97-631Presented By
Referred To
CITY
Council File # ���`
ordinance i
6reen Sheet # ���/�
RESOLUTtON
SAINT PAUL, MINNESOTA t�
Committee: Date
1
2
3
RESOLVED: That application (ID #39749) for a Gas Station, Restaurant-C, Grocery-C, and Cigacette License by
Super America Group Division of Ashland DBA SuperAmerica #4428 (Touy Eneanya, Manager)
at 232 Fairview Avenue South be and the same is hereby approved.
4
5 Requested by Department of:
6 �Ye s Navs Rbsent
7 B a e� V
6 Bostr� _m � �— Off+ce of License Ingy�ections and
9 Har zs
10 Me ar � Environmental Protection
12 T une
14 Morton � � , � � �
15
16 Adopted by Council: Date a q BY=
17
18 Adoption Certified by Council Secretary
19 Form Approved by City Attorney
20
21 By: _ �,
22 By '
23 Approved by Mayor: Date � S�
24
25 Approved by Mayor £or Submisaion to
Z6 BY. � Council
27 ,
By:
c.'1e \
DEPARTMENT/OFFICE/COUNCI� DATE�NRIATED GREEN SHEE N� 35318
LIEP/Licensing -- -
CqNTACTPERSONBPHONE �DEPARiMENTDIRECTORNRIAIJDATE ❑Cm �� C � INfTIAVDATE
Christine Ro2ek, 266-9108 ^�'�" �crrcnrrotwer �crrrc�uc
MU5i BE ON COUNCIL ACaENDA BY (DATE NUYBEfl ROfl O BUOGET DIRECTOR � FIN. & MGT. SERVICES Diq.
p0UT1NG
FOZ hearin : '(.� Q1 ��� Q�YOfl (Ofl ASSISTANT) �
TOTAL # OF SIGNANRE PAQES (CUP AlL LOCATIONS FOR SIGNATURE)
ACfION REQUE5TED:
The SuperAmerica Group Division of Ashland DBA SuperAmerica ��4428 requests Council
approval of its application for a Gas Station, Restaurant-C, Crocery-C and Cigarette
License located at 232 Fairview Avenue South (ID �k39749).
RECOMMENDA7iONS: Approva (A) a Rejecl (R) pERSONAL SERYICE CANTRACTS MUST ANSW ER THE FOLLOWING QUESTION5:
_ PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �� Has this perwn/firm ever worketl urwer a coMract for this departrnent? �
_ CIB COMMITTEE _ YES �NO
—�� — 2. Has this person/firm ever been a City employee?
YES NO
._ oiS7nicr CAUa7 _ 3. Does this persoNfirm possess a skiil not normally possessetl by any curceM c'rty empiqree?
SUPPOfiTS WHICH CAUNCIL OBJECTIVE? YES NO '
Explain al{ yea nnswers on separete sMeet antl ettaeh to green sheet
INITIATMIG PROBLEM. ISSLLE.OPPOATUNITY (Who, WAat. Wf�en. Where. Why):
ADVANTA(`aES IFAPPROVED: '
DISAWANTAGES IF APPROVED:
1 °a �,n
'm-:�'euL: 4 ,. ' .-..s;<.,,:;y
. ... �_. _ .,-a��y.
E�4�` � � a���
DISADVANTAGES IF NOT APPROVED:
TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETEU (CIRCLE ONE) YES NO
FUND{HG SOURCE ACTIVI7Y NUMBER
FINqNCIAL INFOAMATION: (EXPI,AIN)
Greensheet # 35318 L.f.E.P. REVIEW CHECKLIST Date: 3/27/97 �
tn Tracke�? App'n Received J App'n Processed
License ID # 39749 License Type: Gas Station, Restaurant—C, Crocerv—C, and Ciearette
Company Name: SuperAmerica GrouD Div of Ashland DBA: SuperAmerica�14428
Business Addresss: 232 Fairview Avenue South, 105 Business Phone: 690-4658
Contact Name(Addfess: Tonv Eneanva, 232 Fairview Ave S Home Phone:
Date to CounCif Research: 55105
Public Hearing Date: � �1 ��- Labels Ordered: '�
Notice Sent to Applicant: _ District Council #: �
Notice Sent to
Date Inspections
Ward
�
Department j
City Attomey
�.
