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97-643Council File # �b"�3 Ordinance # Presented By Referred To Green Sheet # ��`�� RESOLUTION CITY OF SAINT PAUL, MINNESO7A �� Committee: Date 1 RESOLVED: That application (ID # 16629) for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License by 2 Super America Group Division of Asliland DBA SuperAmerica #4030 (Paul Larson, Manager) at 3 1625 Rice Street be and the same is hereby approved 4 5 Requeated by Department of: 6 Yeas Navs �Abse�t_ 7 B a� � 8 Bostrom � Off�ce of License Inspections and 9 H r i � 10 M r Envirorimenta� Protect+on 11 1 , �s � 13 Morton n 15 � � BYe ��/��'Y`^ti. �f 1 �Y"-i 16 Adopted by Council: Date 17 18 Adoption Certified by Council Secretary 19 Form Approved by City Attorney 20 / 21 By: �_ a � /� � JJ 22 p � $y' ____�_ J 23 Approved by Mayor: Date "t �� 24 ZS Approved by Mayor for Submiasion to Z6 BY. Council 27 By: °�-�y3 OEPI�R�MIENTIOFFICEICOUNqL DATE iNR1ATED � � � � J LIEP/Licensin GREEN SHEE CONiACf PEHSON & PHONE INITIAf1DATE MfT1AVDA7E �OEPl.FiiMENT0IRECTOR �CITYCDUNqL Christine Rozek 266-9108 A� �CfTYATTORNEY �CRYCLERK MUST BE ON COUNCR AGENDA BY DATE AUMBEfl FOA � BUDGET DIflECTOR � FlN. & MGT. SEFiVICES DIR. ^ flOUTING For hearin : '(f�r `'1 1 OBDER �MqyOR(ORASSI5fANn � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION RE�UESTED: The SuperAmerica Group Division of Ashland DBA SuperAmerica II4030 requests Council approval of its application for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License located at 1625 Rice Street (ID �116629). RECAMMENDATIONS: Approve (A7 or 9eject (R) PERSONAL SERVICE CONiRACTS MUST ANSWER SHE FOLLOW{NG QUESTIONS: _ PLANTIMG CAMMISSION _ IIIVIL SERVICE COMMISSION �� Has iqis pOCSONfirm evCr Worketl under a cOntfact for th�5 tlepartmeni? _ CIB COMMITTEE YES NO _ S7AFF 2. Has this personlfirm ever 6een a ciry employee? — — YES NO _ oiSiRICT cOUR7 _ _ _ g, Does this person/tirm possess a skill no[ normalty possessetl by any curtent ciry empl0yee? SUPPOHTSWHICHCOUNCILO&IEQTIME? YES NO Explafn a11 yes answers on separa[e sheet and ettach to 9reen sheet INITIATING PROBIEM, ISSUE, OPPOISTUNIN (Who, Wh81. W��, Y�t�rQ, Why): ADVANTAGESIFAPPpOVED� �' � ' � � DISADVANTAGES IF APPROVE�' �� @,yRB�a3�C �:°,.;.'y:r;� � �M :1 f'F`f�Er �. � b�:�`.�� DISADVANTAGESIFNOTAPPROVED: � �� '- ��`.i + �� M �� 12 �g91 JoE �'�L�'it�1� 70TAL AMOUNT OF TRANSACTION S COSi/REVENUE BUDGETEp (CIRCLE ONE) YES NO FUNDIIdG SOURCE ACTIVITV NUMBER FINANCIAL INFORFiAT10N (EXPLAIN) Greensneet # 37933 L.I.E.P. REVIEW CHECKLIST �ate: 312r197 /`��'dy� In Tracke�? App'n Received J App'n Processed Ucense�D # 16629 License Type:�as Station Restaurant-C. Grocery-C, and Giga Pr P T.ice Company Name: The SuperAmerica Group Division of AshlandDBSt1 SunerAmerica �64030 Business Addresss: 1625 Rice Street Business Phone: 488-7663 Contact Name/Address: Paul Larson, 1625 Rice St, l ll Home Phone: Date to Council Research: Pubiic Nearing Date: �Z� ��- Labefs Ordered: �✓� Notice Sent to App{icant: District Council #: ��? d?