97-642Council File # �����
Ordinance #
Green Sheet # 3�
Presented
Referred To
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
�I
Committee: Date
i
2
3
RESOLVED: That apglication (ID #75021) for a Gas 5tation, Restaurant-C, Grocery-C, and Cigazette License by
Super America Cnoup Division of Asiiland DBA SugerAmerica #4409 (Tom Boland, Manager) az
957 Rice Stred be and the same is hereby approved.
4
6 Yeas Nays Abse Requeated by Department of:
7 Bae — �
8 Bostrom Office of License. Inspections and
9 Harris �-
10 Me� Enviro mental Protect+on
11 -- '��: r �� � �
12 T une �
14 Morton (��L�(n,�v`�"""' J�
15 �
16 Adopted by Council: Date $ y'
17
18 Adoption Certified by Council Secretary
19 Forn Approved by City Attorney
20 / 21 By:
22 ' )` / By:
23 Approved by Mayor: Date �'i� "i� J
24
25 Approved by Mayor for Subsieaion to
26 BY_ � Council
27
By:
G"'l—lcycl
DEPAHTMENTlOFFlCFJCQUNCIL DATEINRIATED GREEN SHEE �° 3 5 3 2 4
LIEP/Licensing -- --
GJNTACT PERSON 8 PNONE O DEPAFlTMENT DIAECTORNrt1AUDATE � cm couNCa INffIAVDATE
Christine Rozek, 266-9108 "���" ��'TM^T��R"E`' �°i'�'��
NUYBERFOX
MUST BE ON COUNCIL AGENDA 8Y (DAT� pOM� O BUOGEf DIflECTOR � flN. 8 MGL SEPVICES DIR
Por hearin : 2� G� °ipe ❑M'�v°Rt°`a"ss'sr"o"� ❑
TOTAI # OP S16NATURE PAGES {CLIP AI.L IOCATIONS FOR SIGNATURE)
ncSioN HE�uES7E�:
The SupexAmerica Group Division of Ashland DBA SuperAmerica �4409 requests Council approval
of its application for a Gas Station, Restaurant=C, 6rocery-C, and Cigarette License
located at 957 Rice Street (ID IF75021}.
RECOMMENDATtoNS: Apprwe (A) or Reject (R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE POLLOWING �UESTIONS:
_ PIANNING COMMISSION _ CNIL SEfNICE CqMMISSION 1_ Has this perso�rm ever worketl under a contract for ihi5 tlepartmeM? -
_ C�8 COMMI7TEE 1ES NO
— �� F - 2. Has this perSONfirm ever been a city employee?
YES NO
_ D�STn�Cr Couar _ 3. �oes Nis personlfirm posuss a skill not normaily possessed hy any curte�t cily empirn/ee?
SUPPORTSWHICHCOUNCILO&IECT�VE7 YES NO
Explain all yes answers on separate sheet and attach to green sheet
INrtiATMG PROBLEM, ISSUE, OPPOqTUNYTY i`Ni+o, What. Wrren. Where, Why):
ADVANTA6ES IFAPPflOVED:
DISADVANTAGES IFAPPROVED:
� '(v,g S� e.° � _,....-. _ . .v�! �;� .
a1�._ :':��
i'r1:�1 �,� 'i�r�'�
,_ ...�._ _ - =-'-_�,.�w
DISADVAMAGES IF NOTAPPqOVED: �
F�EG���ED
MAY 12 199i
�flE (d��.o��`��
TOTAL AMOUNT OF TRANSACTION S COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO
FUNDIHG SOURCE ACTIVITY NUMBER
FINANGIAI INFORMATION: (EXPtA1N)
Greensheet # 35324
in Trackef?
License ID # �5021
L.I.E.P. REVIEW CHECKLIST Date: 3/27/97 q� �`�Z
APP'n Received ! APP'n Processed
License Type: Gas Station Restaurant-C, Grocery-C, and Ciearette Lice.