Environmental
Health
�
License
�����I
Police
�
Zoning
�"12/9�-
Comments
�• �
N.A �
o•�
Site Plan Received:_
Lease Received:
� ��
�
�.� �
MW2- 19-1997 11�98 CITY OF ST PAUL LIEP 612
e
C�,(�$$ �j CITY OF SAINT pA�7L.
o$«or�,r,�;oK
LiCENSB APPLICATION �a�,,�,
1 �ar � ��P�¢��
��a� u,o�
��,�ev�A.r,�u ��ko� � �oao, �Hr��, �� 4�, �a�n�.������z.
�IS LLC �1��� ��� �I����� �
PLEASE'fYFE ORPRINT IN Itv'IC �� -
T�pe of Licease(s) being appliad for:
CompanpName: ��►�N j(../4 Wli KIG`A
Corpontioa! Pettnert6i.p / sok i�opri�t�rship
If busaness is incatparaced, pive date of in�ipora,tion: _
Doiag B�isiness As; � �. l� .� �
���aaar�:�3� .5�a-� �j ui,r
14.
G-��. -
>'3\
$��n�: � � L -bqa-ybS�
ssius
sxa.aderc� ciry
BCIWCCII Whfli CtOSS sh'eet5 1S ihe bt15lne55 lOCflt2d?
Are the premises no� occupied7 Whaz Type of B�iuess?
�xe��= P a a�u � �uo � Lexi N��t
�� �
Applicant tnforc
Namt aud Tifle_
jiave an
saa �Yiam� tas�ad) �n rak '
Home Address: ��l Q �„� �U Q t�- -- -
svea nedn5e c;ry s�,te yp
Aate ofBirtfi: 1�.. (e -(� � Piace af Birth: Aome Phone;�` 3 S� ��3
Ha�e you ever baea comictcd of's¢p felom�, aime os vioiation of Rny city ordin�ce ofher than traffic? Y£S _ NO,�_
Date of alrest: Wherel
Charge:
Coaviotio¢: Senteace:
list�ht neaxs �d residences of ttuee persons of good motal charactu, &ving within tbe Twiu Cities Meuv Area, aot rdated to the apptieant
oz fiaazuaally interested'm the premises or buriness, who may be rcfared k� as to the applicauY's character.
Q NAME -/� ADDRESS PHONE
DAA� l�1bQ,ii,� S— 147��—�IaND S'7:S .�1-�}�.�. G/�.�13L-S3��
��
�10�a, f07�1tf]y Ilel� Or
Hsve �'of the above named
V l�I•
Stat� Zep
WIllCl2 S1�G OISIIC SKGGI�
S! 2
n". z�r
fwL-4u/ L��.
YES � ISO Tf ycs, list the dat�s and xesoiss fox revocatioa:
2'18N7
MAR -19-1997 11�98 CITY OF ST PAUL LIEP 612 266 9124 P.�4i06
�t��a3�
Azeyrougoing;ooperucthisbusiaess�asonslly? YES �NOlfnot,�choKil3operete
w�� �u
xox aae.ee� seG Wc —... C:.�• su7c zi� Phox �,rnsrr
Ax�r� �mg to ��e a�ger oicss:�at in ilris bvsiaess? YES :�i0 Tf tbe msaager is not tLe szme €s tLe operator,
��
r ., . • - -
info:matioa fac each parmer jvse additional paga if naessffiy):
xoaeaddmt: 5rvu\ame C,rty Swc ZiP PEone:'�S�bcr
Fc�e�me '..SddkInitid (�iridcn) La Ds+eef8uth
Hom�.ad&w: saea?w�e Cry suu Zip Phox!�'usba
MINI�S07A I'AX IDENTIFICATION NUMBER - P�usuaat to thc Law•s of 2.�finaesota,1984, Chapter 502,.4rticle 8, Sectioa 2(270.72}
(Ta� Cleatance; Issuance of Licenses)> &eensing surhorities zre requfred to pmvide to the State of Mmnesota Commissioner of Reveaue. the
�ta bvsiaess tsx idenvEcation numba add the social sxwiry a�ber of cach &crnse applicaut
Under the M�naesot� Governmcat Data Yractices Aa ��e Frdernl Pricacg Act of t 974, we me requiraI to advise qou of the follav.ing
regardingtheuse oftlze Mmnesota TscIdeottification2�umba:
- This infamation msq be used to dcap efie i�a�... a reaewat af pour Iiccuse in the ovtut you owe Muwesota sales, emplay� s
withholding a mot� vebicle exase taee�
- Upon receivmg $ris uda�maao� the Iicensiag aumoriry w�l supply it oaIy to t�e Mu�s�esota AtParm�eat of Revmua However,
uuda the Fedeisl Ex�gt of In€ormarioa Agre�men� the Dep�tmmt of Rcvenue maY sa�PlY this informa6ou w the Smernal
Revwme Seivica � _
Mmn� Tsx IdmuSr�onNumbas (Sa1es & Use Tax N�ttnbc) msybe obtamed from �e S�au of Mmnesota, Busirxss Records Depaztmcnt.