�>r'. � � Notice Sent to Public: �� Ward #: �/ Department/ Date Inspections Commerits City Attomey �•2- O,� . Environmentai Heaith fw v � ' Fire �.� • License Site Plan Reeeivad:� Lease Received: 5 �� l � �,� Police �r-' ' 2 ' Ci�'' � • �, . i Zoni�g � �� 11�08 CITY OF ST PRUL LIEP 9124 P.02i66 ��,q �-� ey3 cz.ass z� CITY OF SAINT PAUL o�«�rt,;«��;� J � ; LICENSE APPI,ICA�'ION �a��rra� 396ZPe45t5m�3� Sm¢Pu�Nppcm SSiOi C��` `� �C�1�9116 � �yxw;�c � �� f �oao W��. � i � �� THIS APPF C�� Vg�� I�� t � PLEASE TYPE OR PR1NT Ild 7NK - Trpe ofI.icense(s) be� aPPHed for: Compffiy Name: Corptxation tPatna�tiP � �u �OP^�p If bosiness is iucoipcxated, give date of inwspozaSion: � T)oiag $us9ness As: ,,,�C bl U� ��1�lil� � 1 Ln Busmas Address: �,��.� L- i L� .� � se«s aaAe�s �nr Betwaa what cross she�rs is the busaess located? Are thc presaises now occupied7 S�1haa Type of Business? �ra� ro.aaa��: .,p 8 B U1G t V UU �C L_e �C i N4� same aee�. crt Applicsat Iafom Name sad 7iflc: 612 � '�UL! i 1 As1� �hNd J—N� Bvsiness Phone: �K '.��3 %/7 s„� z� Nhicfi side of the srre�t? T� p S s,,,� Z �r �• . / .A . saa _ --- — � s�iame (Maidm) Lws r�tk Home Address: �(1 U V�,� �/ V(t O ' sr«enaasean Cnr senre zip Date of Birtfi: 11. �0 �� Place of $irth: _ Home Phoae;b8 L 3 S7 .� � 1� Haveyou ever been comieted of sctp felony, csune or tiolation of any city ordinance other than traffic? YES _ NO _� Date of arrest: Where7 C�srge: Coavictipa; SentaKC: List dxnama �d�ences of tLree pasons of good morsl charaMer, &vivg within the Twin Cities Meha Area, not ntated to the apglicant or fin�cially interested in the premi.ves or business, who may be refared to as to the applicant s character: NAME R ADDRESS PHONE �J�IAr� I111nR,4t,r S- 1`l72 o-y� � S7=S .�1-�}i�- bl�-Y3�-S337 licenses hol� foimaly � �H4 J'T �/ �1/ � �R � M may Iuve mm interest in: � wl_.4u/ L I ] . YES � NO ffya, list the datrs and reasons fos revocatioa: 2/18�97 11�08 CITY OF ST PAUL LIEP 612 266 9124 P.04i06 � q�b�3 8�€ �o opetrsc this busiaess pusonally? YES �?30 If not, �rho WYll o p axtc �'i7PERAAiERICAI G1�OXI1 ��;m� Ho�e ADErea� C� Aiec��to�zc•eal:��aofess.s�zatiathisbvsiness? ✓S'ES � , :fr, � P.O. BOX Lexir�gtoi srau 2i� :v0 If �Le maaxger is not she sxme €s tbe opaator, i5 8 f4r each parma (use additional pages if na:ess�y): C��) Nv�eaddrn+- Stren�ame City Swc TiP Fnox:4mba F'ra\ame ?.Gddteinitid G��) f.sa DamefB'vth HomeAddcnn: StreaSa�c CitY Sute Zip PncxA'usbet MI232dE507A TAX IDENt1FICAFION 2�JM&ER - P�us�nt to the I.sa�s of T�fanesota,1984, Chapter 502, Ar@cle 8. Sation 2(270.72} (Tsc Cl�raace> Lssuanee of Licensesj, liansing azuhoriries are reqe�ed to pmvedn to the State of 2�/Gnnesota Commissioner ofRcveauS the Muinaata busiuesstax idearification nvmba sad the sociat sa7airy numbec of cach Iicaiu appficent Undes tbe Minaesota Gwecnmeat Datx Pracz'sas Aa assd the Federal Pricary Ad of' f 974, we me requirod to advise you of the foIlowing regard'mgthe nse od'tfie N{�mesata TaxIdefllification23um� _��nt'ama8� msy be ussd to deap tfie iss�ce � reaewal of yoc4 liccus� in the cvmt you owe Mum�sota ss7es, empIoyer s wit�olt}�g or mo�vctuc]e exdse texe.