97-647Council File � �����
ordinance #
Green Sheet # "? � 1� �
1
z
3
Presented By _
Referred To
MINNESOTA
Committee: Date
��
RESOLVED: That application (ID #19926) for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License by
Super America Group Division of Asliland DBA SuperAmerica #A023 (Preston Bowen, Manager)
ak 577 Smith Avenue South be and the same is hereby approved
4
5 Requested by Department of:
6 Yeas Na�s Abse
7 B a�Tcey
9 � Harr � r s m � �2 Office of L•�cens� Insnections and
10 Me a d _ Environmental Protection
11
12 T un
13 Morton
15 � �
16 Adopted by Council: Date $Y '
17
18 Adoption Certified by Council Secretary
���� � ��
19 Fors Approved by City Attorney
20
21 By: 7
22 l Yr i � vw/
23 Approved by Mayor: Date �r� �
24 �
25 Approved by Mayor for Submission to
26 $Y. � L Counci.l
27
sy:
�'1 b�Y`1
�PM7MENTADFF�C6COUNCIL OATE INITIATEO 3 1�! 2(
LIEPjLicensing GREEN SHEE
CONTACi PEHSON & PHONE INITIAVDA7E INRIAUDATE
�OEPARTMENTDIpECTOR �CT'COUNCIL
Christine Rozek, 266-910$ q��'N �CRYAITOHNEY �CT'CLERK
MUST BE ON fAUNCiI AGENOA HY (DAT� NII4BER FOR ❑��� DIRECTOR � FlN. & MGT. SERVICES DIR.
ROUTING
r'OT hearin : '� OADER �MqyOR(ORASSI5fANn a
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACC�ON REQUES'(ED:
The SuperAmerica Group Division of Ashland DBA SuperAmerica 1�4023 requests Council approval
of its application for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License located
at 577 Smith Avenue South (ID 19926).
RECOMMENDATIOMS: Approve (A) m aejeei (A) pEHSONAL SERVICE CONTHACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PUW NING COMMISSION _ pVIL SFAVICE COMMISSION 1. Has this person/firm ever worketl untler a contract for ihis tlepartment?
_ a0 COMMiTfEE _ YES NO
_ STAFF 2. Has this perspnlfirm ever been a ciry emplayee?
— YES NO
_ o�sifuC7 cqUai _ 3. Does this person/Firm possess a skiil not norrnaly possessed by any cunent city employee?
SUP?ORTS WHiCH COUNGIL OBJECFIVE? YES NO
Explain all yes answero on separate aheet anA attaeh to green shcet
INRIATING PROBLEM, ISSUE, OPMJRTUNT' (Who. What, When. Where, Why):
AOYANTAGES IF APPROVED:
DISAOVANTAGES IFAPPROVED:
��-�i.�.,. _ ..�__ .�_. b_�;'^�
� � `� � � �l�s;s�
ri�,�:
�.�«-��,s
DISA�VANTA6ES IF NOTAPPROVED: � "
TOTAL AMOUNT OF TRANSACTION S COS7/REVENUE BUDGE7ED (C{RCLE ONE) YES NO
FUNDIWG SOURCE ACTIVIiY NUMBER
FINANCIAL 1NFORf.FATION. (E%PfA1N)
Greensheet # 37927 L.I.E.P. REVIEW CHECKLIST Date: 3j27/97 ,
In Tracker avp�n aecened / App'n Processed
�t"�b�`�
LicenSe 1D # 19926 LicenSe Type: Gas Station Restaurant—C Grocery—C and C"g3ratr i' ce,
COmpany NamB: SuperAmerica Group Division o£ Ashland DBA: S„� rAm T'ca 4I40 't
Business Addresss: 577 Smith Avenue South Susiness Phone: 228-9098
Contact Name/Address: Preston Bowen, 577 Smith Avenue S Home Phone:
Date to Council Research: 55102
Public Hearing Date: � z 8 �
Notice Sent to Applicant: ��/j�i l
Labels Ordered: /�/�
District Council #: ✓
J ` ' d5/J� o r�v
Notice Sent to Public: �/ �� � ��� Ward #: �
Departmentf Date Inspections Comments
City Attorney
r' � °l � L7
Environmental
Health
N.J�•
Fire
���f F � �. � .
