97-637Council File # _`�`� J
Ordinance #
Green Sheet # � ��
Referred To
�; , �
Presented By
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
�
Committee: Date
1
2
3
RESOLVED: That application (ID #43299) for a Gas Station, Restaurant-C, Gtocery-C, and Cigarette License by
Super America Group Division of Asliland DBA SuperAmerica #f4359 (Irma Thomas, Manager) at
950 Lexington Avenue North be and the same is hereby approved.
4
5 Requested by Department of:
7 B a e�Tc � — Yeas Na�s b3e
1
8 Bostrom � _��
9 Hars
10 e a �
11
12 T ane
13 Morton
14
15
16 Adapted by Council: Date �1�� V ��'"I
17 �
18 Adoption Certified by Council Secretary
19
20
21 Byc
22
23 ApF
24
25
26 By:
27
• - - -- - -
R •tii ' •t
BY: �1/�"V`^"�" �- f`^'l,u._-- –
Rorm Approved hy City Attorney
By'
Approved by Mayor for Submission to
Council
�
����.,.
DEPl1RTMENTAFFICFICOUNGL DATE 1NI5IATED � � a� � �
LIEPJLicensin GREEN SHEE
CONTACTPERSON&PMONE WIT�AV�ATE _ INRIAVDPTE
O DEPAflTMENTDIRECfOR � CffYCOUNCIL
Christine Rozek, 266-9108 ��GN �CRVATfORNEY Darvc�aK
NUMBEAFOR
MUSTEE ON COUNCILAGENDA BY (DATE) ROUTING � BUDGET DIRECTOR � FIN. & MGT. SERVICES DIR.
ONDEH MpYOR (OR ASSISTAN�
For hearin : � � � �
TOTAL # OF SiGNATURE PAGES (CLIP ALL IOCATtONS FOR SIGNATURE)
AGTION flEQUESTED:
The SuperAmerica Group Division of Ashland DBA SuperAmerica 4i4359 requests Council approva
of its application for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License
located at 950 Lexington � North (ID 0�43299).
RECAMMENDaiIONS: Appmve (AJ or Reject (R) pEpSONAL SEHVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTION5:
_ PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �� Has this perso�rtn ever wo�ked under a contract for this tlepartment?
_ Cf8 GOMMITTEE _ YES �NO
2. Has this personttirtn ever been a city amployee?
_ STAFF — YES NO
.� o�s7a�ci cOUxr _ 3. �oes this persoNfirm possess a skill not normally possessed Dy any current ciry employee?
SUPPOF(TS WHICH COUNGIL OBJECTIVE? YES NO
Explafn all yes anawers on separete sMeet anC attach to green sheet
INITIATING PFOBLEM, ISSUE, OPP�flTUNITY (Who, What, When. Where. Why):
ADVANTAGESIFAPPROVED:
DISADVANTAGES IF APPFOVED�
' �� p�,�.
�v:'.w':. _.. , .� ..,. �e.%�Y.Ofi:ra
p. r •.. �} R � Q
lii}'°�'� 1 f:t i�.tv
� _ .._.....,.--�:t
DISAWAMAGE6 IF NOT APPROVED� -
��v���3 ��
MA� 12 19g�
J�� ���"���
TOTAL AMOUNT OF TRANSACTION S COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
FUNDIfiG SOURCE ACTIVITY NUMBER
FINANCIAL INFORFSATION: (EXPLAIN)
Greensheet # 37938
In Tracken
�icense lD # 43299
L.I.E.P. REVIEW CHECKLIST Date: 3/27/97 /���
ApP n Received / ApP'n Processed
Lic2nse Type: Gas Station, Restaurant—C, Grocery—C, and CiQarette Lic
Company Neme: 5uperAmerica Group Division of Ashland DBA: SunerAmerica �t4359
Business Addresss: 450 Lexington Pkwy No BusinesS Phone: 487-9488
Contact Name/Address: Irma Thomas, 950 Lexington Pkwy N Home Phone:
Date to Council Research: 55103
Public Hearing Date: � Z�' ��' Labels Ordered: lf�
Notice Sent to Applicant: District Councii #:
_ � _
�-���. �1 �
Notice Sent to Public: � 7��� Ward #:
Department/ Date Inspections Comments
City Attorney
v�2 °/'a- p .`� •
Environmental
Health
N.