� - �P°n �8 tbis imf'o�msaam, tFie Gcwsiag asuLo�iry ws�l suppl9 it oaly a the Muwesota 1�eQazment of Rcvenue. However, unda the Federal FxcbaAga of 7nfomnation A�; tSe DeP�mt of Reveaue maY �PPtY this'v�f'ormaiion ta t2m Iauma3 Revenue SaiSx � I�fmneaxa Tax Id�ScaDCm2��s (Sales &Use TaxNumbrr) maYbe obtamed 5omtbe S�u of N6nnesd,�, Bu� R�ds I7epmtmak 20RivaParkPlazaC612-296- .. .r.;. _ s�� s«�s rr�� p /— G l a-��S U �� - s� �a�us�� rr,��: : l�� v�S _ ffa D�iaaesota Tax Idcnt7ficauoa laumber ss ad requi:ed f� t3u businas btmg operated. indicau so by placing aa'X" ia zhe box �., e �� Pkxse fistyour e:np3o;ment }ustory for tbe pre�5mzs five {5) � ezr peiiial: , Lisc zll other o�eas of tbe «upo: Etioa p�� TT'n.� HOA'1E HO'.�E BLISL'�'ESS DATE OF ;.'.a �� (O,`��e He� � AAI�?tESS PHO\'E PH4h'E BIRTH Council File # �b"�3 Ordinance # Presented By Referred To Green Sheet # ��`�� RESOLUTION CITY OF SAINT PAUL, MINNESO7A �� Committee: Date 1 RESOLVED: That application (ID # 16629) for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License by 2 Super America Group Division of Asliland DBA SuperAmerica #4030 (Paul Larson, Manager) at 3 1625 Rice Street be and the same is hereby approved 4 5 Requeated by Department of: 6 Yeas Navs �Abse�t_ 7 B a� � 8 Bostrom � Off�ce of License Inspections and 9 H r i � 10 M r Envirorimenta� Protect+on 11 1 , �s � 13 Morton n 15 � � BYe ��/��'Y`^ti. �f 1 �Y"-i 16 Adopted by Council: Date 17 18 Adoption Certified by Council Secretary 19 Form Approved by City Attorney 20 / 21 By: �_ a � /� � JJ 22 p � $y' ____�_ J 23 Approved by Mayor: Date "t �� 24 ZS Approved by Mayor for Submiasion to Z6 BY. Council 27 By: °�-�y3 OEPI�R�MIENTIOFFICEICOUNqL DATE iNR1ATED � � � � J LIEP/Licensin GREEN SHEE CONiACf PEHSON & PHONE INITIAf1DATE MfT1AVDA7E �OEPl.FiiMENT0IRECTOR �CITYCDUNqL Christine Rozek 266-9108 A� �CfTYATTORNEY �CRYCLERK MUST BE ON COUNCR AGENDA BY DATE AUMBEfl FOA � BUDGET DIflECTOR � FlN. & MGT. SEFiVICES DIR. ^ flOUTING For hearin : '(f�r `'1 1 OBDER �MqyOR(ORASSI5fANn � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION RE�UESTED: The SuperAmerica Group Division of Ashland DBA SuperAmerica II4030 requests Council approval of its application for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License located at 1625 Rice Street (ID �116629). RECAMMENDATIONS: Approve (A7 or 9eject (R) PERSONAL SERVICE CONiRACTS MUST ANSWER SHE FOLLOW{NG QUESTIONS: _ PLANTIMG CAMMISSION _ IIIVIL SERVICE COMMISSION �� Has iqis pOCSONfirm evCr Worketl under a cOntfact for th�5 tlepartmeni? _ CIB COMMITTEE YES NO _ S7AFF 2. Has this personlfirm ever 6een a ciry employee? — — YES NO _ oiSiRICT cOUR7 _ _ _ g, Does this person/tirm possess a skill no[ normalty possessetl by any curtent ciry empl0yee? SUPPOHTSWHICHCOUNCILO&IEQTIME? YES NO Explafn a11 yes answers on separa[e sheet and ettach to 9reen sheet INITIATING PROBIEM, ISSUE, OPPOISTUNIN (Who, Wh81. W��, Y�t�rQ, Why): ADVANTAGESIFAPPpOVED� �' � ' � � DISADVANTAGES IF APPROVE�' �� @,yRB�a3�C �:°,.;.'y:r;� � �M :1 f'F`f�Er �. � b�:�`.