License Site Ptan Received:_
Lease fleceived:
5��[�7 a��
Police
�1����- �.� .
Zoning
�" � �� o�K .
_ �,.:�w�� ._ _ _ _ -� - -
MRR 11:08 CITY OF ST PAUL LIFP �����
.. . . . 612 266 9124 P.02i0$
°
CLc�SS III CITI' OF SAINT �AUI.
LICENSE APPLICATIQN ��� ��
Ap 1 �ar ' ��P����
��.���
1 [ � � (a��ssso�e �tc�)zsssiza
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li� ):1 _
�• • � � �
�cpe ofLicense(s) bemg BPPlied for:
� ' a,���
�d�1�F P� t�ac� (��
�a�a r.�n s S!� � ,
�.�± �tc,uva�f-� �► '
Compmmy Name: _�,_,lA t1J- � J4 j'//� t (j.) G`A lEf 1
Co+Por4+oa/Pm4ttxsFip /So]e Etaprictotship
I€bvsiness is incotporated, give date of inco:pozatioa:
�°� $�� �: �2 Awt.e R i u► �#
Busmess Address: r �� .
seas nad,w
BMwear wLat cross s�ts is the busaess locat��
An thcpremises aow ied7 What Type ofBcuiAess?
� ra ��_ P� 8 (n� t +� �u�,�e,
sa�a na�,,. �
AppGcanl7nfoimafic�m J �
Name sadTiflc_ l/ /1���1/l�Q. SU ]� a.
�� ���
x�� A��: � Q riY . c��, � x
�_��.fi��
s � S,F ct u
�-
��
�S
_ _ ___ �
1 TJ. .r s`F A c� 1Jt �,d � a,c
a�. :�b
�....--�„_. Business Phone.�/� s?..2 a�l�' 41�
'_u/.r, o. S1l07
c�ry 5...^ �y,
Which side of tlx sa�eet?
�GN �t� VOS/2
ciry .� SYUC �P
C �/iC�iNt fr /�
� T
sv�ana�„ - �
r... y �
�7ate of Birth: �± (e �__L '�f___ Place of $uth:
Home PhoneLa f. 3 7:33 °.�
Have}rov everbeen comicud of saqfelon}; aime or violatiou ofany ary ordinance other than traffic?
Date of am�t; ��7 �S--_ NO �_
��&�
Convicti�;
Srnt�ce:
� mes and �idences of three persons of good moral charecter, fiving withm the Twiu Cities Mehv Ar not mlated to the
ally inierested in the pre�ni.4es or b�tsiness, who may bt rtf�red so as to the applicauYs chasacter: � $PFiicani
B N � ADDRESS
a C � S 14 0-yaN D S7.'S . PxorrE
�__�v �► i� a v► ��.�- /.�l3,4. 5,�; �
M /► �� / - ��r-�g.� s� N� - ti�waR:.��.-►.� �r b33 �y
F={�"� 14 a3 � e a. w� u ti i i � i nee.��a • � � �w i -- ----r--
�
or may LeVC en [jttezeyj jB;
i�
abov� named liamses e� be� revokedT � -
YES NO Ifyes, list tfie dates and reesons fox revocatioa:
MFlR-19-1997 11�08 CITY OF 5T PRUL LIEP
612 266 9124 P.04/�� b � ,
Are yrou going ,o opetuc this bwiaess pexsonaFl}•? � _,.{� NO If not, �cho w operete �p�� �E�C�I: GRO�I2
Div
��� ���� ���
� P.a. Box i40QS'��s'�'`
xox
c:,•
s�
ti
Pse c� g�m, to �xre a�zazgc oiess.�z�t in this b�uiaess? YES : i0 If the mxaxga is r.ot the seme €s the operator,
9�
r � -
is e v�mcsb�n, vlea.�e include}he follqw�ing infcmadon for each parma (use additionsl pages if necessffiy):
xo�er�d�e� straa�m� eisr s+n� 7ig re�ne:�t�mmtKr
Fi-at� !�feddeini6=S �3tideal Lu[ Defeef8atk
fiomeAdQmt� Saea?w�e Cit�' Suu Z+P Phox\'wnlcr