Fire
�'z � �,�.
License site �an aeceived:_
tsase �;�ed:
�� Cj� �� � lL/
b
Police
2 ��- .� .
Zoning
� Z q�- Q. � .
a'�-b'3'i
MAR-19-1997 11�0$ CI'(Y OF ST PR..P�. LIEP 612 2 ��c� 9124 P.02/06
. °.__ ---ti . �Y �-f�.-�99
��,�5 � CITX OF SAINT PAI1I.
o�a�u«�,t�«ao�
A LICENSE APPLdCATION � � ��
1 -�'ar ` ��P��.��
�� �����
� i ao ��3, �, 4�3z, ���������s
�y+�c��t � f �° ' s �
S � c�, '��' ' �� ��4'�t, �ts �-�"
PLEASE'FYPE ORPRTt3T IN II.RC �b
rcpe of License(s> being applied tor:
CampffiyName: .��}r 1f� R WlL KI G`�
Corpontion IPa4t�ap / Sale FYoprictorskip
If business is incotporated, give date of incotporarion: _
DoinB �usiness As: � Vl�� �G � Wl� �R! (�+�
$usmess Address: �D %�/- I�Q�t/ �,! w �
G-aa. 3
Strmt Addxu c;ry
Betwtess wLat cross sheeTS is ihe bvsiness located?
Ar� tix premises now occupied? Whaf Type ofBusiness?
� ro .��: p 0� UXi t t1uU �C l.e x i N4�
�� �
AppGcaaz Infom
Name snd Tii2c:
�
� �1r�4-/
BusinessPhone�/2 • YS� 9 �8
M.� SS. �3
sw� zep
Whicll side of the 5[rert?
., yast
� n... � �
_ I� . I .A .
F'urt � '.�.fiddle (Maidea) l._' F�sl -'_""_ Trtk
HOIDC P.(id7C5S: � C� L� V�� U U� _ .
StRet ad�s City Stete Zip
Date of Birth: 1 ��(s � L 7 Place of $irtti Home Phone�a(J f. 3 S7 :� z�,3
Have yon c,wer beea comicud of mry felcmy, crimE or violatitm of any aty ordinance other than taffic? YES NO �_
Date of azrest; Where?
��5�
Coaviction: Scnta3a:
7-ist thCnsmes and msidences of three persons of good moral chm�ctt , fiving within ihe Twiu Cities Mehro Area, not rclazed to the appIicant
a fina�ciaily interested m ihe premises or basiness, who may be refared ro as to the applicanf's chsracter:
$�i�c� �O�RAL� S 14 �„� p—y� 0 S7.'S . �1-�}�ti .�1� `�36-533 j
�A�v CH I �P �I �n — )IoJt ►- � 9�1a�. S� �u ti_v_ _ - N��v��: �l; t� b � a • 633_
2-
�r�.� ���e �,���a
f��r�b��a.or
been revokedT
;�t«��:
YES � NO Ifyes, list tIu dates and reasons for r�ocarioa:
2/18N7
MAR-19-1997 11�08 CITY OF ST PAUL LIFP
612 266 9124 P.94i06
��1 b'3�
Are }rou gcring �o operr�c this busiaess pesoaatly? YES �?�7 ICAOt, k'7f0 a71I O�CFEIC J�PI�.R AMEKIi,[i GKOIT�
Div' '
�,,,���x �sa� �a ��> � P.O. Box 1 t300�" °f a �''`
H�x xae.� scza �.ae
Cr•
Arcrmag�to'cnea�znzgerc¢ess,�tinilsssSs:siuess? YES
plPZSC waplete th� foL� ing uu`ormr.tion:
�v /CI V �
s�
PJ�u li4 your emplo;ment his[ory for the prc�na:LS five (5) ceas period:
a„�slE qIqp7o�ment Address
�
;i0 I£the msaaga is twt the szaie fs Uu operator,
S�
Datc
� V,