�� DISADVANTAGESIFNOTAPPROVED: � �� '- ��`.i + �� M �� 12 �g91 JoE �'�L�'it�1� 70TAL AMOUNT OF TRANSACTION S COSi/REVENUE BUDGETEp (CIRCLE ONE) YES NO FUNDIIdG SOURCE ACTIVITV NUMBER FINANCIAL INFORFiAT10N (EXPLAIN) Greensneet # 37933 L.I.E.P. REVIEW CHECKLIST �ate: 312r197 /`��'dy� In Tracke�? App'n Received J App'n Processed Ucense�D # 16629 License Type:�as Station Restaurant-C. Grocery-C, and Giga Pr P T.ice Company Name: The SuperAmerica Group Division of AshlandDBSt1 SunerAmerica �64030 Business Addresss: 1625 Rice Street Business Phone: 488-7663 Contact Name/Address: Paul Larson, 1625 Rice St, l ll Home Phone: Date to Council Research: Pubiic Nearing Date: �Z� ��- Labefs Ordered: �✓� Notice Sent to App{icant: District Council #: ��? d?�>r'. � � Notice Sent to Public: �� Ward #: �/ Department/ Date Inspections Commerits City Attomey �•2- O,� . Environmentai Heaith fw v � ' Fire �.� • License Site Plan Reeeivad:� Lease Received: 5 �� l � �,� Police �r-' ' 2 ' Ci�'' � • �, . i Zoni�g � �� 11�08 CITY OF ST PRUL LIEP 9124 P.02i66 ��,q �-� ey3 cz.ass z� CITY OF SAINT PAUL o�«�rt,;«��;� J � ; LICENSE APPI,ICA�'ION �a��rra� 396ZPe45t5m�3� Sm¢Pu�Nppcm SSiOi C��` `� �C�1�9116 � �yxw;�c � �� f �oao W��. � i � �� THIS APPF C�� Vg�� I�� t � PLEASE TYPE OR PR1NT Ild 7NK - Trpe ofI.icense(s) be� aPPHed for: Compffiy Name: Corptxation tPatna�tiP � �u �OP^�p If bosiness is iucoipcxated, give date of inwspozaSion: � T)oiag $us9ness As: ,,,�C bl U� ��1�lil� � 1 Ln Busmas Address: �,��.� L- i L� .� � se«s aaAe�s �nr Betwaa what cross she�rs is the busaess located? Are thc presaises now occupied7 S�1haa Type of Business? �ra� ro.aaa��: .,p 8 B U1G t V UU �C L_e �C i N4� same aee�. crt Applicsat Iafom Name sad 7iflc: 612 � '�UL! i 1 As1� �hNd J—N� Bvsiness Phone: �K '.��3 %/7 s„� z� Nhicfi side of the srre�t? T� p S s,,,� Z �r �• . / .A . saa _ --- — � s�iame (Maidm) Lws r�tk Home Address: �(1 U V�,� �/ V(t O ' sr«enaasean Cnr senre zip Date of Birtfi: 11. �0 �� Place of $irth: _ Home Phoae;b8 L 3 S7 .� � 1� Haveyou ever been comieted of sctp felony, csune or tiolation of any city ordinance other than traffic? YES _ NO _� Date of arrest: Where7 C�srge: Coavictipa; SentaKC: List dxnama �d�ences of tLree pasons of good morsl charaMer, &vivg within the Twin Cities Meha Area, not ntated to the apglicant or fin�cially interested in the premi.ves or business, who may be refared to as to the applicant s character: NAME R ADDRESS PHONE �J�IAr� I111nR,4t,r S- 1`l72 o-y� � S7=S .