Companyt�lame: SuperAmerica Group Division of Ashland DBA: SunerAmerica I144Q9
Business Addresss: 957 Rice Street Business Phone: 489-8118
Contact Name/Address: Tom Boland, 957 Rice Street, 117 Home Phone:
Date to Counci
Public Hearing
Notice Sent to
Labels Ordered: N�
Districi Council
Notice Sent to Public: �/(Qj! ! 7/� Ward #: .�
Departmentj Date Inspections Commems
City Attor�ey
� ( o � � (�. .
Environmental
Health
1�•�
Fire
��f� � Q.� .
License �� �� ������—
Lease Raceived:
� ( � � ��
p �v
Police
��b���- d.� .
Zoning
� � q � D•�K .
--i9l�19-1997 11�68 CITY OF ST PAUL LIEP
CL.ASS III CITY OF SAINT PAUL
o$«ofr: �,rm�x.i�s
LICENSE APPLICATION ��� ��
A 1 �r � �� p��.��
s�sr.�tsrm�m ssim
p �"�'G''-A�v`a�az ���' �°a `���' `�'` �'�' �6,z,��«��,z.
�s �,tc �fs � ' S ��t�', �4'� t �f{fs�$
PLEASE TYPE ORPR1NT TN S�K
of Licease(s) being
CompffiyName: ���}'� 1(�, FF WlL �c.1 C.`A
Cocppa4at/ Pmtnas6iP! Sok Proprie�na�sEip
if business is incorporated, give date of incozporation: _
Doing Business As: � { R. /� �1 �
���aaar�:957 �C�c .S?jf�tt
saeaad&aa
BMwan what cross s7eets is the bvsaess located?
Are tfic premises now occupied7 Whai Type of B�tsinessl
�Ta.��: p 0��.4 t vUU � Le
swa aa�.. '
Applicant InfrnmaGw:
Nante ffid Tide: ��'�sG L Z q.v.v�.
_ Psn _ �.Yamc
G—
c+�r
��
— s b
BusinessPhone�0� y g'
H,✓ S,S't/7
sw� z;p
Wfrich side ofthc meet�
u ��, e�o S�Z
�— h•e^ �
CV.A�,�r f.���,e/
� rax
l�►
x� a:aa��: � � �' v x�,.Y u u c
s�.sea� c;Ty s� z;P
Aate of Birth: I I�.5� �� Place af $inh: $ome Phone:la0 (. 3 S? :2113
Have you ever been comicud of a�tp felotry, ctime or violaGOn of any ciry ordinance other than haffic? YES _ NO �_
Date of acrest: Where?
Chazge:
Coaviu;on: 5rnta�a:
Listt3xnsmes and xesldences of three persons of good moral chmactc, &ving within the Twin Cities Metro Area, not rdated to the apgticsnt
or finmxis2$= interested Sn the pzemises or bus7ness, who may bc rcferred to as to tLe applicanYs character:
NAME �p ADDRESS PHONE
�AAd Ir10�1iL� S 1`i �„� 0-N� p S7.'S • �-�`'f��- �1,2•�13jrS33
�a�v c.•R ��1 v� _- !bR t- t��N�. _ Si iu +v - N�w 6a: �l,-�NV 6� a- b33-��
n� — i a p � I�ArJIIK
hold, formr$y hdd, or may heve an
Have s�y'of fne sbove nsmed
in:
612 266 912i1 P
.. .., .
��
revoked7 YES � NO If yes, lisc the data snd rexsons for revocadon:
�'ISr97
.