MIt1t.'ESO7A TAX IDENI7fICATiON NUMBER - P�asuant to the Law�s of I�iauesota, 1984, Chapta SQ2, Atticle $, Sxtion 2(270.72)
(Tsc Clearance; Issuanu of i.icens�s). licensing suth�ities are requued to pravide to the State of Msuuesota Commissioner of Revatue, the
2�Gnaesota bnsiaess rsx id�nuficaVOn narnbei aAd tbe saisl sxuriry mmmber of cach &caiu appHcant
Under tbe I�fin�sotz Gwecmnmt Dsta PtacLices Aa �d the F�da�at Privacy Ad of i 974, we sre required to ad�ise pou of thc foIlouing
regard�g the use of the Mmuesosa Tax TdenriScaiion Numba:
- This infamatio� may be used to depp the issvana ot reaewat of yo�s iiccssc in tfie rvart you owe MmnESata sa7es, employer s
mithholcliag os motffi vehicic accise t�tr�
'�P� �S t2BS i�afoam�oa, the liceusiag aiAhoriry w�l supply it aaly to tbe Muznesorta 7JcPar¢neat af Revrnue. Fiowever,
undec the Fedecal ExcL�tgt of 7ufomtation A�eemen� tfie Departmwt of Rtveaue maY supP1Y tbis infrnma6on to the Sateraal
Reveoue Seiv;ce .
M� Sa�c Idr�tibcationNumbecs (Sales &Use TmcWumb�') �}'be ob2ained from the S�ate of ��, Bus'suess Recor35 DePmtmnu.
lORi�cPartcPlaza(612-296-6281} ... _- -. .
s�;� s��y r�va: /- � I��-a'S G _ Mmnesota Tax IdeutiScauoa 23�bes:.: Ir� �� ��
^ If a hfiacesota Ta�c ldrntificatioa Nucnba u aot requised far t�e basincu bemg oQasted, indieate so by placing an`X" ia z� box
,,, e �„
Pkzse listyour e:nplo;meat bistor5' for tLe prc�7aas 5va (5} ceas period:
List zll other o�cas of the ccupo: ztion:
p��g TI'lT,E HO?�SE k30V,E B13S�TESS DAT£ OF
�*extc r[1;ficrT-ieLh . ADI3RFSS PHO\'E PHOI.E B��
Council File � �����
ordinance #
Green Sheet # "? � 1� �
1
z
3
Presented By _
Referred To
MINNESOTA
Committee: Date
��
RESOLVED: That application (ID #19926) for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License by
Super America Group Division of Asliland DBA SuperAmerica #A023 (Preston Bowen, Manager)
ak 577 Smith Avenue South be and the same is hereby approved
4
5 Requested by Department of:
6 Yeas Na�s Abse
7 B a�Tcey
9 � Harr � r s m � �2 Office of L•�cens� Insnections and
10 Me a d _ Environmental Protection
11
12 T un
13 Morton
15 � �
16 Adopted by Council: Date $Y '
17
18 Adoption Certified by Council Secretary
���� � ��
19 Fors Approved by City Attorney
20
21 By: 7
22 l Yr i � vw/
23 Approved by Mayor: Date �r� �
24 �
25 Approved by Mayor for Submission to
26 $Y. � L Counci.l
27
sy:
�'1 b�Y`1
�PM7MENTADFF�C6COUNCIL OATE INITIATEO 3 1�! 2(
LIEPjLicensing GREEN SHEE
CONTACi PEHSON & PHONE INITIAVDA7E INRIAUDATE
�OEPARTMENTDIpECTOR �CT'COUNCIL
Christine Rozek, 266-910$ q��'N �CRYAITOHNEY �CT'CLERK
MUST BE ON fAUNCiI AGENOA HY (DAT� NII4BER FOR ❑��� DIRECTOR � FlN. & MGT. SERVICES DIR.