�1-�}i�- bl�-Y3�-S337 licenses hol� foimaly � �H4 J'T �/ �1/ � �R � M may Iuve mm interest in: � wl_.4u/ L I ] . YES � NO ffya, list the datrs and reasons fos revocatioa: 2/18�97 11�08 CITY OF ST PAUL LIEP 612 266 9124 P.04i06 � q�b�3 8�€ �o opetrsc this busiaess pusonally? YES �?30 If not, �rho WYll o p axtc �'i7PERAAiERICAI G1�OXI1 ��;m� Ho�e ADErea� C� Aiec��to�zc•eal:��aofess.s�zatiathisbvsiness? ✓S'ES � , :fr, � P.O. BOX Lexir�gtoi srau 2i� :v0 If �Le maaxger is not she sxme €s tbe opaator, i5 8 f4r each parma (use additional pages if na:ess�y): C��) Nv�eaddrn+- Stren�ame City Swc TiP Fnox:4mba F'ra\ame ?.Gddteinitid G��) f.sa DamefB'vth HomeAddcnn: StreaSa�c CitY Sute Zip PncxA'usbet MI232dE507A TAX IDENt1FICAFION 2�JM&ER - P�us�nt to the I.sa�s of T�fanesota,1984, Chapter 502, Ar@cle 8. Sation 2(270.72} (Tsc Cl�raace> Lssuanee of Licensesj, liansing azuhoriries are reqe�ed to pmvedn to the State of 2�/Gnnesota Commissioner ofRcveauS the Muinaata busiuesstax idearification nvmba sad the sociat sa7airy numbec of cach Iicaiu appficent Undes tbe Minaesota Gwecnmeat Datx Pracz'sas Aa assd the Federal Pricary Ad of' f 974, we me requirod to advise you of the foIlowing regard'mgthe nse od'tfie N{�mesata TaxIdefllification23um� _��nt'ama8� msy be ussd to deap tfie iss�ce � reaewal of yoc4 liccus� in the cvmt you owe Mum�sota ss7es, empIoyer s wit�olt}�g or mo�vctuc]e exdse texe.� - �P°n �8 tbis imf'o�msaam, tFie Gcwsiag asuLo�iry ws�l suppl9 it oaly a the Muwesota 1�eQazment of Rcvenue. However, unda the Federal FxcbaAga of 7nfomnation A�; tSe DeP�mt of Reveaue maY �PPtY this'v�f'ormaiion ta t2m Iauma3 Revenue SaiSx � I�fmneaxa Tax Id�ScaDCm2��s (Sales &Use TaxNumbrr) maYbe obtamed 5omtbe S�u of N6nnesd,�, Bu� R�ds I7epmtmak 20RivaParkPlazaC612-296- .. .r.;. _ s�� s«�s rr�� p /— G l a-��S U �� - s� �a�us�� rr,��: : l�� v�S _ ffa D�iaaesota Tax Idcnt7ficauoa laumber ss ad requi:ed f� t3u businas btmg operated. indicau so by placing aa'X" ia zhe box �., e �� Pkxse fistyour e:np3o;ment }ustory for tbe pre�5mzs five {5) � ezr peiiial: , Lisc zll other o�eas of tbe «upo: Etioa p�� TT'n.� HOA'1E HO'.�E BLISL'�'ESS DATE OF ;.'.a �� (O,`��e He� � AAI�?tESS PHO\'E PH4h'E BIRTH Council File # �b"�3 Ordinance # Presented By Referred To Green Sheet # ��`�� RESOLUTION CITY OF SAINT PAUL, MINNESO7A �� Committee: Date 1 RESOLVED: That application (ID # 16629) for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License by 2 Super America Group Division of Asliland DBA SuperAmerica #4030 (Paul Larson, Manager) at 3 1625 Rice Street be and the same is hereby approved 4 5 Requeated by Department of: 6 Yeas Navs �Abse�t_ 7 B a� � 8 Bostrom � Off�ce of License Inspections and 9 H r i � 10 M r Envirorimenta� Protect+on 11 1 , �s � 13 Morton n 15 � � BYe ��/��'Y`^ti. �f 1 �Y"-i 16 Adopted by Council: Date 17 18 Adoption Certified by Council Secretary 19 Form Approved by City Attorney 20 / 21 By: �_ a � /� � JJ 22 p � $y' ____�_ J 23 Approved by Mayor: Date "t �� 24 ZS Approved by Mayor for Submiasion to Z6 BY. Council 27 By: °�-�y3 OEPI�R�MIENTIOFFICEICOUNqL DATE iNR1ATED � � � � J LIEP/Licensin GREEN SHEE CONiACf PEHSON & PHONE INITIAf1DATE