lORivcParkPlazaCbl2-296-bt81} .. ... . ' / - y t
soaa3 se�ity N�v�r �(�, /__5� /� �J _ k�n�ot? rax Ta�tification rr�t+er: ; l,�E 7�?.� JS
ffa NFianesota Tix Idrntificaaoa Number is aot required for the businas bcing operated, iadioate so by placing aa'X" ia ske brn�
�„e��
Plczse list your emplocmeat histrny far the prc«ou five (5); euperiod:
Lis� zll oL�er a.5cas of the co:po: ztion:
0�� TT� Hpiv�E HO.V,£ BUSE.*ESS DATE OF
:.*A.�4�.. (O�aHt}d) � AD7}2ES5 PHO�'E PHOIv'E BIRTF3
Presented By
Referred To
CITY
Council File # ���`
ordinance i
6reen Sheet # ���/�
RESOLUTtON
SAINT PAUL, MINNESOTA t�
Committee: Date
1
2
3
RESOLVED: That application (ID #39749) for a Gas Station, Restaurant-C, Grocery-C, and Cigacette License by
Super America Group Division of Ashland DBA SuperAmerica #4428 (Touy Eneanya, Manager)
at 232 Fairview Avenue South be and the same is hereby approved.
4
5 Requested by Department of:
6 �Ye s Navs Rbsent
7 B a e� V
6 Bostr� _m � �— Off+ce of License Ingy�ections and
9 Har zs
10 Me ar � Environmental Protection
12 T une
14 Morton � � , � � �
15
16 Adopted by Council: Date a q BY=
17
18 Adoption Certified by Council Secretary
19 Form Approved by City Attorney
20
21 By: _ �,
22 By '
23 Approved by Mayor: Date � S�
24
25 Approved by Mayor £or Submisaion to
Z6 BY. � Council
27 ,
By:
c.'1e \
DEPARTMENT/OFFICE/COUNCI� DATE�NRIATED GREEN SHEE N� 35318
LIEP/Licensing -- -
CqNTACTPERSONBPHONE �DEPARiMENTDIRECTORNRIAIJDATE ❑Cm �� C � INfTIAVDATE
Christine Ro2ek, 266-9108 ^�'�" �crrcnrrotwer �crrrc�uc
MU5i BE ON COUNCIL ACaENDA BY (DATE NUYBEfl ROfl O BUOGET DIRECTOR � FIN. & MGT. SERVICES Diq.
p0UT1NG
FOZ hearin : '(.� Q1 ��� Q�YOfl (Ofl ASSISTANT) �
TOTAL # OF SIGNANRE PAQES (CUP AlL LOCATIONS FOR SIGNATURE)
ACfION REQUE5TED:
The SuperAmerica Group Division of Ashland DBA SuperAmerica ��4428 requests Council
approval of its application for a Gas Station, Restaurant-C, Crocery-C and Cigarette
License located at 232 Fairview Avenue South (ID �k39749).
RECOMMENDA7iONS: Approva (A) a Rejecl (R) pERSONAL SERYICE CANTRACTS MUST ANSW ER THE FOLLOWING QUESTION5:
_ PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �� Has this perwn/firm ever worketl urwer a coMract for this departrnent? �
_ CIB COMMITTEE _ YES �NO
—�� — 2. Has this person/firm ever been a City employee?
YES NO
._ oiS7nicr CAUa7 _ 3. Does this persoNfirm possess a skiil not normally possessetl by any curceM c'rty empiqree?