,�1997 11�08 CITY
�'
.ue }rou going :o opetuc this husiness pasonaU�•1
H�e AddJm: Str�
OF ST PRUL LIEP
612 255 9124 P.64/06
�� M�Z
}�s � NO If not, «'ho u-ill optrau ��P�� �ERICAG�O�1�
C��
Are�•aa�to�rau�meg�or�ss,s:zatinthisbwiness? YES
plezsc comp}ete ih foll uu`oimstion:
��J /7? Da 1 �t•�
F �.�� . � anaa��;s.� � / (v��7
9 S / �IY1P S { S � /i44_ / /H N
Hooc aadrn: sra+�su , L'�Y
Fl�zu listyour emplo;ment his[ary for the praia.0 five (5j ceas period:
$us.�ess/EmoIo� Address
S<.•�
LZ.�7
�7
NO ]f thm msaager is not the s2nse �s t� operalor,
��
is
£irII�smc
iaa
HoaeAAte+i Strea\ame Gity .Slare IIP .�e?5�cba
Fi�t�mre !.GddfeIeitid (-�Sd&a7 La Dattof$utb
HosoAAOm�tr. Sauc`.'v�e Ciiy Sfam Zip Phovel.`umbu
MIDBv'ESOTA I'AX IDENI7FICATION NUMBER - P�ut 10 the Law�s of M�a�sota, 1984, Chapta 502, Article 8, Sxtion 2(270.72}
� �� j ca�nn � �'y��), �iansing suthorities are req�a3 to pmtide to tfie State of M=upesots Cammissioaer ofRevalue, the
2�Cvwesots busiatss ta�t idenriEcation number and the socisl securiry m�mber of eack Tier.qse appficant
Uudei the Nfiaaesote Gwamnart Data Pracsias Aa rrod tk�e Federsl Pricacy Ad of f 974, we sre requ3red to advise you of the foIlmxing
regarding the use oftbe lvfmnesota T�c Ideoti&cation Numba:
_ Shis infamati� msy be used to dc� the +� � renewat of yats Iiansc in tLt eveat you owe Mumcsota sa7es, employea's
witbholr�g oc mMnr vchide exase troce�
- TJpon seceiv�8 flus uda�, tbe licenszag auQwriry ml! supply it aaiy a the?v?'usn� Dtpamneat of Revcnue. xowever,
undcr the Fedaai ExcL�gt of inforaiatioa Ag�eemoa; the Departmcnt of Reveaue maY +�PP�3' this infarma5oe to tbe Iateraal
Reve.¢ue 3eivicc
2vi'.m�ta 7'sx IdmliSc�ioatNumbas (Saks & ISsc Tac i3�e') maY be obtamed &c� tLe S�au of IJ�nnesota, Busin�ss Re�ot3s DeF�tmau.
l0 RivaPark Plaza C612-29b-6181} ..:. c. '. '�- `
Socisl Sxucity Nimmba: �/� I" V I��a'S U'-- SvFmnesota Tax Idenfificatioa I�ba: - �i� ?�[� JS
]f a M'iaaasota T� IdrntiScarioa Nwuba u aot rcqciued for tLe businar brmg operated, ��te so hy placing aa'X' ia �2x box
info:mation for each parma (use additional pages if aecessary):
,,, e �,
Lis� z11 ot+�c oaeers of the octtper. ation:
OFFICER TlTL� Hp?�. H0� BT35�TESS DATE OF
;�*p,t,.t.� j0�,'�tctHej� � ADI�£SS pH4\'E PH02�'E BIFtTH
Council File # �����
Ordinance #
Green Sheet # 3�
Presented
Referred To
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
�I
Committee: Date
i
2
3
RESOLVED: That apglication (ID #75021) for a Gas 5tation, Restaurant-C, Grocery-C, and Cigazette License by
Super America Cnoup Division of Asiiland DBA SugerAmerica #4409 (Tom Boland, Manager) az
957 Rice Stred be and the same is hereby approved.
4
6 Yeas Nays Abse Requeated by Department of:
7 Bae — �
8 Bostrom Office of License. Inspections and
9 Harris �-
10 Me� Enviro mental Protect+on
11 -- '��: r �� � �
12 T une �
14 Morton (��L�(n,�v`�"""' J�
15 �
16 Adopted by Council: Date $ y'
17
18 Adoption Certified by Council Secretary
19 Forn Approved by City Attorney
20 / 21 By:
22 ' )` / By:
23 Approved by Mayor: Date �'i� "i� J
24
25 Approved by Mayor for Subsieaion to
26 BY_ � Council
27
By:
G"'l—lcycl
DEPAHTMENTlOFFlCFJCQUNCIL DATEINRIATED GREEN SHEE �° 3 5 3 2 4
LIEP/Licensing -- --
GJNTACT PERSON 8 PNONE O DEPAFlTMENT DIAECTORNrt1AUDATE � cm couNCa INffIAVDATE
Christine Rozek, 266-9108 "���" ��'TM^T��R"E`' �°i'�'��
NUYBERFOX
MUST BE ON COUNCIL AGENDA 8Y (DAT� pOM� O BUOGEf DIflECTOR � flN. 8 MGL SEPVICES DIR
Por hearin : 2� G� °ipe ❑M'�v°Rt°`a"ss'sr"o"� ❑
TOTAI # OP S16NATURE PAGES {CLIP AI.L IOCATIONS FOR SIGNATURE)
ncSioN HE�uES7E�:
The SupexAmerica Group Division of Ashland DBA SuperAmerica �4409 requests Council approval
of its application for a Gas Station, Restaurant=C, 6rocery-C, and Cigarette License
located at 957 Rice Street (ID IF75021}.