MfT1AVDA7E �OEPl.FiiMENT0IRECTOR �CITYCDUNqL Christine Rozek 266-9108 A� �CfTYATTORNEY �CRYCLERK MUST BE ON COUNCR AGENDA BY DATE AUMBEfl FOA � BUDGET DIflECTOR � FlN. & MGT. SEFiVICES DIR. ^ flOUTING For hearin : '(f�r `'1 1 OBDER �MqyOR(ORASSI5fANn � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION RE�UESTED: The SuperAmerica Group Division of Ashland DBA SuperAmerica II4030 requests Council approval of its application for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License located at 1625 Rice Street (ID �116629). RECAMMENDATIONS: Approve (A7 or 9eject (R) PERSONAL SERVICE CONiRACTS MUST ANSWER SHE FOLLOW{NG QUESTIONS: _ PLANTIMG CAMMISSION _ IIIVIL SERVICE COMMISSION �� Has iqis pOCSONfirm evCr Worketl under a cOntfact for th�5 tlepartmeni? _ CIB COMMITTEE YES NO _ S7AFF 2. Has this personlfirm ever 6een a ciry employee? — — YES NO _ oiSiRICT cOUR7 _ _ _ g, Does this person/tirm possess a skill no[ normalty possessetl by any curtent ciry empl0yee? SUPPOHTSWHICHCOUNCILO&IEQTIME? YES NO Explafn a11 yes answers on separa[e sheet and ettach to 9reen sheet INITIATING PROBIEM, ISSUE, OPPOISTUNIN (Who, Wh81. W��, Y�t�rQ, Why): ADVANTAGESIFAPPpOVED� �' � ' � � DISADVANTAGES IF APPROVE�' �� @,yRB�a3�C �:°,.;.'y:r;� � �M :1 f'F`f�Er �. � b�:�`.�� DISADVANTAGESIFNOTAPPROVED: � �� '- ��`.i + �� M �� 12 �g91 JoE �'�L�'it�1� 70TAL AMOUNT OF TRANSACTION S COSi/REVENUE BUDGETEp (CIRCLE ONE) YES NO FUNDIIdG SOURCE ACTIVITV NUMBER FINANCIAL INFORFiAT10N (EXPLAIN) Greensneet # 37933 L.I.E.P. REVIEW CHECKLIST �ate: 312r197 /`��'dy� In Tracke�? App'n Received J App'n Processed Ucense�D # 16629 License Type:�as Station Restaurant-C. Grocery-C, and Giga Pr P T.ice Company Name: The SuperAmerica Group Division of AshlandDBSt1 SunerAmerica �64030 Business Addresss: 1625 Rice Street Business Phone: 488-7663 Contact Name/Address: Paul Larson, 1625 Rice St, l ll Home Phone: Date to Council Research: Pubiic Nearing Date: �Z� ��- Labefs Ordered: �✓� Notice Sent to App{icant: District Council #: ��? d?�>r'. � � Notice Sent to Public: �� Ward #: �/ Department/ Date Inspections Commerits City Attomey �•2- O,� . Environmentai Heaith fw v � ' Fire �.� • License Site Plan Reeeivad:� Lease Received: 5 �� l � �,� Police �r-' ' 2 ' Ci�'' � • �, . i Zoni�g � �� 11�08 CITY OF ST PRUL LIEP 9124 P.02i66 ��,q �-� ey3 cz.ass z� CITY OF SAINT PAUL o�«�rt,;«��;� J � ; LICENSE APPI,ICA�'ION �a��rra� 396ZPe45t5m�3� Sm¢Pu�Nppcm SSiOi C��` `� �C�1�9116 � �yxw;�c � �� f �oao W��. � i � �� THIS APPF C�� Vg�� I�� t � PLEASE TYPE OR PR1NT Ild 7NK - Trpe ofI.icense(s) be� aPPHed for: Compffiy Name: Corptxation tPatna�tiP � �u �OP^�p If bosiness is iucoipcxated, give date of inwspozaSion: � T)oiag $us9ness As: ,,,�C bl U� ��1�lil� � 1 Ln Busmas Address: �,��.� L- i L� .� � se«s aaAe�s �nr Betwaa what cross she�rs is the busaess located? Are thc presaises now occupied7 S�1haa Type of Business? �ra� ro.aaa��: .,p 8 B U1G t V UU �C L_e �C i N4� same aee�. crt Applicsat Iafom Name sad 7iflc: 612 � '�UL! i 1 As1� �hNd J—N� Bvsiness Phone: �K '.