SUPPOfiTS WHICH CAUNCIL OBJECTIVE? YES NO '
Explain al{ yea nnswers on separete sMeet antl ettaeh to green sheet
INITIATMIG PROBLEM. ISSLLE.OPPOATUNITY (Who, WAat. Wf�en. Where. Why):
ADVANTA(`aES IFAPPROVED: '
DISAWANTAGES IF APPROVED:
1 °a �,n
'm-:�'euL: 4 ,. ' .-..s;<.,,:;y
. ... �_. _ .,-a��y.
E�4�` � � a���
DISADVANTAGES IF NOT APPROVED:
TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETEU (CIRCLE ONE) YES NO
FUND{HG SOURCE ACTIVI7Y NUMBER
FINqNCIAL INFOAMATION: (EXPI,AIN)
Greensheet # 35318 L.f.E.P. REVIEW CHECKLIST Date: 3/27/97 �
tn Tracke�? App'n Received J App'n Processed
License ID # 39749 License Type: Gas Station, Restaurant—C, Crocerv—C, and Ciearette
Company Name: SuperAmerica GrouD Div of Ashland DBA: SuperAmerica�14428
Business Addresss: 232 Fairview Avenue South, 105 Business Phone: 690-4658
Contact Name(Addfess: Tonv Eneanva, 232 Fairview Ave S Home Phone:
Date to CounCif Research: 55105
Public Hearing Date: � �i ��- Labels Ordered: '�
Notice Sent to Applicant: _ District Council #: �
Notice Sent to
Date Inspections
Ward
�
Department j
City Attomey
�.
Environmental
Health
�
License
�����I
Police
�
Zoning
�"12/9�-
Comments
�• �
N.A �
o•�
Site Plan Received:_
Lease Received:
� ��
�
�.� �
MW2- 19-1997 11�98 CITY OF ST PAUL LIEP 612
e
C�,(�$$ �j CITY OF SAINT pA�7L.
o$«or�,r,�;oK
LiCENSB APPLICATION �a�,,�,
1 �ar � ��P�¢��
��a� u,o�
��,�ev�A.r,�u ��ko� � �oao, �Hr��, �� 4�, �a�n�.������z.
�IS LLC �1��� ��� �I����� �
PLEASE'fYFE ORPRINT IN Itv'IC �� -
T�pe of Licease(s) being appliad for:
CompanpName: �Sl4N 1�../4 Wli KIG`A
Corpontioa! Pettnert6i.p / sok i�opri�t�rship
If busaness is incatparaced, pive date of in�ipora,tion: _
Doiag B�isiness As; � �. l� .� �
���aaar�:�3� .5�a-� �j ui,r
14.
G-��. -
>'3\
$��n�: � � L -bqa-ybS�
ssius
sxa.aderc� ciry
BCIWCCII Whfli CtOSS sh'eet5 1S ihe bt15lne55 lOCflt2d?
Are the premises no� occupied7 Whaz Type of B�iuess?
�xe��= P a a�u � �uo � Lexi N��t
�� �
Applicant tnforc
Namt aud Tifle_
jiave an
saa �Yiam� tas�ad) �n rak '
Home Address: ��l Q �„� �U Q t�- -- -
svea nedn5e c;ry s�,te yp
Aate ofBirtfi: 1�.. (e -(� � Piace af Birth: Aome Phone;�` 3 S� ��3
Ha�e you ever baea comictcd of's¢p felom�, aime os vioiation of Rny city ordin�ce ofher than traffic? Y£S _ NO,�_
Date of alrest: Wherel
Charge:
Coaviotio¢: Senteace:
list�ht neaxs �d residences of ttuee persons of good motal charactu, &ving within tbe Twiu Cities Meuv Area, aot rdated to the apptieant
oz fiaazuaally interested'm the premises or buriness, who may be rcfared k� as to the applicauY's character.
Q NAME -/� ADDRESS PHONE
DAA� l�1bQ,ii,� S— 147��—�IaND S'7:S .�1-�}�.�. G/�.�13L-S3��
��
�10�a, f07�1tf]y Ilel� Or
Hsve �'of the above named
V l�I•
Stat� Zep
WIllCl2 S1�G OISIIC SKGGI�
S! 2
n". z�r
fwL-4u/ L��.