ROUTING
r'OT hearin : '� OADER �MqyOR(ORASSI5fANn a
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACC�ON REQUES'(ED:
The SuperAmerica Group Division of Ashland DBA SuperAmerica 1�4023 requests Council approval
of its application for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License located
at 577 Smith Avenue South (ID 19926).
RECOMMENDATIOMS: Approve (A) m aejeei (A) pEHSONAL SERVICE CONTHACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PUW NING COMMISSION _ pVIL SFAVICE COMMISSION 1. Has this person/firm ever worketl untler a contract for ihis tlepartment?
_ a0 COMMiTfEE _ YES NO
_ STAFF 2. Has this perspnlfirm ever been a ciry emplayee?
— YES NO
_ o�sifuC7 cqUai _ 3. Does this person/Firm possess a skiil not norrnaly possessed by any cunent city employee?
SUP?ORTS WHiCH COUNGIL OBJECFIVE? YES NO
Explain all yes answero on separate aheet anA attaeh to green shcet
INRIATING PROBLEM, ISSUE, OPMJRTUNT' (Who. What, When. Where, Why):
AOYANTAGES IF APPROVED:
DISAOVANTAGES IFAPPROVED:
��-�i.�.,. _ ..�__ .�_. b_�;'^�
� � `� � � �l�s;s�
ri�,�:
�.�«-��,s
DISA�VANTA6ES IF NOTAPPROVED: � "
TOTAL AMOUNT OF TRANSACTION S COS7/REVENUE BUDGE7ED (C{RCLE ONE) YES NO
FUNDIWG SOURCE ACTIVIiY NUMBER
FINANCIAL 1NFORf.FATION. (E%PfA1N)
Greensheet # 37927 L.I.E.P. REVIEW CHECKLIST Date: 3j27/97 ,
In Tracker avp�n aecened / App'n Processed
�t"�b�`�
LicenSe 1D # 19926 LicenSe Type: Gas Station Restaurant—C Grocery—C and C"g3ratr i' ce,
COmpany NamB: SuperAmerica Group Division o£ Ashland DBA: S„� rAm T'ca 4I40 't
Business Addresss: 577 Smith Avenue South Susiness Phone: 228-9098
Contact Name/Address: Preston Bowen, 577 Smith Avenue S Home Phone:
Date to Council Research: 55102
Public Hearing Date: � z 8 �
Notice Sent to Applicant: ��/j�i l
Labels Ordered: /�/�
District Council #: ✓
J ` ' d5/J� o r�v
Notice Sent to Public: �/ �� � ��� Ward #: �
Departmentf Date Inspections Comments
City Attorney
r' � °l � L7
Environmental
Health
N.J�•
Fire
���f F � �. � .
License Site Ptan Received:_
Lease fleceived:
5��[�7 a��
Police
�1����- �.� .
Zoning
�" � �� o�K .
_ �,.:�w�� ._ _ _ _ -� - -
MRR 11:08 CITY OF ST PAUL LIFP �����
.. . . . 612 266 9124 P.02i0$
°
CLc�SS III CITI' OF SAINT �AUI.