RECOMMENDATtoNS: Apprwe (A) or Reject (R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE POLLOWING �UESTIONS:
_ PIANNING COMMISSION _ CNIL SEfNICE CqMMISSION 1_ Has this perso�rm ever worketl under a contract for ihi5 tlepartmeM? -
_ C�8 COMMI7TEE 1ES NO
— �� F - 2. Has this perSONfirm ever been a city employee?
YES NO
_ D�STn�Cr Couar _ 3. �oes Nis personlfirm posuss a skill not normaily possessed hy any curte�t cily empirn/ee?
SUPPORTSWHICHCOUNCILO&IECT�VE7 YES NO
Explain all yes answers on separate sheet and attach to green sheet
INrtiATMG PROBLEM, ISSUE, OPPOqTUNYTY i`Ni+o, What. Wrren. Where, Why):
ADVANTA6ES IFAPPflOVED:
DISADVANTAGES IFAPPROVED:
� '(v,g S� e.° � _,....-. _ . .v�! �;� .
a1�._ :':��
i'r1:�1 �,� 'i�r�'�
,_ ...�._ _ - =-'-_�,.�w
DISADVAMAGES IF NOTAPPqOVED: �
F�EG���ED
MAY 12 199i
�flE (d��.o��`��
TOTAL AMOUNT OF TRANSACTION S COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO
FUNDIHG SOURCE ACTIVITY NUMBER
FINANGIAI INFORMATION: (EXPtA1N)
Greensheet # 35324
in Trackef?
License ID # �5021
L.I.E.P. REVIEW CHECKLIST Date: 3/27/97 q� �`�Z
APP'n Received ! APP'n Processed
License Type: Gas Station Restaurant-C, Grocery-C, and Ciearette Lice.
Companyt�lame: SuperAmerica Group Division of Ashland DBA: SunerAmerica I144Q9
Business Addresss: 957 Rice Street Business Phone: 489-8118
Contact Name/Address: Tom Boland, 957 Rice Street, 117 Home Phone:
Date to Counci
Public Hearing
Notice Sent to
Labels Ordered: N�
Districi Council
Notice Sent to Public: �/(Qj! ! 7/� Ward #: .�
Departmentj Date Inspections Commems
City Attor�ey
� ( o � � (�. .
Environmental
Health
1�•�
Fire
��f� � Q.� .
License �� �� ������—
Lease Raceived:
� ( � � ��
p �v
Police
��b���- d.� .
Zoning
� � q � D•�K .
--i9l�19-1997 11�68 CITY OF ST PAUL LIEP
CL.ASS III CITY OF SAINT PAUL
o$«ofr: �,rm�x.i�s
LICENSE APPLICATION ��� ��
A 1 �r � �� p��.��
s�sr.�tsrm�m ssim
p �"�'G''-A�v`a�az ���' �°a `���' `�'` �'�' �6,z,��«��,z.
�s �,tc �fs � ' S ��t�', �4'� t �f{fs�$
PLEASE TYPE ORPR1NT TN S�K
of Licease(s) being
CompffiyName: ���}'� 1(�, FF WlL �c.1 C.`A
Cocppa4at/ Pmtnas6iP! Sok Proprie�na�sEip
if business is incorporated, give date of incozporation: _
Doing Business As: � { R. /� �1 �
���aaar�:957 �C�c .S?jf�tt
saeaad&aa
BMwan what cross s7eets is the bvsaess located?