��3 %/7 s„� z� Nhicfi side of the srre�t? T� p S s,,,� Z �r �• . / .A . saa _ --- — � s�iame (Maidm) Lws r�tk Home Address: �(1 U V�,� �/ V(t O ' sr«enaasean Cnr senre zip Date of Birtfi: 11. �0 �� Place of $irth: _ Home Phoae;b8 L 3 S7 .� � 1� Haveyou ever been comieted of sctp felony, csune or tiolation of any city ordinance other than traffic? YES _ NO _� Date of arrest: Where7 C�srge: Coavictipa; SentaKC: List dxnama �d�ences of tLree pasons of good morsl charaMer, &vivg within the Twin Cities Meha Area, not ntated to the apglicant or fin�cially interested in the premi.ves or business, who may be refared to as to the applicant s character: NAME R ADDRESS PHONE �J�IAr� I111nR,4t,r S- 1`l72 o-y� � S7=S .�1-�}i�- bl�-Y3�-S337 licenses hol� foimaly � �H4 J'T �/ �1/ � �R � M may Iuve mm interest in: � wl_.4u/ L I ] . YES � NO ffya, list the datrs and reasons fos revocatioa: 2/18�97 11�08 CITY OF ST PAUL LIEP 612 266 9124 P.04i06 � q�b�3 8�€ �o opetrsc this busiaess pusonally? YES �?30 If not, �rho WYll o p axtc �'i7PERAAiERICAI G1�OXI1 ��;m� Ho�e ADErea� C� Aiec��to�zc•eal:��aofess.s�zatiathisbvsiness? ✓S'ES � , :fr, � P.O. BOX Lexir�gtoi srau 2i� :v0 If �Le maaxger is not she sxme €s tbe opaator, i5 8 f4r each parma (use additional pages if na:ess�y): C��) Nv�eaddrn+- Stren�ame City Swc TiP Fnox:4mba F'ra\ame ?.Gddteinitid G��) f.sa DamefB'vth HomeAddcnn: StreaSa�c CitY Sute Zip PncxA'usbet MI232dE507A TAX IDENt1FICAFION 2�JM&ER - P�us�nt to the I.sa�s of T�fanesota,1984, Chapter 502, Ar@cle 8. Sation 2(270.72} (Tsc Cl�raace> Lssuanee of Licensesj, liansing azuhoriries are reqe�ed to pmvedn to the State of 2�/Gnnesota Commissioner ofRcveauS the Muinaata busiuesstax idearification nvmba sad the sociat sa7airy numbec of cach Iicaiu appficent Undes tbe Minaesota Gwecnmeat Datx Pracz'sas Aa assd the Federal Pricary Ad of' f 974, we me requirod to advise you of the foIlowing regard'mgthe nse od'tfie N{�mesata TaxIdefllification23um� _��nt'ama8� msy be ussd to deap tfie iss�ce � reaewal of yoc4 liccus� in the cvmt you owe Mum�sota ss7es, empIoyer s wit�olt}�g or mo�vctuc]e exdse texe.� - �P°n �8 tbis imf'o�msaam, tFie Gcwsiag asuLo�iry ws�l suppl9 it oaly a the Muwesota 1�eQazment of Rcvenue. However, unda the Federal FxcbaAga of 7nfomnation A�; tSe DeP�mt of Reveaue maY �PPtY this'v�f'ormaiion ta t2m Iauma3 Revenue SaiSx � I�fmneaxa Tax Id�ScaDCm2��s (Sales &Use TaxNumbrr) maYbe obtamed 5omtbe S�u of N6nnesd,�, Bu� R�ds I7epmtmak 20RivaParkPlazaC612-296- .. .r.;. _ s�� s«�s rr�� p /— G l a-��S U �� - s� �a�us�� rr,��: : l�� v�S _ ffa D�iaaesota Tax Idcnt7ficauoa laumber ss ad requi:ed f� t3u businas btmg operated. indicau so by placing aa'X" ia zhe box �., e �� Pkxse fistyour e:np3o;ment }ustory for tbe pre�5mzs five {5) � ezr peiiial: , Lisc zll other o�eas of tbe «upo: Etioa p�� TT'n.� HOA'1E HO'.�E BLISL'�'ESS DATE OF ;.'.a �� (O,`��e He� � AAI�?tESS PHO\'E PH4h'E BIRTH