LICENSE APPLICATIQN ��� ��
Ap 1 �ar ' ��P����
��.���
1 [ � � (a��ssso�e �tc�)zsssiza
. � ' � � � � ,��
.M:f _ il�1i b fl. SS. fJ� �.:1 ! Z i 1 � � ~ � _
li� ):1 _
�• • � � �
�cpe ofLicense(s) bemg BPPlied for:
� ' a,���
�d�1�F P� t�ac� (��
�a�a r.�n s S!� � ,
�.�± �tc,uva�f-� �► '
Compmmy Name: _�,_,lA t1J- � J4 j'//� t (j.) G`A lEf 1
Co+Por4+oa/Pm4ttxsFip /So]e Etaprictotship
I€bvsiness is incotporated, give date of inco:pozatioa:
�°� $�� �: �2 Awt.e R i u► �#
Busmess Address: r �� .
seas nad,w
BMwear wLat cross s�ts is the busaess locat��
An thcpremises aow ied7 What Type ofBcuiAess?
� ra ��_ P� 8 (n� t +� �u�,�e,
sa�a na�,,. �
AppGcanl7nfoimafic�m J �
Name sadTiflc_ l/ /1���1/l�Q. SU ]� a.
�� ���
x�� A��: � Q riY . c��, � x
�_��.fi��
s � S,F ct u
�-
��
�S
_ _ ___ �
1 TJ. .r s`F A c� 1Jt �,d � a,c
a�. :�b
�....--�„_. Business Phone.�/� s?..2 a�l�' 41�
'_u/.r, o. S1l07
c�ry 5...^ �y,
Which side of tlx sa�eet?
�GN �t� VOS/2
ciry .� SYUC �P
C �/iC�iNt fr /�
� T
sv�ana�„ - �
r... y �
�7ate of Birth: �± (e �__L '�f___ Place of $uth:
Home PhoneLa f. 3 7:33 °.�
Have}rov everbeen comicud of saqfelon}; aime or violatiou ofany ary ordinance other than traffic?
Date of am�t; ��7 �S--_ NO �_
��&�
Convicti�;
Srnt�ce:
� mes and �idences of three persons of good moral charecter, fiving withm the Twiu Cities Mehv Ar not mlated to the
ally inierested in the pre�ni.4es or b�tsiness, who may bt rtf�red so as to the applicauYs chasacter: � $PFiicani
B N � ADDRESS
a C � S 14 0-yaN D S7.'S . PxorrE
�__�v �► i� a v► ��.�- /.�l3,4. 5,�; �
M /► �� / - ��r-�g.� s� N� - ti�waR:.��.-►.� �r b33 �y
F={�"� 14 a3 � e a. w� u ti i i � i nee.��a • � � �w i -- ----r--
�
or may LeVC en [jttezeyj jB;
i�
abov� named liamses e� be� revokedT � -
YES NO Ifyes, list tfie dates and reesons fox revocatioa:
MFlR-19-1997 11�08 CITY OF 5T PRUL LIEP
612 266 9124 P.04/�� b � ,
Are yrou going ,o opetuc this bwiaess pexsonaFl}•? � _,.{� NO If not, �cho w operete �p�� �E�C�I: GRO�I2
Div
��� ���� ���
� P.a. Box i40QS'��s'�'`
xox
c:,•
s�
ti
Pse c� g�m, to �xre a�zazgc oiess.�z�t in this b�uiaess? YES : i0 If the mxaxga is r.ot the seme €s the operator,
9�
r � -
is e v�mcsb�n, vlea.�e include}he follqw�ing infcmadon for each parma (use additionsl pages if necessffiy):
xo�er�d�e� straa�m� eisr s+n� 7ig re�ne:�t�mmtKr
Fi-at� !�feddeini6=S �3tideal Lu[ Defeef8atk
fiomeAdQmt� Saea?w�e Cit�' Suu Z+P Phox\'wnlcr
MIt1t.'ESO7A TAX IDENI7fICATiON NUMBER - P�asuant to the Law�s of I�iauesota, 1984, Chapta SQ2, Atticle $, Sxtion 2(270.72)
(Tsc Clearance; Issuanu of i.icens�s). licensing suth�ities are requued to pravide to the State of Msuuesota Commissioner of Revatue, the
2�Gnaesota bnsiaess rsx id�nuficaVOn narnbei aAd tbe saisl sxuriry mmmber of cach &caiu appHcant
Under tbe I�fin�sotz Gwecmnmt Dsta PtacLices Aa �d the F�da�at Privacy Ad of i 974, we sre required to ad�ise pou of thc foIlouing
regard�g the use of the Mmuesosa Tax TdenriScaiion Numba:
- This infamatio� may be used to depp the issvana ot reaewat of yo�s iiccssc in tfie rvart you owe MmnESata sa7es, employer s
mithholcliag os motffi vehicic accise t�tr�
'�P� �S t2BS i�afoam�oa, the liceusiag aiAhoriry w�l supply it aaly to tbe Muznesorta 7JcPar¢neat af Revrnue. Fiowever,
undec the Fedecal ExcL�tgt of 7ufomtation A�eemen� tfie Departmwt of Rtveaue maY supP1Y tbis infrnma6on to the Sateraal
Reveoue Seiv;ce .