Are tfic premises now occupied7 Whai Type of B�tsinessl
�Ta.��: p 0��.4 t vUU � Le
swa aa�.. '
Applicant InfrnmaGw:
Nante ffid Tide: ��'�sG L Z q.v.v�.
_ Psn _ �.Yamc
G—
c+�r
��
— s b
BusinessPhone�0� y g'
H,✓ S,S't/7
sw� z;p
Wfrich side ofthc meet�
u ��, e�o S�Z
�— h•e^ �
CV.A�,�r f.���,e/
� rax
l�►
x� a:aa��: � � �' v x�,.Y u u c
s�.sea� c;Ty s� z;P
Aate of Birth: I I�.5� �� Place af $inh: $ome Phone:la0 (. 3 S? :2113
Have you ever been comicud of a�tp felotry, ctime or violaGOn of any ciry ordinance other than haffic? YES _ NO �_
Date of acrest: Where?
Chazge:
Coaviu;on: 5rnta�a:
Listt3xnsmes and xesldences of three persons of good moral chmactc, &ving within the Twin Cities Metro Area, not rdated to the apgticsnt
or finmxis2$= interested Sn the pzemises or bus7ness, who may bc rcferred to as to tLe applicanYs character:
NAME �p ADDRESS PHONE
�AAd Ir10�1iL� S 1`i �„� 0-N� p S7.'S • �-�`'f��- �1,2•�13jrS33
�a�v c.•R ��1 v� _- !bR t- t��N�. _ Si iu +v - N�w 6a: �l,-�NV 6� a- b33-��
n� — i a p � I�ArJIIK
hold, formr$y hdd, or may heve an
Have s�y'of fne sbove nsmed
in:
612 266 912i1 P
.. .., .
��
revoked7 YES � NO If yes, lisc the data snd rexsons for revocadon:
�'ISr97
.
,�1997 11�08 CITY
�'
.ue }rou going :o opetuc this husiness pasonaU�•1
H�e AddJm: Str�
OF ST PRUL LIEP
612 255 9124 P.64/06
�� M�Z
}�s � NO If not, «'ho u-ill optrau ��P�� �ERICAG�O�1�
C��
Are�•aa�to�rau�meg�or�ss,s:zatinthisbwiness? YES
plezsc comp}ete ih foll uu`oimstion:
��J /7? Da 1 �t•�
F �.�� . � anaa��;s.� � / (v��7
9 S / �IY1P S { S � /i44_ / /H N
Hooc aadrn: sra+�su , L'�Y
Fl�zu listyour emplo;ment his[ary for the praia.0 five (5j ceas period:
$us.�ess/EmoIo� Address
S<.•�
LZ.�7
�7
NO ]f thm msaager is not the s2nse �s t� operalor,
��
is
£irII�smc
iaa
HoaeAAte+i Strea\ame Gity .Slare IIP .�e?5�cba
Fi�t�mre !.GddfeIeitid (-�Sd&a7 La Dattof$utb
HosoAAOm�tr. Sauc`.'v�e Ciiy Sfam Zip Phovel.`umbu
MIDBv'ESOTA I'AX IDENI7FICATION NUMBER - P�ut 10 the Law�s of M�a�sota, 1984, Chapta 502, Article 8, Sxtion 2(270.72}
� �� j ca�nn � �'y��), �iansing suthorities are req�a3 to pmtide to tfie State of M=upesots Cammissioaer ofRevalue, the
2�Cvwesots busiatss ta�t idenriEcation number and the socisl securiry m�mber of eack Tier.qse appficant
Uudei the Nfiaaesote Gwamnart Data Pracsias Aa rrod tk�e Federsl Pricacy Ad of f 974, we sre requ3red to advise you of the foIlmxing
regarding the use oftbe lvfmnesota T�c Ideoti&cation Numba:
_ Shis infamati� msy be used to dc� the +� � renewat of yats Iiansc in tLt eveat you owe Mumcsota sa7es, employea's
witbholr�g oc mMnr vchide exase troce�
- TJpon seceiv�8 flus uda�, tbe licenszag auQwriry ml! supply it aaiy a the?v?'usn� Dtpamneat of Revcnue. xowever,
undcr the Fedaai ExcL�gt of inforaiatioa Ag�eemoa; the Departmcnt of Reveaue maY +�PP�3' this infarma5oe to tbe Iateraal
Reve.¢ue 3eivicc
2vi'.m�ta 7'sx IdmliSc�ioatNumbas (Saks & ISsc Tac i3�e') maY be obtamed &c� tLe S�au of IJ�nnesota, Busin�ss Re�ot3s DeF�tmau.
