at 1229 Payne Avenue be and the same is hereby approved with the following conditions: RESOLUTION CITY OF SAINT PAUL, MINNESOTA � 1. Pazldng for customers and employees shall be arranged on the lot as shown on the site plan. No more than 15 vehicles shall be pazked outdoors on the lot at any time. Only customer velucles and employee velucles of the pern�ittee may be pazked on the lot. This condition is intended to prohibit long term storage of velricles on the lot. � By: Greensneet# sssoo L.I.E.P. REVIEW CHECKLIST �ate: s/2o/96 � In Trdckel'? App'n Received / App'n Processetl �`l -C��-`1 License ID # 20459 License Type: Auto Repair Gara¢e Company Name_ M�cheal Sullivan pgq: Mike's Auto Service Business Addresss: I2z9 Payne Avenue Business Phone: 771-8470 Cornact NameJAddress: M�-cheal Sullivan, 2036 Chamber St. {iome Phone: 484-4461 Maplewood, 55109 Date to Council - ' Public Hearing ( Notice Sent to E N oti c e Sent to F Depa�tment/ City Attorney Environmental Heaith Labels Ordered: �t17 District Council #: �J z7r'1, Date Ward #: � Comments . (v.iA Fire 9 •3 • D.� - License f I 5rte Plan Received:_ I Lease Received: - — 5�i��(-� � a�c� G� �� c-�,d �� q�•3 •`�I� �J'g '9� � ��— _. -.:�= zs, �.� . �-- ka l� �9� �l� - Ga�( DEPARTAENT/OFfICE/COUNCIL DATEINRIATED GREEN SHEE N� 35500 LIEP/Licensin - - CONTACTPEFSON & PHONE � DEPAfiTMENT DIflECTOR ' O CfTV GOUNCIL �R4AVOATE Chiistine Rozek 266-9108 "��" �carraroa�r OC�IYCLERK NUYBERFOR - MUSTBE ON COUNCILAGENDA �(DAT�E (� p��nN� O BU06Ef DIflECfOR O FIN.B MGT. SEflVICES DIR. For hearin : 5 �a –1� ONDEp O�pypR(ORASSISTM7T) � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE� � ACS10N RE�UESIED: Micheal Sullivan DBA Mike's Auto Service requests Council approval of its application for an Auto Repair Garage License located at 1229 Payne Avenue (ID �F20459). RECOMMENDA7lON5: Approve (A) or peject (R) pERSONAL SEHVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS: _ PLANNING COMMISSION _ CML SERVICE COMMISSION �� H25 th"r5 pefSOrlHilm eVet Wotk¢d Under a CDMr2C[ foT tfli5 dBp3rtmEM? - _ CIB COMMR7EE _ YES NO _ STAFF 2. Has this person/firm ever been a city employee? — YES NO _ o�57AiCT CAUH7 � 3. Does this personRirm possess a skill not normall � y possessed by any curteM city employee. SUPPOFiTS WXICH COUNGILOBlECT7VE4 YES NO Explain all yes answers on separete sheet antl attaeh to green Sheet INiTIATING PpOBLEM. 55UE, OPPORTUNI7Y (Who. Whai. Whan. Where, W�y): ADVANTAGESIFAPPROVED: DISA�VANTAGES IFAPPFOVED: � h ! '' - ' '�...,. - s'�?.��,.,_;: �.�` �s..: "'� s:;�%(+°� a.t�� t5.2 i �ta �' DISADVANTAGES IF NOTAPPROVED: T07AL AMOUNT OF TRANSACTION $ COST/REVENUE 6UDGETED (CIHCLE ONE) YES NO FUNDIHG SOUtiCE ACTIVITY NUMBER FINANC�AL INFOFMATION: (EXPLAIN) C CLASS III LICENSE APPLICATION r CITY OF SAINT PAUL Office of license. Inspections and Em•ironmenui Protection 350Si Paer Sc Suim 300 Sai1rc Paui. blinzsw 55102 (b1Z)1669090 fu (61� 266-9124 �A � � �f � THIS APPLICATIO':V TS SUBJECI' TO REVIEW BY THE PUBLIC PLEASE TYPE OR PRINT IN INK Type of License(s) being applied for: Company Name: If business is incorporated, give date Doing Business As: , S Business Addtess: sveet Adaress Between what cross streets is the business Iceated? � �`� �t� r ^ Bosiness Phone: �� S� - J (� �i , 00 Which side of the street? �'3cS�' Are the premises now occupied� `�/, �_ � What Type of Business? �c ��• �, ��_ n� Mail To Address < • T �'f3t�� - �{� v � Street Addcess City State Zip Applicant Inform � NameandTitle,'S\\��C�.z,'P�- �� i �. C'iia7' _�•��. First Middte (Maiden) Last tide Home Address: Sheet Address City Swte Zip �, � ' . n �a c�t_ Aome Phone: ' � 4 Date of Birth: �-�� -�,<'�, Piace of Birth: S\ '( Have you ever been convicted of any feiony, crime or violation oF any city ordinance other tt�an traffic? YES _ NO� Date of azrest: Where? Chazge: ' Coovicdon: � Sentence: List tbe names and residences of three persons of good morai character, living within the Twin Cities Metro Area, not related to the applicant or tlnancially interested in the premises or business, who may be referred to as to the applicant's chazacter. NAME �� '�k r M Ca.� �e._ - r�- < �, n _ 'T� . � . ,.:� List cuaenUy hold, formerly � .» n,. _ 4' [� City �� or may have an interest in: ;��I PHONE Have any of the above named licenses ever been revoked? _ YES � NO If yes, list the dates and reasons for revocation: Are you going to operate this business personally? � YES _ NO if not, who will operate it? Frst Name Middie tnitiai (Maiden) Iast Dam of Hinh Home Addras: Strect Name City S�ate Zip �--- _ . .. _ _ ._._-°-- — "-- - - `- � - ' � a` � Are you going to have a manaaer or assistant in this business? _ YES NO If the mas�ager is not the san�e as the opetator, p(ease "' complete the following information: � ��l -La.'� ""� Frst Name MidNe UNial (Maiden) Iast Date of Binh Iiome Address: St�eet Namc City State Zip Ptwne Numbec Please list yo¢r employment history for the previous five {� yeaz period: . � S !11 1 �7� � List all other officers of �he coxporaaon: OFFICER 7'ITLE NAME (Office Held) �I HOME ADDRESS Address HOME PH013E If business is a pazcnership, please include th following informaGon for each partner (use ��l iu�e i �� V � Me ��,t � First Name Midclle G � (Maide ) �o � �nQ.i-v� l�(- �`�" Y" t G�fl�Gln ) l°Y �LQ Home Address: Streei Name Frst Name Home Address: S Veet Name Middle Initiai City (Maiden) City �-�F"- �� BUSINESS PHONE 3itional pages if necessary): �c i I i vQ vv — 1� I i� Last .J �f (�� ' s,�ce z;P I.ast State Zip DATE OF BIRTH Phone Num6er Date of Binh Phone Number MINNESOTA TAX IDENTIFTCATTON NUMBER - Pursuant to the I.aws of Mianesota, 1984, Chapter $02, rUticle 8, Secflon 2(270.72) (Tar Cleazance; Issuaz�ce of Licenses), licensing authorities are requued to provide to We State of Mivaesota Comcnissionet of Revenue, the Minnesota business tax identification oumber and the social security number of each license applicant. Under the Minnesot� Govemrz�eni Data Practices Act and the Fedaral Pitvacy Act of 1974, we aze required ta a3vise you of the faliowing regazding the use of the Minnesota Tax Idendfication Number: . -11us information may be used [o deny the issuance or renewal of yev[!icense in the event you owe Minnesota sates, employei s withholding or motor velucle excise taxes; - Upon ieceiving this information, the licensing autharity will supply ii only to the Minnesata Department of Revenue. However, under the Federal Exchange of Informaflon Agreement, the Department of Revenue may supply this information to the Intemal Revenue Service. Minnesota Taz IdeutificaGon Numbers (Sales & Use Taz Number) may be obtained from [he State of Minnesota, Business Records Department, ]0 River Pazk Plaza (612-296-6181). Social Security,Number: � �� '�ZS� �6Q'7. : � Minnesota Tax Idenfification Number: ��7.