YES � ISO Tf ycs, list the dat�s and xesoiss fox revocatioa:
2'18N7
MAR -19-1997 11�98 CITY OF ST PAUL LIEP 612 266 9124 P.�4i06
�t��a3�
Azeyrougoing;ooperucthisbusiaess�asonslly? YES �NOlfnot,�choKil3operete
w�� �u
xox aae.ee� seG Wc —... C:.�• su7c zi� Phox �,rnsrr
Ax�r� �mg to ��e a�ger oicss:�at in ilris bvsiaess? YES :�i0 Tf tbe msaager is not tLe szme €s tLe operator,
��
r ., . • - -
info:matioa fac each parmer jvse additional paga if naessffiy):
xoaeaddmt: 5rvu\ame C,rty Swc ZiP PEone:'�S�bcr
Fc�e�me '..SddkInitid (�iridcn) La Ds+eef8uth
Hom�.ad&w: saea?w�e Cry suu Zip Phox!�'usba
MINI�S07A I'AX IDENTIFICATION NUMBER - P�usuaat to thc Law•s of 2.�finaesota,1984, Chapter 502,.4rticle 8, Sectioa 2(270.72}
(Ta� Cleatance; Issuance of Licenses)> &eensing surhorities zre requfred to pmvide to the State of Mmnesota Commissioner of Reveaue. the
�ta bvsiaess tsx idenvEcation numba add the social sxwiry a�ber of cach &crnse applicaut
Under the M�naesot� Governmcat Data Yractices Aa ��e Frdernl Pricacg Act of t 974, we me requiraI to advise qou of the follav.ing
regardingtheuse oftlze Mmnesota TscIdeottification2�umba:
- This infamation msq be used to dcap efie i�a�... a reaewat af pour Iiccuse in the ovtut you owe Muwesota sales, emplay� s
withholding a mot� vebicle exase taee�
- Upon receivmg $ris uda�maao� the Iicensiag aumoriry w�l supply it oaIy to t�e Mu�s�esota AtParm�eat of Revmua However,
uuda the Fedeisl Ex�gt of In€ormarioa Agre�men� the Dep�tmmt of Rcvenue maY sa�PlY this informa6ou w the Smernal
Revwme Seivica � _
Mmn� Tsx IdmuSr�onNumbas (Sa1es & Use Tax N�ttnbc) msybe obtamed from �e S�au of Mmnesota, Busirxss Records Depaztmcnt.
lORivcParkPlazaCbl2-296-bt81} .. ... . ' / - y t
soaa3 se�ity N�v�r �(�, /__5� /� �J _ k�n�ot? rax Ta�tification rr�t+er: ; l,�E 7�?.� JS
ffa NFianesota Tix Idrntificaaoa Number is aot required for the businas bcing operated, iadioate so by placing aa'X" ia ske brn�
�„e��
Plczse list your emplocmeat histrny far the prc«ou five (5); euperiod:
Lis� zll oL�er a.5cas of the co:po: ztion:
0�� TT� Hpiv�E HO.V,£ BUSE.*ESS DATE OF
:.*A.�4�.. (O�aHt}d) � AD7}2ES5 PHO�'E PHOIv'E BIRTF3
Presented By
Referred To
CITY
Council File # ���`
ordinance i
6reen Sheet # ���/�
RESOLUTtON
SAINT PAUL, MINNESOTA t�
Committee: Date
1
2
3
RESOLVED: That application (ID #39749) for a Gas Station, Restaurant-C, Grocery-C, and Cigacette License by
Super America Group Division of Ashland DBA SuperAmerica #4428 (Touy Eneanya, Manager)
at 232 Fairview Avenue South be and the same is hereby approved.