l0 RivaPark Plaza C612-29b-6181} ..:. c. '. '�- `
Socisl Sxucity Nimmba: �/� I" V I��a'S U'-- SvFmnesota Tax Idenfificatioa I�ba: - �i� ?�[� JS
]f a M'iaaasota T� IdrntiScarioa Nwuba u aot rcqciued for tLe businar brmg operated, ��te so hy placing aa'X' ia �2x box
info:mation for each parma (use additional pages if aecessary):
,,, e �,
Lis� z11 ot+�c oaeers of the octtper. ation:
OFFICER TlTL� Hp?�. H0� BT35�TESS DATE OF
;�*p,t,.t.� j0�,'�tctHej� � ADI�£SS pH4\'E PH02�'E BIFtTH
Council File # �����
Ordinance #
Green Sheet # 3�
Presented
Referred To
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
�I
Committee: Date
i
2
3
RESOLVED: That apglication (ID #75021) for a Gas 5tation, Restaurant-C, Grocery-C, and Cigazette License by
Super America Cnoup Division of Asiiland DBA SugerAmerica #4409 (Tom Boland, Manager) az
957 Rice Stred be and the same is hereby approved.
4
6 Yeas Nays Abse Requeated by Department of:
7 Bae — �
8 Bostrom Office of License. Inspections and
9 Harris �-
10 Me� Enviro mental Protect+on
11 -- '��: r �� � �
12 T une �
14 Morton (��L�(n,�v`�"""' J�
15 �
16 Adopted by Council: Date $ y'
17
18 Adoption Certified by Council Secretary
19 Forn Approved by City Attorney
20 / 21 By:
22 ' )` / By:
23 Approved by Mayor: Date �'i� "i� J
24
25 Approved by Mayor for Subsieaion to
26 BY_ � Council
27
By:
G"'l—lcycl
DEPAHTMENTlOFFlCFJCQUNCIL DATEINRIATED GREEN SHEE �° 3 5 3 2 4
LIEP/Licensing -- --
GJNTACT PERSON 8 PNONE O DEPAFlTMENT DIAECTORNrt1AUDATE � cm couNCa INffIAVDATE
Christine Rozek, 266-9108 "���" ��'TM^T��R"E`' �°i'�'��
NUYBERFOX
MUST BE ON COUNCIL AGENDA 8Y (DAT� pOM� O BUOGEf DIflECTOR � flN. 8 MGL SEPVICES DIR
Por hearin : 2� G� °ipe ❑M'�v°Rt°`a"ss'sr"o"� ❑
TOTAI # OP S16NATURE PAGES {CLIP AI.L IOCATIONS FOR SIGNATURE)
ncSioN HE�uES7E�:
The SupexAmerica Group Division of Ashland DBA SuperAmerica �4409 requests Council approval
of its application for a Gas Station, Restaurant=C, 6rocery-C, and Cigarette License
located at 957 Rice Street (ID IF75021}.
RECOMMENDATtoNS: Apprwe (A) or Reject (R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE POLLOWING �UESTIONS:
_ PIANNING COMMISSION _ CNIL SEfNICE CqMMISSION 1_ Has this perso�rm ever worketl under a contract for ihi5 tlepartmeM? -
_ C�8 COMMI7TEE 1ES NO
— �� F - 2. Has this perSONfirm ever been a city employee?