�.� If a Minnesota Tax Identitication Number is not required for the business being operated, indicate so by p]acing an "X" iu the box. Council File # Q�Z� Ordinance # Green Sheet # �� r�;�,��^.�� s ; � �'_.: �.. �, .�� 1 2 3 4 5 6 � s 9 lo 11 12 13 14 15 16 17 18 19 20 21 22 3. 4. 5. All velucles pazked outdoors on the lot shall be completely assembled with no parts missing. Velucle salvage is not permitted. Pazking of vehicles that are awaiting repair or that have been repaired shall be prolubital in the public streets. Wheelstops shall be installed along the sidewalk on Hawkhorne Avenue, between the driveway and the alley, to prevent vehicles from driving on the sidewalk. The hours of operation shall be those stated by the applicant 8:00 a.m. to 8:00 p.m. Monday through Friday; 8:00 a.m. to 4:00 p.m. Sahuday; and closed Sunday. 23 24 Requeated by Department of: 25 Y� Na� Absent 26 B a� eTT 27 Bostrom o ice of License rnspections and 28 Hairzs 29 Meqa� — y7` Env+ronmental Protect<on 30 Morton �/' 31 T un� ✓' 32 Co� � 34 � � t.�;� � 35 Adopted by Council: Date qq� B Y' 36 37 Adoption Certified by Council Secretary 38 Form Approved by City Attorney 39 ` 40 By: c `t}- �E' — = ' �Y Cc� 41 I J �' . 42 Approved by Mayor: Date �( �/�/ �-- 43 44 Approved by Mayor for Submission to 45 By: � G council 46 Presented By Referred To Committee: Date RESOLVED: That application (ID #20459) for am Auw Body Repau Garage License by Ivlicheal Sullivan DBA Mike's Auto Services (Micheal Sullivan, Owner) at 1229 Payne Avenue be and the same is hereby approved with the following conditions: RESOLUTION CITY OF SAINT PAUL, MINNESOTA � 1. Pazldng for customers and employees shall be arranged on the lot as shown on the site plan. No more than 15 vehicles shall be pazked outdoors on the lot at any time. Only customer velucles and employee velucles of the pern�ittee may be pazked on the lot. This condition is intended to prohibit long term storage of velricles on the lot. � By: Greensneet# sssoo L.I.E.P. REVIEW CHECKLIST �ate: s/2o/96 � In Trdckel'? App'n Received / App'n Processetl �`l -C��-`1 License ID # 20459 License Type: Auto Repair Gara¢e Company Name_ M�cheal Sullivan pgq: Mike's Auto Service Business Addresss: I2z9 Payne Avenue Business Phone: 771-8470 Cornact NameJAddress: M�-cheal Sullivan, 2036 Chamber St. {iome Phone: 484-4461 Maplewood, 55109 Date to Council - ' Public Hearing ( Notice Sent to E N oti c e Sent to F Depa�tment/ City Attorney Environmental Heaith Labels Ordered: �t17 District Council #: �J z7r'1, Date Ward #: � Comments . (v.iA Fire 9 •3 • D.� - License f I 5rte Plan Received:_ I Lease Received: - — 5�i��(-� � a�c� G� �� c-�,d �� q�•3 •`�I� �J'g '9� � ��— _. -.:�= zs, �.� . �-- ka l� �9� �l� - Ga�( DEPARTAENT/OFfICE/COUNCIL DATEINRIATED GREEN SHEE N� 35500 LIEP/Licensin - - CONTACTPEFSON & PHONE � DEPAfiTMENT DIflECTOR ' O CfTV GOUNCIL �R4AVOATE Chiistine Rozek 266-9108 "��" �carraroa�r OC�IYCLERK NUYBERFOR - MUSTBE ON COUNCILAGENDA �(DAT�E (� p��nN� O BU06Ef DIflECfOR O FIN.B MGT. SEflVICES DIR. For hearin : 5 �a –1� ONDEp O�pypR(ORASSISTM7T) � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE� � ACS10N RE�UESIED: Micheal Sullivan DBA Mike's Auto Service requests Council approval of its application for an Auto Repair Garage License located at 