M� Sa�c Idr�tibcationNumbecs (Sales &Use TmcWumb�') �}'be ob2ained from the S�ate of ��, Bus'suess Recor35 DePmtmnu.
lORi�cPartcPlaza(612-296-6281} ... _- -. .
s�;� s��y r�va: /- � I��-a'S G _ Mmnesota Tax IdeutiScauoa 23�bes:.: Ir� �� ��
^ If a hfiacesota Ta�c ldrntificatioa Nucnba u aot requised far t�e basincu bemg oQasted, indieate so by placing an`X" ia z� box
,,, e �„
Pkzse listyour e:nplo;meat bistor5' for tLe prc�7aas 5va (5} ceas period:
List zll other o�cas of the ccupo: ztion:
p��g TI'lT,E HO?�SE k30V,E B13S�TESS DAT£ OF
�*extc r[1;ficrT-ieLh . ADI3RFSS PHO\'E PHOI.E B��
Council File � �����
ordinance #
Green Sheet # "? � 1� �
1
z
3
Presented By _
Referred To
MINNESOTA
Committee: Date
��
RESOLVED: That application (ID #19926) for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License by
Super America Group Division of Asliland DBA SuperAmerica #A023 (Preston Bowen, Manager)
ak 577 Smith Avenue South be and the same is hereby approved
4
5 Requested by Department of:
6 Yeas Na�s Abse
7 B a�Tcey
9 � Harr � r s m � �2 Office of L•�cens� Insnections and
10 Me a d _ Environmental Protection
11
12 T un
13 Morton
15 � �
16 Adopted by Council: Date $Y '
17
18 Adoption Certified by Council Secretary
���� � ��
19 Fors Approved by City Attorney
20
21 By: 7
22 l Yr i � vw/
23 Approved by Mayor: Date �r� �
24 �
25 Approved by Mayor for Submission to
26 $Y. � L Counci.l
27
sy:
�'1 b�Y`1
�PM7MENTADFF�C6COUNCIL OATE INITIATEO 3 1�! 2(
LIEPjLicensing GREEN SHEE
CONTACi PEHSON & PHONE INITIAVDA7E INRIAUDATE
�OEPARTMENTDIpECTOR �CT'COUNCIL
Christine Rozek, 266-910$ q��'N �CRYAITOHNEY �CT'CLERK
MUST BE ON fAUNCiI AGENOA HY (DAT� NII4BER FOR ❑��� DIRECTOR � FlN. & MGT. SERVICES DIR.
ROUTING
r'OT hearin : '� OADER �MqyOR(ORASSI5fANn a
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACC�ON REQUES'(ED:
The SuperAmerica Group Division of Ashland DBA SuperAmerica 1�4023 requests Council approval
of its application for a Gas Station, Restaurant-C, Grocery-C, and Cigarette License located
at 577 Smith Avenue South (ID 19926).