4
5 Requested by Department of:
6 �Ye s Navs Rbsent
7 B a e� V
6 Bostr� _m � �— Off+ce of License Ingy�ections and
9 Har zs
10 Me ar � Environmental Protection
12 T une
14 Morton � � , � � �
15
16 Adopted by Council: Date a q BY=
17
18 Adoption Certified by Council Secretary
19 Form Approved by City Attorney
20
21 By: _ �,
22 By '
23 Approved by Mayor: Date � S�
24
25 Approved by Mayor £or Submisaion to
Z6 BY. � Council
27 ,
By:
c.'1e \
DEPARTMENT/OFFICE/COUNCI� DATE�NRIATED GREEN SHEE N� 35318
LIEP/Licensing -- -
CqNTACTPERSONBPHONE �DEPARiMENTDIRECTORNRIAIJDATE ❑Cm �� C � INfTIAVDATE
Christine Ro2ek, 266-9108 ^�'�" �crrcnrrotwer �crrrc�uc
MU5i BE ON COUNCIL ACaENDA BY (DATE NUYBEfl ROfl O BUOGET DIRECTOR � FIN. & MGT. SERVICES Diq.
p0UT1NG
FOZ hearin : '(.� Q1 ��� Q�YOfl (Ofl ASSISTANT) �
TOTAL # OF SIGNANRE PAQES (CUP AlL LOCATIONS FOR SIGNATURE)
ACfION REQUE5TED:
The SuperAmerica Group Division of Ashland DBA SuperAmerica ��4428 requests Council
approval of its application for a Gas Station, Restaurant-C, Crocery-C and Cigarette
License located at 232 Fairview Avenue South (ID �k39749).
RECOMMENDA7iONS: Approva (A) a Rejecl (R) pERSONAL SERYICE CANTRACTS MUST ANSW ER THE FOLLOWING QUESTION5:
_ PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �� Has this perwn/firm ever worketl urwer a coMract for this departrnent? �
_ CIB COMMITTEE _ YES �NO
—�� — 2. Has this person/firm ever been a City employee?
YES NO
._ oiS7nicr CAUa7 _ 3. Does this persoNfirm possess a skiil not normally possessetl by any curceM c'rty empiqree?
SUPPOfiTS WHICH CAUNCIL OBJECTIVE? YES NO '
Explain al{ yea nnswers on separete sMeet antl ettaeh to green sheet
INITIATMIG PROBLEM. ISSLLE.OPPOATUNITY (Who, WAat. Wf�en. Where. Why):
ADVANTA(`aES IFAPPROVED: '
DISAWANTAGES IF APPROVED:
1 °a �,n
'm-:�'euL: 4 ,. ' .-..s;<.,,:;y
. ... �_. _ .,-a��y.
E�4�` � � a���
DISADVANTAGES IF NOT APPROVED:
TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETEU (CIRCLE ONE) YES NO
FUND{HG SOURCE ACTIVI7Y NUMBER
FINqNCIAL INFOAMATION: (EXPI,AIN)
Greensheet # 35318 L.f.E.P. REVIEW CHECKLIST Date: 3/27/97 �
tn Tracke�? App'n Received J App'n Processed
License ID # 39749 License Type: Gas Station, Restaurant—C, Crocerv—C, and Ciearette
Company Name: SuperAmerica GrouD Div of Ashland DBA: SuperAmerica�14428
Business Addresss: 232 Fairview Avenue South, 105 Business Phone: 690-4658
Contact Name(Addfess: Tonv Eneanva, 232 Fairview Ave S Home Phone:
Date to CounCif Research: 55105
Public Hearing Date: � �i ��- Labels Ordered: '�
Notice Sent to Applicant: _ District Council #: �
Notice Sent to
Date Inspections
Ward
�
Department j
City Attomey
�.
Environmental
Health
�
License
�����I
Police
�
Zoning
�"12/9�-
Comments
�• �
N.A �
o•�
Site Plan Received:_
Lease Received:
� ��
�
�.� �
MW2- 19-1997 11�98 CITY OF ST PAUL LIEP 612
e
C�,(�$$ �j CITY OF SAINT pA�7L.
o$«or�,r,�;oK
LiCENSB APPLICATION �a�,,�,
1 �ar � ��P�¢��
��a� u,o�
��,�ev�A.r,�u ��ko� � �oao, �Hr��, �� 4�, �a�n�.������z.
�IS LLC �1��� ��� �I����� �
PLEASE'fYFE ORPRINT IN Itv'IC �� -
T�pe of Licease(s) being appliad for:
CompanpName: �Sl4N 1�../4 Wli KIG`A
Corpontioa! Pettnert6i.p / sok i�opri�t�rship
If busaness is incatparaced, pive date of in�ipora,tion: _
Doiag B�isiness As; � �. l� .� �
���aaar�:�3� .5�a-� �j ui,r
14.