1229 Payne Avenue (ID �F20459). RECOMMENDA7lON5: Approve (A) or peject (R) pERSONAL SEHVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS: _ PLANNING COMMISSION _ CML SERVICE COMMISSION �� H25 th"r5 pefSOrlHilm eVet Wotk¢d Under a CDMr2C[ foT tfli5 dBp3rtmEM? - _ CIB COMMR7EE _ YES NO _ STAFF 2. Has this person/firm ever been a city employee? — YES NO _ o�57AiCT CAUH7 � 3. Does this personRirm possess a skill not normall � y possessed by any curteM city employee. SUPPOFiTS WXICH COUNGILOBlECT7VE4 YES NO Explain all yes answers on separete sheet antl attaeh to green Sheet INiTIATING PpOBLEM. 55UE, OPPORTUNI7Y (Who. Whai. Whan. Where, W�y): ADVANTAGESIFAPPROVED: DISA�VANTAGES IFAPPFOVED: � h ! '' - ' '�...,. - s'�?.��,.,_;: �.�` �s..: "'� s:;�%(+°� a.t�� t5.2 i �ta �' DISADVANTAGES IF NOTAPPROVED: T07AL AMOUNT OF TRANSACTION $ COST/REVENUE 6UDGETED (CIHCLE ONE) YES NO FUNDIHG SOUtiCE ACTIVITY NUMBER FINANC�AL INFOFMATION: (EXPLAIN) C CLASS III LICENSE APPLICATION r CITY OF SAINT PAUL Office of license. Inspections and Em•ironmenui Protection 350Si Paer Sc Suim 300 Sai1rc Paui. blinzsw 55102 (b1Z)1669090 fu (61� 266-9124 �A � � �f � THIS APPLICATIO':V TS SUBJECI' TO REVIEW BY THE PUBLIC PLEASE TYPE OR PRINT IN INK Type of License(s) being applied for: Company Name: If business is incorporated, give date Doing Business As: , S Business Addtess: sveet Adaress Between what cross streets is the business Iceated? � �`� �t� r ^ Bosiness Phone: �� S� - J (� �i , 00 Which side of the street? �'3cS�' Are the premises now occupied� `�/, �_ � What Type of Business? �c ��• �, ��_ n� Mail To Address < • T �'f3t�� - �{� v � Street Addcess City State Zip Applicant Inform � NameandTitle,'S\\��C�.z,'P�- �� i �. C'iia7' _�•��. First Middte (Maiden) Last tide Home Address: Sheet Address City Swte Zip �, � ' . n �a c�t_ Aome Phone: ' � 4 Date of Birth: �-�� -�,<'�, Piace of Birth: S\ '( Have you ever been convicted of any feiony, crime or violation oF any city ordinance other tt�an traffic? YES _ NO� Date of azrest: Where? Chazge: ' Coovicdon: � Sentence: List tbe names and residences of three persons of good morai character, living within the Twin Cities Metro Area, not related to the applicant or tlnancially interested in the premises or business, who may be referred to as to the applicant's chazacter. NAME �� '�k r M Ca.� �e._ - r�- < �, n _ 'T� . � . ,.:� List cuaenUy hold, formerly � .» n,. _ 4' [� City �� or may have an interest in: ;��I PHONE Have any of the above named licenses ever been revoked? _ YES � NO If yes, list the dates and reasons for revocation: Are you going to operate this business personally? � YES _ NO if not, who will operate it? Frst Name Middie tnitiai (Maiden) Iast Dam of Hinh Home Addras: Strect Name City S�ate Zip �--- _ . .. _ _ ._._-°-- — "-- - - `- � - ' � a` � Are you going to have a manaaer or assistant in this business? _ YES NO If the mas�ager is not the san�e as the opetator, p(ease "' complete the following information: � ��l -La.'