RECOMMENDATIOMS: Approve (A) m aejeei (A) pEHSONAL SERVICE CONTHACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PUW NING COMMISSION _ pVIL SFAVICE COMMISSION 1. Has this person/firm ever worketl untler a contract for ihis tlepartment?
_ a0 COMMiTfEE _ YES NO
_ STAFF 2. Has this perspnlfirm ever been a ciry emplayee?
— YES NO
_ o�sifuC7 cqUai _ 3. Does this person/Firm possess a skiil not norrnaly possessed by any cunent city employee?
SUP?ORTS WHiCH COUNGIL OBJECFIVE? YES NO
Explain all yes answero on separate aheet anA attaeh to green shcet
INRIATING PROBLEM, ISSUE, OPMJRTUNT' (Who. What, When. Where, Why):
AOYANTAGES IF APPROVED:
DISAOVANTAGES IFAPPROVED:
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ri�,�:
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DISA�VANTA6ES IF NOTAPPROVED: � "
TOTAL AMOUNT OF TRANSACTION S COS7/REVENUE BUDGE7ED (C{RCLE ONE) YES NO
FUNDIWG SOURCE ACTIVIiY NUMBER
FINANCIAL 1NFORf.FATION. (E%PfA1N)
Greensheet # 37927 L.I.E.P. REVIEW CHECKLIST Date: 3j27/97 ,
In Tracker avp�n aecened / App'n Processed
�t"�b�`�
LicenSe 1D # 19926 LicenSe Type: Gas Station Restaurant—C Grocery—C and C"g3ratr i' ce,
COmpany NamB: SuperAmerica Group Division o£ Ashland DBA: S„� rAm T'ca 4I40 't
Business Addresss: 577 Smith Avenue South Susiness Phone: 228-9098
Contact Name/Address: Preston Bowen, 577 Smith Avenue S Home Phone:
Date to Council Research: 55102
Public Hearing Date: � z 8 �
Notice Sent to Applicant: ��/j�i l
Labels Ordered: /�/�
District Council #: ✓
J ` ' d5/J� o r�v
Notice Sent to Public: �/ �� � ��� Ward #: �
Departmentf Date Inspections Comments
City Attorney
r' � °l � L7
Environmental
Health
N.J�•
Fire
���f F � �. � .
License Site Ptan Received:_
Lease fleceived:
5��[�7 a��
Police
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Zoning
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_ �,.:�w�� ._ _ _ _ -� - -
MRR 11:08 CITY OF ST PAUL LIFP �����
.. . . . 612 266 9124 P.02i0$
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CLc�SS III CITI' OF SAINT �AUI.
LICENSE APPLICATIQN ��� ��
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�cpe ofLicense(s) bemg BPPlied for:
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Compmmy Name: _�,_,lA t1J- � J4 j'//� t (j.) G`A lEf 1
Co+Por4+oa/Pm4ttxsFip /So]e Etaprictotship
I€bvsiness is incotporated, give date of inco:pozatioa:
�°� $�� �: �2 Awt.e R i u► �#
Busmess Address: r �� .
seas nad,w
BMwear wLat cross s�ts is the busaess locat��
An thcpremises aow ied7 What Type ofBcuiAess?
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sa�a na�,,. �
AppGcanl7nfoimafic�m J �
Name sadTiflc_ l/ /1���1/l�Q. SU ]� a.
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�....--�„_. Business Phone.�/� s?..2 a�l�' 41�
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c�ry 5...^ �y,
Which side of tlx sa�eet?
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ciry .� SYUC �P
C �/iC�iNt fr /�
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�7ate of Birth: �± (e �__L '�f___ Place of $uth:
Home PhoneLa f. 3 7:33 °.�
Have}rov everbeen comicud of saqfelon}; aime or violatiou ofany ary ordinance other than traffic?