infcr.mation fa each parma (use additicnal gaga if necessffiy)_
xvxaaare� sron�m+e Gcv sLuc Zip Phwe:'mbc
Fi�t�amc �ddS<� (-�S+ida) Lssc Dattef8'uth
HomeAdh+'�t� Saas:<+�e Gry Stau Zip �none:.'uaLa
2�l�ThES�TA TAX IIlEN17FICA?IO1�I NUMBER - P��nt ta tho Laas of M�auesota, i984, Chapter 502, Article 8, Scetioa 2(270.72)
(ia� Cieareaa; Iswance of Licenses},liansing aurhoxi$es are required to provide to tbe State of Mtunes�ta Commissioaer of Reveaue, the
Ivfvaaasota busiarss tae identi5cation numba aad tha socisl se�airy wmber of caeh &ceose applicant
Under the Mmaesotz Govaz�art Data Aactioes Aa apd tl�e Fedaal Pricacy Ad of f 97d, we ffie requSred to advise you ofthe follaN�ng
regarding t�t use ad'the Mumaota Troc Ideetificatiou Numba:
_�his infamatiou msq be used to dtap the :K or reaewsf oFyocu iiccssc iar tfie rvcat you owe Mwn�sota sa]es, employ� s
wicbholdvag a motnc vet�icle «cise tsxe�
- uPon rc�vm8 tlas inf'ams6an, She Gceusiag sat�ity ws�l suppty it oaty to tha Minnesota 1hPsrtment of Revmne. Howewer,
wda the Federal �gt of Snformatian Agrcement tbe IkPmtm°u of Reveeue maY ?�PP1Y this iuf'ormatian to the 7ateraal
Revwue Seivim
M�s Tax Ia�tiseffiica Numbas (sates & Use T�eNua�'3mayte � from ex state of N�n�sote, susiucss R�ras DcpazimcnT,
]ORiverPcrkPlazx(b12-296-6181�. . _ .. .
s�� s�� r�uu� /— G! a-a-�S G_�� r� aa�,;s�v� rr��: �•� 9�13 �SS
^ If a NGnaeso'� Tsx IdrrniScarioa I3umba is aot requ"u� fa flx businas beiag operated, indicato so by placiag aa `X" ia ihe box
..,, e �.,
List a11 otha o�cas of the ccttpo: ctioa:
p�FiCER 'FI'17..E I30?.7E HO.V,� BUSL'.'ESS DATE OF
,aa t�,rc �n,Y,�r Heu� . ADI]kE55 PHO\'E PHOA� BIATH
Council File # _`�`� J
Ordinance #
Green Sheet # � ��
Referred To
�; , �
Presented By
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
�
Committee: Date
1
2
3
RESOLVED: That application (ID #43299) for a Gas Station, Restaurant-C, Gtocery-C, and Cigarette License by
Super America Group Division of Asliland DBA SuperAmerica #f4359 (Irma Thomas, Manager) at
950 Lexington Avenue North be and the same is hereby approved.
4
5 Requested by Department of:
7 B a e�Tc � — Yeas Na�s b3e
1
8 Bostrom � _��
9 Hars
10 e a �
11
12 T ane
13 Morton
14
15
16 Adapted by Council: Date �1�� V ��'"I
17 �
18 Adoption Certified by Council Secretary
19
20
21 Byc
22
23 ApF
24
25
26 By:
27
• - - -- - -
R •tii ' •t
BY: �1/�"V`^"�" �- f`^'l,u._-- –
Rorm Approved hy City Attorney
By'
Approved by Mayor for Submission to
Council
�
����.,.