� ""� Frst Name MidNe UNial (Maiden) Iast Date of Binh Iiome Address: St�eet Namc City State Zip Ptwne Numbec Please list yo¢r employment history for the previous five {� yeaz period: . � S !11 1 �7� � List all other officers of �he coxporaaon: OFFICER 7'ITLE NAME (Office Held) �I HOME ADDRESS Address HOME PH013E If business is a pazcnership, please include th following informaGon for each partner (use ��l iu�e i �� V � Me ��,t � First Name Midclle G � (Maide ) �o � �nQ.i-v� l�(- �`�" Y" t G�fl�Gln ) l°Y �LQ Home Address: Streei Name Frst Name Home Address: S Veet Name Middle Initiai City (Maiden) City �-�F"- �� BUSINESS PHONE 3itional pages if necessary): �c i I i vQ vv — 1� I i� Last .J �f (�� ' s,�ce z;P I.ast State Zip DATE OF BIRTH Phone Num6er Date of Binh Phone Number MINNESOTA TAX IDENTIFTCATTON NUMBER - Pursuant to the I.aws of Mianesota, 1984, Chapter $02, rUticle 8, Secflon 2(270.72) (Tar Cleazance; Issuaz�ce of Licenses), licensing authorities are requued to provide to We State of Mivaesota Comcnissionet of Revenue, the Minnesota business tax identification oumber and the social security number of each license applicant. Under the Minnesot� Govemrz�eni Data Practices Act and the Fedaral Pitvacy Act of 1974, we aze required ta a3vise you of the faliowing regazding the use of the Minnesota Tax Idendfication Number: . -11us information may be used [o deny the issuance or renewal of yev[!icense in the event you owe Minnesota sates, employei s withholding or motor velucle excise taxes; - Upon ieceiving this information, the licensing autharity will supply ii only to the Minnesata Department of Revenue. However, under the Federal Exchange of Informaflon Agreement, the Department of Revenue may supply this information to the Intemal Revenue Service. Minnesota Taz IdeutificaGon Numbers (Sales & Use Taz Number) may be obtained from [he State of Minnesota, Business Records Department, ]0 River Pazk Plaza (612-296-6181). Social Security,Number: � �� '�ZS� �6Q'7. : � Minnesota Tax Idenfification Number: ��7.�.� If a Minnesota Tax Identitication Number is not required for the business being operated, indicate so by p]acing an "X" iu the box. Council File # Q�Z� Ordinance # Green Sheet # �� r�;�,��^.�� s ; � �'_.: �.. �, .�� 1 2 3 4 5 6 � s 9 lo 11 12 13 14 15 16 17 18 19 20 21 22 3. 4. 5. All velucles pazked outdoors on the lot shall be completely assembled with no parts missing. Velucle salvage is not permitted. Pazking of vehicles that are awaiting repair or that have been repaired shall be prolubital in the public streets. Wheelstops shall be installed along the sidewalk on Hawkhorne Avenue, between the driveway and the alley, to prevent vehicles from driving on the sidewalk. The hours of operation shall be those stated by the applicant 8:00 a.m. to 8:00 p.m. Monday through Friday; 8:00 a.m. to 4:00 p.m. Sahuday; and closed Sunday. 23 24 Requeated by Department of: 25 Y� Na� Absent 26 B a� eTT 27 Bostrom o ice of License rnspections and 28 Hairzs 29 Meqa� — y7` Env+ronmental Protect<on 30 Morton �/' 31 T un� ✓' 32 Co� � 34 � � t.�;� � 35 Adopted by Council: Date qq� B Y' 36 37 Adoption Certified by Council Secretary 38 Form Approved by City Attorney 39 ` 40 By: c `t}- �E' — = ' �Y Cc� 41 I J �' . 