YES NO
_ D�STn�Cr Couar _ 3. �oes Nis personlfirm posuss a skill not normaily possessed hy any curte�t cily empirn/ee?
SUPPORTSWHICHCOUNCILO&IECT�VE7 YES NO
Explain all yes answers on separate sheet and attach to green sheet
INrtiATMG PROBLEM, ISSUE, OPPOqTUNYTY i`Ni+o, What. Wrren. Where, Why):
ADVANTA6ES IFAPPflOVED:
DISADVANTAGES IFAPPROVED:
� '(v,g S� e.° � _,....-. _ . .v�! �;� .
a1�._ :':��
i'r1:�1 �,� 'i�r�'�
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DISADVAMAGES IF NOTAPPqOVED: �
F�EG���ED
MAY 12 199i
�flE (d��.o��`��
TOTAL AMOUNT OF TRANSACTION S COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO
FUNDIHG SOURCE ACTIVITY NUMBER
FINANGIAI INFORMATION: (EXPtA1N)
Greensheet # 35324
in Trackef?
License ID # �5021
L.I.E.P. REVIEW CHECKLIST Date: 3/27/97 q� �`�Z
APP'n Received ! APP'n Processed
License Type: Gas Station Restaurant-C, Grocery-C, and Ciearette Lice.
Companyt�lame: SuperAmerica Group Division of Ashland DBA: SunerAmerica I144Q9
Business Addresss: 957 Rice Street Business Phone: 489-8118
Contact Name/Address: Tom Boland, 957 Rice Street, 117 Home Phone:
Date to Counci
Public Hearing
Notice Sent to
Labels Ordered: N�
Districi Council
Notice Sent to Public: �/(Qj! ! 7/� Ward #: .�
Departmentj Date Inspections Commems
City Attor�ey
� ( o � � (�. .
Environmental
Health
1�•�
Fire
��f� � Q.� .
License �� �� ������—
Lease Raceived:
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p �v
Police
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Zoning
� � q � D•�K .
--i9l�19-1997 11�68 CITY OF ST PAUL LIEP
CL.ASS III CITY OF SAINT PAUL
o$«ofr: �,rm�x.i�s
LICENSE APPLICATION ��� ��
A 1 �r � �� p��.��
s�sr.�tsrm�m ssim
p �"�'G''-A�v`a�az ���' �°a `���' `�'` �'�' �6,z,��«��,z.
�s �,tc �fs � ' S ��t�', �4'� t �f{fs�$
PLEASE TYPE ORPR1NT TN S�K
of Licease(s) being
CompffiyName: ���}'� 1(�, FF WlL �c.1 C.`A
Cocppa4at/ Pmtnas6iP! Sok Proprie�na�sEip
if business is incorporated, give date of incozporation: _
Doing Business As: � { R. /� �1 �
���aaar�:957 �C�c .S?jf�tt
saeaad&aa
BMwan what cross s7eets is the bvsaess located?
Are tfic premises now occupied7 Whai Type of B�tsinessl
�Ta.��: p 0��.4 t vUU � Le
swa aa�.. '
Applicant InfrnmaGw:
Nante ffid Tide: ��'�sG L Z q.v.v�.
_ Psn _ �.Yamc
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BusinessPhone�0� y g'
H,✓ S,S't/7
sw� z;p
Wfrich side ofthc meet�
u ��, e�o S�Z
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CV.A�,�r f.���,e/
� rax
l�►
x� a:aa��: � � �' v x�,.Y u u c
s�.sea� c;Ty s� z;P
Aate of Birth: I I�.5� �� Place af $inh: $ome Phone:la0 (. 3 S? :2113
Have you ever been comicud of a�tp felotry, ctime or violaGOn of any ciry ordinance other than haffic? YES _ NO �_
Date of acrest: Where?