DEPl1RTMENTAFFICFICOUNGL DATE 1NI5IATED � � a� � �
LIEPJLicensin GREEN SHEE
CONTACTPERSON&PMONE WIT�AV�ATE _ INRIAVDPTE
O DEPAflTMENTDIRECfOR � CffYCOUNCIL
Christine Rozek, 266-9108 ��GN �CRVATfORNEY Darvc�aK
NUMBEAFOR
MUSTEE ON COUNCILAGENDA BY (DATE) ROUTING � BUDGET DIRECTOR � FIN. & MGT. SERVICES DIR.
ONDEH MpYOR (OR ASSISTAN�
For hearin : � � � �
TOTAL # OF SiGNATURE PAGES (CLIP ALL IOCATtONS FOR SIGNATURE)
AGTION flEQUESTED:
The SuperAmerica Group Division of Ashland DBA SuperAmerica 4i4359 requests Council approva
of its application for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License
located at 950 Lexington � North (ID 0�43299).
RECAMMENDaiIONS: Appmve (AJ or Reject (R) pEpSONAL SEHVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTION5:
_ PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �� Has this perso�rtn ever wo�ked under a contract for this tlepartment?
_ Cf8 GOMMITTEE _ YES �NO
2. Has this personttirtn ever been a city amployee?
_ STAFF — YES NO
.� o�s7a�ci cOUxr _ 3. �oes this persoNfirm possess a skill not normally possessed Dy any current ciry employee?
SUPPOF(TS WHICH COUNGIL OBJECTIVE? YES NO
Explafn all yes anawers on separete sMeet anC attach to green sheet
INITIATING PFOBLEM, ISSUE, OPP�flTUNITY (Who, What, When. Where. Why):
ADVANTAGESIFAPPROVED:
DISADVANTAGES IF APPFOVED�
' �� p�,�.
�v:'.w':. _.. , .� ..,. �e.%�Y.Ofi:ra
p. r •.. �} R � Q
lii}'°�'� 1 f:t i�.tv
� _ .._.....,.--�:t
DISAWAMAGE6 IF NOT APPROVED� -
��v���3 ��
MA� 12 19g�
J�� ���"���
TOTAL AMOUNT OF TRANSACTION S COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
FUNDIfiG SOURCE ACTIVITY NUMBER
FINANCIAL INFORFSATION: (EXPLAIN)
Greensheet # 37938
In Tracken
�icense lD # 43299
L.I.E.P. REVIEW CHECKLIST Date: 3/27/97 /���
ApP n Received / ApP'n Processed
Lic2nse Type: Gas Station, Restaurant—C, Grocery—C, and CiQarette Lic
Company Neme: 5uperAmerica Group Division of Ashland DBA: SunerAmerica �t4359
Business Addresss: 450 Lexington Pkwy No BusinesS Phone: 487-9488
Contact Name/Address: Irma Thomas, 950 Lexington Pkwy N Home Phone:
Date to Council Research: 55103
Public Hearing Date: � Z�' ��' Labels Ordered: lf�
Notice Sent to Applicant: District Councii #:
_ � _
�-���. �1 �
Notice Sent to Public: � 7��� Ward #:
Department/ Date Inspections Comments
City Attorney
v�2 °/'a- p .`� •
Environmental
Health
N.
Fire
�'z � �,�.
License site �an aeceived:_
tsase �;�ed:
�� Cj� �� � lL/
b
Police
2 ��- .� .
Zoning
� Z q�- Q. � .
a'�-b'3'i
MAR-19-1997 11�0$ CI'(Y OF ST PR..P�. LIEP 612 2 ��c� 9124 P.02/06
. °.__ ---ti . �Y �-f�.-�99
��,�5 � CITX OF SAINT PAI1I.
o�a�u«�,t�«ao�
A LICENSE APPLdCATION � � ��
1 -�'ar ` ��P��.��
�� �����
� i ao ��3, �, 4�3z, ���������s
�y+�c��t � f �° ' s �
S � c�, '��' ' �� ��4'�t, �ts �-�"
PLEASE'FYPE ORPRTt3T IN II.RC �b
rcpe of License(s> being applied tor:
CampffiyName: .��}r 1f� R WlL KI G`�
Corpontion IPa4t�ap / Sale FYoprictorskip
If business is incotporated, give date of incotporarion: _
DoinB �usiness As: � Vl�� �G � Wl� �R! (�+�
$usmess Address: �D %�/- I�Q�t/ �,! w �
G-aa. 3
Strmt Addxu c;ry
Betwtess wLat cross sheeTS is ihe bvsiness located?