G-��. -
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Are the premises no� occupied7 Whaz Type of B�iuess?
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Applicant tnforc
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Home Address: ��l Q �„� �U Q t�- -- -
svea nedn5e c;ry s�,te yp
Aate ofBirtfi: 1�.. (e -(� � Piace af Birth: Aome Phone;�` 3 S� ��3
Ha�e you ever baea comictcd of's¢p felom�, aime os vioiation of Rny city ordin�ce ofher than traffic? Y£S _ NO,�_
Date of alrest: Wherel
Charge:
Coaviotio¢: Senteace:
list�ht neaxs �d residences of ttuee persons of good motal charactu, &ving within tbe Twiu Cities Meuv Area, aot rdated to the apptieant
oz fiaazuaally interested'm the premises or buriness, who may be rcfared k� as to the applicauY's character.
Q NAME -/� ADDRESS PHONE
DAA� l�1bQ,ii,� S— 147��—�IaND S'7:S .�1-�}�.�. G/�.�13L-S3��
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Hsve �'of the above named
V l�I•
Stat� Zep
WIllCl2 S1�G OISIIC SKGGI�
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YES � ISO Tf ycs, list the dat�s and xesoiss fox revocatioa:
2'18N7
MAR -19-1997 11�98 CITY OF ST PAUL LIEP 612 266 9124 P.�4i06
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Azeyrougoing;ooperucthisbusiaess�asonslly? YES �NOlfnot,�choKil3operete
w�� �u
xox aae.ee� seG Wc —... C:.�• su7c zi� Phox �,rnsrr
Ax�r� �mg to ��e a�ger oicss:�at in ilris bvsiaess? YES :�i0 Tf tbe msaager is not tLe szme €s tLe operator,
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r ., . • - -
info:matioa fac each parmer jvse additional paga if naessffiy):
xoaeaddmt: 5rvu\ame C,rty Swc ZiP PEone:'�S�bcr
Fc�e�me '..SddkInitid (�iridcn) La Ds+eef8uth
Hom�.ad&w: saea?w�e Cry suu Zip Phox!�'usba
MINI�S07A I'AX IDENTIFICATION NUMBER - P�usuaat to thc Law•s of 2.�finaesota,1984, Chapter 502,.4rticle 8, Sectioa 2(270.72}
(Ta� Cleatance; Issuance of Licenses)> &eensing surhorities zre requfred to pmvide to the State of Mmnesota Commissioner of Reveaue. the
�ta bvsiaess tsx idenvEcation numba add the social sxwiry a�ber of cach &crnse applicaut
Under the M�naesot� Governmcat Data Yractices Aa ��e Frdernl Pricacg Act of t 974, we me requiraI to advise qou of the follav.ing
regardingtheuse oftlze Mmnesota TscIdeottification2�umba:
- This infamation msq be used to dcap efie i�a�... a reaewat af pour Iiccuse in the ovtut you owe Muwesota sales, emplay� s
withholding a mot� vebicle exase taee�
- Upon receivmg $ris uda�maao� the Iicensiag aumoriry w�l supply it oaIy to t�e Mu�s�esota AtParm�eat of Revmua However,
uuda the Fedeisl Ex�gt of In€ormarioa Agre�men� the Dep�tmmt of Rcvenue maY sa�PlY this informa6ou w the Smernal
Revwme Seivica � _
Mmn� Tsx IdmuSr�onNumbas (Sa1es & Use Tax N�ttnbc) msybe obtamed from �e S�au of Mmnesota, Busirxss Records Depaztmcnt.
lORivcParkPlazaCbl2-296-bt81} .. ... . ' / - y t
soaa3 se�ity N�v�r �(�, /__5� /� �J _ k�n�ot? rax Ta�tification rr�t+er: ; l,�E 7�?.� JS
ffa NFianesota Tix Idrntificaaoa Number is aot required for the businas bcing operated, iadioate so by placing aa'X" ia ske brn�
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Plczse list your emplocmeat histrny far the prc«ou five (5); euperiod:
Lis� zll oL�er a.5cas of the co:po: ztion:
0�� TT� Hpiv�E HO.V,£ BUSE.*ESS DATE OF
:.*A.�4�.. (O�aHt}d) � AD7}2ES5 PHO�'E PHOIv'E BIRTF3