42 Approved by Mayor: Date �( �/�/ �-- 43 44 Approved by Mayor for Submission to 45 By: � G council 46 Presented By Referred To Committee: Date RESOLVED: That application (ID #20459) for am Auw Body Repau Garage License by Ivlicheal Sullivan DBA Mike's Auto Services (Micheal Sullivan, Owner) at 1229 Payne Avenue be and the same is hereby approved with the following conditions: RESOLUTION CITY OF SAINT PAUL, MINNESOTA � 1. Pazldng for customers and employees shall be arranged on the lot as shown on the site plan. No more than 15 vehicles shall be pazked outdoors on the lot at any time. Only customer velucles and employee velucles of the pern�ittee may be pazked on the lot. This condition is intended to prohibit long term storage of velricles on the lot. � By: Greensneet# sssoo L.I.E.P. REVIEW CHECKLIST �ate: s/2o/96 � In Trdckel'? App'n Received / App'n Processetl �`l -C��-`1 License ID # 20459 License Type: Auto Repair Gara¢e Company Name_ M�cheal Sullivan pgq: Mike's Auto Service Business Addresss: I2z9 Payne Avenue Business Phone: 771-8470 Cornact NameJAddress: M�-cheal Sullivan, 2036 Chamber St. {iome Phone: 484-4461 Maplewood, 55109 Date to Council - ' Public Hearing ( Notice Sent to E N oti c e Sent to F Depa�tment/ City Attorney Environmental Heaith Labels Ordered: �t17 District Council #: �J z7r'1, Date Ward #: � Comments . (v.iA Fire 9 •3 • D.� - License f I 5rte Plan Received:_ I Lease Received: - — 5�i��(-� � a�c� G� �� c-�,d �� q�•3 •`�I� �J'g '9� � ��— _. -.:�= zs, �.� . �-- ka l� �9� �l� - Ga�( DEPARTAENT/OFfICE/COUNCIL DATEINRIATED GREEN SHEE N� 35500 LIEP/Licensin - - CONTACTPEFSON & PHONE � DEPAfiTMENT DIflECTOR ' O CfTV GOUNCIL �R4AVOATE Chiistine Rozek 266-9108 "��" �carraroa�r OC�IYCLERK NUYBERFOR - MUSTBE ON COUNCILAGENDA �(DAT�E (� p��nN� O BU06Ef DIflECfOR O FIN.B MGT. SEflVICES DIR. For hearin : 5 �a –1� ONDEp O�pypR(ORASSISTM7T) � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE� � ACS10N RE�UESIED: Micheal Sullivan DBA Mike's Auto Service requests Council approval of its application for an Auto Repair Garage License located at 1229 Payne Avenue (ID �F20459). RECOMMENDA7lON5: Approve (A) or peject (R) pERSONAL SEHVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS: _ PLANNING COMMISSION _ CML SERVICE COMMISSION �� H25 th"r5 pefSOrlHilm eVet Wotk¢d Under a CDMr2C[ foT tfli5 dBp3rtmEM? - _ CIB COMMR7EE _ YES NO _ STAFF 2. Has this person/firm ever been a city employee? — YES NO _ o�57AiCT CAUH7 � 3. Does this personRirm possess a skill not normall � y possessed by any curteM city employee. SUPPOFiTS WXICH COUNGILOBlECT7VE4 YES NO Explain all yes answers on separete sheet antl attaeh to green Sheet INiTIATING PpOBLEM. 55UE, OPPORTUNI7Y (Who. Whai. Whan. Where, W�y): ADVANTAGESIFAPPROVED: DISA�VANTAGES IFAPPFOVED: � h ! '' - ' '�...,. - s'�?.��,.,_;: �.�` �s..: "'� s:;�%(+°� a.t�� t5.2 i �ta �' DISADVANTAGES IF NOTAPPROVED: T07AL AMOUNT OF TRANSACTION $ COST/REVENUE 6UDGETED (CIHCLE ONE) YES NO FUNDIHG SOUtiCE ACTIVITY NUMBER FINANC�AL INFOFMATION: (EXPLAIN) C CLASS III LICENSE APPLICATION r CITY OF SAINT PAUL Office of license. Inspections and Em•ironmenui Protection 350Si Paer Sc Suim 300 Sai1rc Paui. blinzsw 55102 (b1Z)1669090 fu (61� 266-9124 �A � � �f � THIS APPLICATIO':V TS SUBJECI' TO REVIEW BY THE PUBLIC PLEASE TYPE OR PRINT IN INK Type of License(s) being applied for: Company Name: If business is incorporated, give date Doing Business As: , S Business Addtess: sveet Adaress Between what cross streets is the business Iceated? � �`� �t� r ^ Bosiness Phone: �� S� - J (� �i , 00 Which side of the street? �'3cS�' Are the premises now occupied� `�/, �_ � What Type of Business? �c ��• �, ��_ n� Mail To Address < • T �'f3t�� - �{� v � Street Addcess City State Zip Applicant Inform � NameandTitle,'S\\��C�.z,'P�- �� i �. C'iia7' _�•��. First Middte (Maiden) Last tide Home Address: Sheet Address