Ar� tix premises now occupied? Whaf Type ofBusiness?
� ro .��: p 0� UXi t t1uU �C l.e x i N4�
�� �
AppGcaaz Infom
Name snd Tii2c:
�
� �1r�4-/
BusinessPhone�/2 • YS� 9 �8
M.� SS. �3
sw� zep
Whicll side of the 5[rert?
., yast
� n... � �
_ I� . I .A .
F'urt � '.�.fiddle (Maidea) l._' F�sl -'_""_ Trtk
HOIDC P.(id7C5S: � C� L� V�� U U� _ .
StRet ad�s City Stete Zip
Date of Birth: 1 ��(s � L 7 Place of $irtti Home Phone�a(J f. 3 S7 :� z�,3
Have yon c,wer beea comicud of mry felcmy, crimE or violatitm of any aty ordinance other than taffic? YES NO �_
Date of azrest; Where?
��5�
Coaviction: Scnta3a:
7-ist thCnsmes and msidences of three persons of good moral chm�ctt , fiving within ihe Twiu Cities Mehro Area, not rclazed to the appIicant
a fina�ciaily interested m ihe premises or basiness, who may be refared ro as to the applicanf's chsracter:
$�i�c� �O�RAL� S 14 �„� p—y� 0 S7.'S . �1-�}�ti .�1� `�36-533 j
�A�v CH I �P �I �n — )IoJt ►- � 9�1a�. S� �u ti_v_ _ - N��v��: �l; t� b � a • 633_
2-
�r�.� ���e �,���a
f��r�b��a.or
been revokedT
;�t«��:
YES � NO Ifyes, list tIu dates and reasons for r�ocarioa:
2/18N7
MAR-19-1997 11�08 CITY OF ST PAUL LIFP
612 266 9124 P.94i06
��1 b'3�
Are }rou gcring �o operr�c this busiaess pesoaatly? YES �?�7 ICAOt, k'7f0 a71I O�CFEIC J�PI�.R AMEKIi,[i GKOIT�
Div' '
�,,,���x �sa� �a ��> � P.O. Box 1 t300�" °f a �''`
H�x xae.� scza �.ae
Cr•
Arcrmag�to'cnea�znzgerc¢ess,�tinilsssSs:siuess? YES
plPZSC waplete th� foL� ing uu`ormr.tion:
�v /CI V �
s�
PJ�u li4 your emplo;ment his[ory for the prc�na:LS five (5) ceas period:
a„�slE qIqp7o�ment Address
�
;i0 I£the msaaga is twt the szaie fs Uu operator,
S�
Datc
� V,
infcr.mation fa each parma (use additicnal gaga if necessffiy)_
xvxaaare� sron�m+e Gcv sLuc Zip Phwe:'mbc
Fi�t�amc �ddS<� (-�S+ida) Lssc Dattef8'uth
HomeAdh+'�t� Saas:<+�e Gry Stau Zip �none:.'uaLa
2�l�ThES�TA TAX IIlEN17FICA?IO1�I NUMBER - P��nt ta tho Laas of M�auesota, i984, Chapter 502, Article 8, Scetioa 2(270.72)
(ia� Cieareaa; Iswance of Licenses},liansing aurhoxi$es are required to provide to tbe State of Mtunes�ta Commissioaer of Reveaue, the
Ivfvaaasota busiarss tae identi5cation numba aad tha socisl se�airy wmber of caeh &ceose applicant
Under the Mmaesotz Govaz�art Data Aactioes Aa apd tl�e Fedaal Pricacy Ad of f 97d, we ffie requSred to advise you ofthe follaN�ng
regarding t�t use ad'the Mumaota Troc Ideetificatiou Numba:
_�his infamatiou msq be used to dtap the :K or reaewsf oFyocu iiccssc iar tfie rvcat you owe Mwn�sota sa]es, employ� s
wicbholdvag a motnc vet�icle «cise tsxe�
- uPon rc�vm8 tlas inf'ams6an, She Gceusiag sat�ity ws�l suppty it oaty to tha Minnesota 1hPsrtment of Revmne. Howewer,
wda the Federal �gt of Snformatian Agrcement tbe IkPmtm°u of Reveeue maY ?�PP1Y this iuf'ormatian to the 7ateraal
Revwue Seivim
M�s Tax Ia�tiseffiica Numbas (sates & Use T�eNua�'3mayte � from ex state of N�n�sote, susiucss R�ras DcpazimcnT,
]ORiverPcrkPlazx(b12-296-6181�. . _ .. .