Date of am�t; ��7 �S--_ NO �_
��&�
Convicti�;
Srnt�ce:
� mes and �idences of three persons of good moral charecter, fiving withm the Twiu Cities Mehv Ar not mlated to the
ally inierested in the pre�ni.4es or b�tsiness, who may bt rtf�red so as to the applicauYs chasacter: � $PFiicani
B N � ADDRESS
a C � S 14 0-yaN D S7.'S . PxorrE
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F={�"� 14 a3 � e a. w� u ti i i � i nee.��a • � � �w i -- ----r--
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or may LeVC en [jttezeyj jB;
i�
abov� named liamses e� be� revokedT � -
YES NO Ifyes, list tfie dates and reesons fox revocatioa:
MFlR-19-1997 11�08 CITY OF 5T PRUL LIEP
612 266 9124 P.04/�� b � ,
Are yrou going ,o opetuc this bwiaess pexsonaFl}•? � _,.{� NO If not, �cho w operete �p�� �E�C�I: GRO�I2
Div
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� P.a. Box i40QS'��s'�'`
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Pse c� g�m, to �xre a�zazgc oiess.�z�t in this b�uiaess? YES : i0 If the mxaxga is r.ot the seme €s the operator,
9�
r � -
is e v�mcsb�n, vlea.�e include}he follqw�ing infcmadon for each parma (use additionsl pages if necessffiy):
xo�er�d�e� straa�m� eisr s+n� 7ig re�ne:�t�mmtKr
Fi-at� !�feddeini6=S �3tideal Lu[ Defeef8atk
fiomeAdQmt� Saea?w�e Cit�' Suu Z+P Phox\'wnlcr
MIt1t.'ESO7A TAX IDENI7fICATiON NUMBER - P�asuant to the Law�s of I�iauesota, 1984, Chapta SQ2, Atticle $, Sxtion 2(270.72)
(Tsc Clearance; Issuanu of i.icens�s). licensing suth�ities are requued to pravide to the State of Msuuesota Commissioner of Revatue, the
2�Gnaesota bnsiaess rsx id�nuficaVOn narnbei aAd tbe saisl sxuriry mmmber of cach &caiu appHcant
Under tbe I�fin�sotz Gwecmnmt Dsta PtacLices Aa �d the F�da�at Privacy Ad of i 974, we sre required to ad�ise pou of thc foIlouing
regard�g the use of the Mmuesosa Tax TdenriScaiion Numba:
- This infamatio� may be used to depp the issvana ot reaewat of yo�s iiccssc in tfie rvart you owe MmnESata sa7es, employer s
mithholcliag os motffi vehicic accise t�tr�
'�P� �S t2BS i�afoam�oa, the liceusiag aiAhoriry w�l supply it aaly to tbe Muznesorta 7JcPar¢neat af Revrnue. Fiowever,
undec the Fedecal ExcL�tgt of 7ufomtation A�eemen� tfie Departmwt of Rtveaue maY supP1Y tbis infrnma6on to the Sateraal
Reveoue Seiv;ce .
M� Sa�c Idr�tibcationNumbecs (Sales &Use TmcWumb�') �}'be ob2ained from the S�ate of ��, Bus'suess Recor35 DePmtmnu.
lORi�cPartcPlaza(612-296-6281} ... _- -. .
s�;� s��y r�va: /- � I��-a'S G _ Mmnesota Tax IdeutiScauoa 23�bes:.: Ir� �� ��
^ If a hfiacesota Ta�c ldrntificatioa Nucnba u aot requised far t�e basincu bemg oQasted, indieate so by placing an`X" ia z� box
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Pkzse listyour e:nplo;meat bistor5' for tLe prc�7aas 5va (5} ceas period:
List zll other o�cas of the ccupo: ztion:
p��g TI'lT,E HO?�SE k30V,E B13S�TESS DAT£ OF
�*extc r[1;ficrT-ieLh . ADI3RFSS PHO\'E PHOI.E B��