City Swte Zip �, � ' . n �a c�t_ Aome Phone: ' � 4 Date of Birth: �-�� -�,<'�, Piace of Birth: S\ '( Have you ever been convicted of any feiony, crime or violation oF any city ordinance other tt�an traffic? YES _ NO� Date of azrest: Where? Chazge: ' Coovicdon: � Sentence: List tbe names and residences of three persons of good morai character, living within the Twin Cities Metro Area, not related to the applicant or tlnancially interested in the premises or business, who may be referred to as to the applicant's chazacter. NAME �� '�k r M Ca.� �e._ - r�- < �, n _ 'T� . � . ,.:� List cuaenUy hold, formerly � .» n,. _ 4' [� City �� or may have an interest in: ;��I PHONE Have any of the above named licenses ever been revoked? _ YES � NO If yes, list the dates and reasons for revocation: Are you going to operate this business personally? � YES _ NO if not, who will operate it? Frst Name Middie tnitiai (Maiden) Iast Dam of Hinh Home Addras: Strect Name City S�ate Zip �--- _ . .. _ _ ._._-°-- — "-- - - `- � - ' � a` � Are you going to have a manaaer or assistant in this business? _ YES NO If the mas�ager is not the san�e as the opetator, p(ease "' complete the following information: � ��l -La.'� ""� Frst Name MidNe UNial (Maiden) Iast Date of Binh Iiome Address: St�eet Namc City State Zip Ptwne Numbec Please list yo¢r employment history for the previous five {� yeaz period: . � S !11 1 �7� � List all other officers of �he coxporaaon: OFFICER 7'ITLE NAME (Office Held) �I HOME ADDRESS Address HOME PH013E If business is a pazcnership, please include th following informaGon for each partner (use ��l iu�e i �� V � Me ��,t � First Name Midclle G � (Maide ) �o � �nQ.i-v� l�(- �`�" Y" t G�fl�Gln ) l°Y �LQ Home Address: Streei Name Frst Name Home Address: S Veet Name Middle Initiai City (Maiden) City �-�F"- �� BUSINESS PHONE 3itional pages if necessary): �c i I i vQ vv — 1� I i� Last .J �f (�� ' s,�ce z;P I.ast State Zip DATE OF BIRTH Phone Num6er Date of Binh Phone Number MINNESOTA TAX IDENTIFTCATTON NUMBER - Pursuant to the I.aws of Mianesota, 1984, Chapter $02, rUticle 8, Secflon 2(270.72) (Tar Cleazance; Issuaz�ce of Licenses), licensing authorities are requued to provide to We State of Mivaesota Comcnissionet of Revenue, the Minnesota business tax identification oumber and the social security number of each license applicant. Under the Minnesot� Govemrz�eni Data Practices Act and the Fedaral Pitvacy Act of 1974, we aze required ta a3vise you of the faliowing regazding the use of the Minnesota Tax Idendfication Number: . -11us information may be used [o deny the issuance or renewal of yev[!icense in the event you owe Minnesota sates, employei s withholding or motor velucle excise taxes; - Upon ieceiving this information, the licensing autharity will supply ii only to the Minnesata Department of Revenue. However, under the Federal Exchange of Informaflon Agreement, the Department of Revenue may supply this information to the Intemal Revenue Service. Minnesota Taz IdeutificaGon Numbers (Sales & Use Taz Number) may be obtained from [he State of Minnesota, Business Records Department, ]0 River Pazk Plaza (612-296-6181). Social Security,Number: � �� '�ZS� �6Q'7. : � Minnesota Tax Idenfification Number: ��7.�.� If a Minnesota Tax Identitication Number is not required for the business being operated, indicate so by p]acing an "X" iu the box.