s�� s�� r�uu� /— G! a-a-�S G_�� r� aa�,;s�v� rr��: �•� 9�13 �SS
^ If a NGnaeso'� Tsx IdrrniScarioa I3umba is aot requ"u� fa flx businas beiag operated, indicato so by placiag aa `X" ia ihe box
..,, e �.,
List a11 otha o�cas of the ccttpo: ctioa:
p�FiCER 'FI'17..E I30?.7E HO.V,� BUSL'.'ESS DATE OF
,aa t�,rc �n,Y,�r Heu� . ADI]kE55 PHO\'E PHOA� BIATH
Council File # _`�`� J
Ordinance #
Green Sheet # � ��
Referred To
�; , �
Presented By
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
�
Committee: Date
1
2
3
RESOLVED: That application (ID #43299) for a Gas Station, Restaurant-C, Gtocery-C, and Cigarette License by
Super America Group Division of Asliland DBA SuperAmerica #f4359 (Irma Thomas, Manager) at
950 Lexington Avenue North be and the same is hereby approved.
4
5 Requested by Department of:
7 B a e�Tc � — Yeas Na�s b3e
1
8 Bostrom � _��
9 Hars
10 e a �
11
12 T ane
13 Morton
14
15
16 Adapted by Council: Date �1�� V ��'"I
17 �
18 Adoption Certified by Council Secretary
19
20
21 Byc
22
23 ApF
24
25
26 By:
27
• - - -- - -
R •tii ' •t
BY: �1/�"V`^"�" �- f`^'l,u._-- –
Rorm Approved hy City Attorney
By'
Approved by Mayor for Submission to
Council
�
����.,.
DEPl1RTMENTAFFICFICOUNGL DATE 1NI5IATED � � a� � �
LIEPJLicensin GREEN SHEE
CONTACTPERSON&PMONE WIT�AV�ATE _ INRIAVDPTE
O DEPAflTMENTDIRECfOR � CffYCOUNCIL
Christine Rozek, 266-9108 ��GN �CRVATfORNEY Darvc�aK
NUMBEAFOR
MUSTEE ON COUNCILAGENDA BY (DATE) ROUTING � BUDGET DIRECTOR � FIN. & MGT. SERVICES DIR.
ONDEH MpYOR (OR ASSISTAN�
For hearin : � � � �
TOTAL # OF SiGNATURE PAGES (CLIP ALL IOCATtONS FOR SIGNATURE)
AGTION flEQUESTED:
The SuperAmerica Group Division of Ashland DBA SuperAmerica 4i4359 requests Council approva
of its application for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License
located at 950 Lexington � North (ID 0�43299).
RECAMMENDaiIONS: Appmve (AJ or Reject (R) pEpSONAL SEHVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTION5:
_ PLANNING COMMISSION _ CIVIL SERVICE COMMISSION �� Has this perso�rtn ever wo�ked under a contract for this tlepartment?
_ Cf8 GOMMITTEE _ YES �NO
2. Has this personttirtn ever been a city amployee?
_ STAFF — YES NO
.� o�s7a�ci cOUxr _ 3. �oes this persoNfirm possess a skill not normally possessed Dy any current ciry employee?