Chazge:
Coaviu;on: 5rnta�a:
Listt3xnsmes and xesldences of three persons of good moral chmactc, &ving within the Twin Cities Metro Area, not rdated to the apgticsnt
or finmxis2$= interested Sn the pzemises or bus7ness, who may bc rcferred to as to tLe applicanYs character:
NAME �p ADDRESS PHONE
�AAd Ir10�1iL� S 1`i �„� 0-N� p S7.'S • �-�`'f��- �1,2•�13jrS33
�a�v c.•R ��1 v� _- !bR t- t��N�. _ Si iu +v - N�w 6a: �l,-�NV 6� a- b33-��
n� — i a p � I�ArJIIK
hold, formr$y hdd, or may heve an
Have s�y'of fne sbove nsmed
in:
612 266 912i1 P
.. .., .
��
revoked7 YES � NO If yes, lisc the data snd rexsons for revocadon:
�'ISr97
.
,�1997 11�08 CITY
�'
.ue }rou going :o opetuc this husiness pasonaU�•1
H�e AddJm: Str�
OF ST PRUL LIEP
612 255 9124 P.64/06
�� M�Z
}�s � NO If not, «'ho u-ill optrau ��P�� �ERICAG�O�1�
C��
Are�•aa�to�rau�meg�or�ss,s:zatinthisbwiness? YES
plezsc comp}ete ih foll uu`oimstion:
��J /7? Da 1 �t•�
F �.�� . � anaa��;s.� � / (v��7
9 S / �IY1P S { S � /i44_ / /H N
Hooc aadrn: sra+�su , L'�Y
Fl�zu listyour emplo;ment his[ary for the praia.0 five (5j ceas period:
$us.�ess/EmoIo� Address
S<.•�
LZ.�7
�7
NO ]f thm msaager is not the s2nse �s t� operalor,
��
is
£irII�smc
iaa
HoaeAAte+i Strea\ame Gity .Slare IIP .�e?5�cba
Fi�t�mre !.GddfeIeitid (-�Sd&a7 La Dattof$utb
HosoAAOm�tr. Sauc`.'v�e Ciiy Sfam Zip Phovel.`umbu
MIDBv'ESOTA I'AX IDENI7FICATION NUMBER - P�ut 10 the Law�s of M�a�sota, 1984, Chapta 502, Article 8, Sxtion 2(270.72}
� �� j ca�nn � �'y��), �iansing suthorities are req�a3 to pmtide to tfie State of M=upesots Cammissioaer ofRevalue, the
2�Cvwesots busiatss ta�t idenriEcation number and the socisl securiry m�mber of eack Tier.qse appficant
Uudei the Nfiaaesote Gwamnart Data Pracsias Aa rrod tk�e Federsl Pricacy Ad of f 974, we sre requ3red to advise you of the foIlmxing
regarding the use oftbe lvfmnesota T�c Ideoti&cation Numba:
_ Shis infamati� msy be used to dc� the +� � renewat of yats Iiansc in tLt eveat you owe Mumcsota sa7es, employea's
witbholr�g oc mMnr vchide exase troce�
- TJpon seceiv�8 flus uda�, tbe licenszag auQwriry ml! supply it aaiy a the?v?'usn� Dtpamneat of Revcnue. xowever,
undcr the Fedaai ExcL�gt of inforaiatioa Ag�eemoa; the Departmcnt of Reveaue maY +�PP�3' this infarma5oe to tbe Iateraal
Reve.¢ue 3eivicc
2vi'.m�ta 7'sx IdmliSc�ioatNumbas (Saks & ISsc Tac i3�e') maY be obtamed &c� tLe S�au of IJ�nnesota, Busin�ss Re�ot3s DeF�tmau.
l0 RivaPark Plaza C612-29b-6181} ..:. c. '. '�- `
Socisl Sxucity Nimmba: �/� I" V I��a'S U'-- SvFmnesota Tax Idenfificatioa I�ba: - �i� ?�[� JS
]f a M'iaaasota T� IdrntiScarioa Nwuba u aot rcqciued for tLe businar brmg operated, ��te so hy placing aa'X' ia �2x box
info:mation for each parma (use additional pages if aecessary):
,,, e �,
Lis� z11 ot+�c oaeers of the octtper. ation:
OFFICER TlTL� Hp?�. H0� BT35�TESS DATE OF
;�*p,t,.t.� j0�,'�tctHej� � ADI�£SS pH4\'E PH02�'E BIFtTH