SUPPOF(TS WHICH COUNGIL OBJECTIVE? YES NO
Explafn all yes anawers on separete sMeet anC attach to green sheet
INITIATING PFOBLEM, ISSUE, OPP�flTUNITY (Who, What, When. Where. Why):
ADVANTAGESIFAPPROVED:
DISADVANTAGES IF APPFOVED�
' �� p�,�.
�v:'.w':. _.. , .� ..,. �e.%�Y.Ofi:ra
p. r •.. �} R � Q
lii}'°�'� 1 f:t i�.tv
� _ .._.....,.--�:t
DISAWAMAGE6 IF NOT APPROVED� -
��v���3 ��
MA� 12 19g�
J�� ���"���
TOTAL AMOUNT OF TRANSACTION S COST/REVENUE BUDGETED (CIRCLE ONE) YES NO
FUNDIfiG SOURCE ACTIVITY NUMBER
FINANCIAL INFORFSATION: (EXPLAIN)
Greensheet # 37938
In Tracken
�icense lD # 43299
L.I.E.P. REVIEW CHECKLIST Date: 3/27/97 /���
ApP n Received / ApP'n Processed
Lic2nse Type: Gas Station, Restaurant—C, Grocery—C, and CiQarette Lic
Company Neme: 5uperAmerica Group Division of Ashland DBA: SunerAmerica �t4359
Business Addresss: 450 Lexington Pkwy No BusinesS Phone: 487-9488
Contact Name/Address: Irma Thomas, 950 Lexington Pkwy N Home Phone:
Date to Council Research: 55103
Public Hearing Date: � Z�' ��' Labels Ordered: lf�
Notice Sent to Applicant: District Councii #:
_ � _
�-���. �1 �
Notice Sent to Public: � 7��� Ward #:
Department/ Date Inspections Comments
City Attorney
v�2 °/'a- p .`� •
Environmental
Health
N.
Fire
�'z � �,�.
License site �an aeceived:_
tsase �;�ed:
�� Cj� �� � lL/
b
Police
2 ��- .� .
Zoning
� Z q�- Q. � .
a'�-b'3'i
MAR-19-1997 11�0$ CI'(Y OF ST PR..P�. LIEP 612 2 ��c� 9124 P.02/06
. °.__ ---ti . �Y �-f�.-�99
��,�5 � CITX OF SAINT PAI1I.
o�a�u«�,t�«ao�
A LICENSE APPLdCATION � � ��
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PLEASE'FYPE ORPRTt3T IN II.RC �b
rcpe of License(s> being applied tor:
CampffiyName: .��}r 1f� R WlL KI G`�
Corpontion IPa4t�ap / Sale FYoprictorskip
If business is incotporated, give date of incotporarion: _
DoinB �usiness As: � Vl�� �G � Wl� �R! (�+�
$usmess Address: �D %�/- I�Q�t/ �,! w �
G-aa. 3
Strmt Addxu c;ry
Betwtess wLat cross sheeTS is ihe bvsiness located?
Ar� tix premises now occupied? Whaf Type ofBusiness?
� ro .��: p 0� UXi t t1uU �C l.e x i N4�
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AppGcaaz Infom
Name snd Tii2c:
�
� �1r�4-/
BusinessPhone�/2 • YS� 9 �8
M.� SS. �3
sw� zep
Whicll side of the 5[rert?
., yast
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_ I� . I .A .
F'urt � '.�.fiddle (Maidea) l._' F�sl -'_""_ Trtk
HOIDC P.(id7C5S: � C� L� V�� U U� _ .
StRet ad�s City Stete Zip
Date of Birth: 1 ��(s � L 7 Place of $irtti Home Phone�a(J f. 3 S7 :� z�,3
Have yon c,wer beea comicud of mry felcmy, crimE or violatitm of any aty ordinance other than taffic? YES NO �_
Date of azrest; Where?
��5�
Coaviction: Scnta3a:
7-ist thCnsmes and msidences of three persons of good moral chm�ctt , fiving within ihe Twiu Cities Mehro Area, not rclazed to the appIicant
a fina�ciaily interested m ihe premises or basiness, who may be refared ro as to the applicanf's chsracter:
$�i�c� �O�RAL� S 14 �„� p—y� 0 S7.'S . �1-�}�ti .�1� `�36-533 j
�A�v CH I �P �I �n — )IoJt ►- � 9�1a�. S� �u ti_v_ _ - N��v��: �l; t� b � a • 633_
2-
�r�.� ���e �,���a
f��r�b��a.or
been revokedT
;�t«��:
YES � NO Ifyes, list tIu dates and reasons for r�ocarioa:
2/18N7
MAR-19-1997 11�08 CITY OF ST PAUL LIFP
612 266 9124 P.94i06
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Are }rou gcring �o operr�c this busiaess pesoaatly? YES �?�7 ICAOt, k'7f0 a71I O�CFEIC J�PI�.R AMEKIi,[i GKOIT�
Div' '
�,,,���x �sa� �a ��> � P.O. Box 1 t300�" °f a �''`
H�x xae.� scza �.ae
Cr•
Arcrmag�to'cnea�znzgerc¢ess,�tinilsssSs:siuess? YES
plPZSC waplete th� foL� ing uu`ormr.tion:
�v /CI V �
s�
PJ�u li4 your emplo;ment his[ory for the prc�na:LS five (5) ceas period:
a„�slE qIqp7o�ment Address
�
;i0 I£the msaaga is twt the szaie fs Uu operator,
S�
Datc
� V,
infcr.mation fa each parma (use additicnal gaga if necessffiy)_
xvxaaare� sron�m+e Gcv sLuc Zip Phwe:'mbc
Fi�t�amc �ddS<� (-�S+ida) Lssc Dattef8'uth
HomeAdh+'�t� Saas:<+�e Gry Stau Zip �none:.'uaLa
2�l�ThES�TA TAX IIlEN17FICA?IO1�I NUMBER - P��nt ta tho Laas of M�auesota, i984, Chapter 502, Article 8, Scetioa 2(270.72)
(ia� Cieareaa; Iswance of Licenses},liansing aurhoxi$es are required to provide to tbe State of Mtunes�ta Commissioaer of Reveaue, the
Ivfvaaasota busiarss tae identi5cation numba aad tha socisl se�airy wmber of caeh &ceose applicant
Under the Mmaesotz Govaz�art Data Aactioes Aa apd tl�e Fedaal Pricacy Ad of f 97d, we ffie requSred to advise you ofthe follaN�ng
regarding t�t use ad'the Mumaota Troc Ideetificatiou Numba:
_�his infamatiou msq be used to dtap the :K or reaewsf oFyocu iiccssc iar tfie rvcat you owe Mwn�sota sa]es, employ� s
wicbholdvag a motnc vet�icle «cise tsxe�
- uPon rc�vm8 tlas inf'ams6an, She Gceusiag sat�ity ws�l suppty it oaty to tha Minnesota 1hPsrtment of Revmne. Howewer,
wda the Federal �gt of Snformatian Agrcement tbe IkPmtm°u of Reveeue maY ?�PP1Y this iuf'ormatian to the 7ateraal
Revwue Seivim
M�s Tax Ia�tiseffiica Numbas (sates & Use T�eNua�'3mayte � from ex state of N�n�sote, susiucss R�ras DcpazimcnT,
]ORiverPcrkPlazx(b12-296-6181�. . _ .. .
s�� s�� r�uu� /— G! a-a-�S G_�� r� aa�,;s�v� rr��: �•� 9�13 �SS
^ If a NGnaeso'� Tsx IdrrniScarioa I3umba is aot requ"u� fa flx businas beiag operated, indicato so by placiag aa `X" ia ihe box
..,, e �.,
List a11 otha o�cas of the ccttpo: ctioa:
p�FiCER 'FI'17..E I30?.7E HO.V,� BUSL'.'ESS DATE OF
,aa t�,rc �n,Y,�r Heu� . ADI]kE55 PHO\'E PHOA� BIATH