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97-720Council Eile # �" l � l�� ordinance # Green Sheet # RESOLUTION OF SAINT PAUL, MINNESO7A Presented By Referred To Co[nmittee: Date 3 75'(� �! 1 RESOLVED: That application (ID #25581) for a Liquor-Off Sale License by Capital City Properties DAB 2 Radisson Inn St Paul (John Carr) at 411 Minnesota Street be and the same is hereby approved 3 4 Requested by Department of: 5 Yeas a s Ab__ s ent 6 B a�Tcev ✓ 7 Bostr�_m � Office of License Inspections and 8 Harris �� 9 Meaa� �^ Fnvironmental Protection 10 Morton 11 T un� t�'e 1 3 Co ins � q 14 O �`iY� Tl �� 15 Adopted by Council: Date �`qq B Y' 16 17 Adoption Certified by Council 5ecretary 18 Form Approved by City Attorney 19 \ g /� � � 2� BYe ._-�., c3 , � cv--.l�ai.fa-� y: `/l' 21 t 22 Approved by Mayor: Date �`tb�4`l� 23 � 24 Approved by Mayor for Submission to 25 By: � Council 26 By: q� - � ao DEW1XiMENLDFFlCE/COUNdL DATE INITIATED �� V �,j LIEPJLicensing GREEN SHEE CONTACTPERSON 8 PHONE INITIAVDATE INRIAVDATE ODEPARTMENTDIRECTOR �CITYCOONCII Christine Aozek, 266-9108 p� CfT'/ATTOANEY CiTYCLERK MI1ST BE ON CAUNCIL AGENDA BY (DATE) NUNBER FOfl O BUDGEf DIRECTOfl O FIN_ & MGT. SEqVICES DIR. ROUTING For hearin : � ORDEH O MAYOR (ORASSISTANn � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS POR SIGNATURE) ACTfON AEQUE5TED: Capital City Properties DBA Radisson Inn St. Pau1 requests Council approval of its application for a Liquor-Off Sale License located at 411 Minnesota Stxeet (ID ��25581). FECOMMENDATIONS: Approve (A) or Reject iR) pERSONAL SERVICE CONTRACTS MUST ANSW ER THE FOLLOWING �UESTIONS: _ PLANNING COMMISSION _ CIVI� SERVICE COMMISSION �� Has this personffirm e�er worketl under a contrac[ for this department? _ CIB COMMfITEE _ YES NO _ S7AFF 2. Has this personttirm ever been a ciry employee? — YES NO _ DISTRICT COURT _ 3. D025 thls ersonrtirm o552ss 8 Skill nOt nOfinell � p p y possessed by any curreM city employee. SUPPOFiTS WHICH COUNCIL O&IECTIVE? YES NO Explain all yea answers on separete sheet and anaeh to green aheet INITIATING PROBLEM. ISSUE, OPPORTUNITV (VJho, What, VJhen, Where, Why): �� MAY 2 8 199T ADVANTAGES IFAPPROVED' DISADVANTAGES IF APPROVED. DISADVANTAGES IF NOTAPPROVED: � ,��1 n � 1'�n7 TOTAL AMOUN70F TFANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDIWG SOURCE ACTIVITY NUMBER FINANCIAL INFORFnATION� (EXPLAIN) Greensneet # 37960 L.I.E.P. REVIEW CHECKLIST Date: 5/23/97 / q1 �1a0 in Tracke�?� App'n aeceived / npp�n arocessed License ID # 25581 License Type: Liquor—Off Sale CompBny Name: Capital City Properties DBA: Radisson Inn St. Paul Business Addresss: 411 Minnesota Sereet Business Phone: 224-5686 Contact Name/Addresx John Carr, 1773 Bromlev Drive Home Phone: 730-6022 Woodbury, 55125 Date to Council Research: Public Hearing Date: ji� �� / � Notice Sent to Applicant:� SF.�� Labels Ordered: District Council #: /� �/!� �'CC L % b Notice Sent to Public: ��/'I Ward #: Department/ Date Inspections Commenis City Attorney .� • � Environmental Health � � � 0 • `k . Fire �v 3,�' �-- � � � License Site Plan Received: tsase Received: � �� . Police � 3 �j �- o� . Zoning ��3 �cf 2 � . �. . = ��.0 .... - 1 "� � �Jt� ��` � ,� S y� CLASS III (�� CITY OF SAINT PAUL LICENSE APPLICATION `1 Office of License, Inspections ^/� and Environmental Protection C IL',� �( 350 5� Pnv 5� Svim i00 V� ^ �� _� (� Saim P�ul, Ninnezou ssmz ` J �1 � {� —� G (613)=669090 fu(612)'66-91?4 � �-C' _ n ��1 �Gt 5� 1� ) � � THIS APPLICATION IS SUBJECT TO REVIE�V BY THE PUBLIC PLEASfi TYPE OR PRINT IN INK T}pe of License(s) bein� applied for: Hotel/Motel, On-5ale Liquor, Restaurant, Cigarettes, Swimming Pooi (Indoor), Entertainmenf Ciass B, Sunday On-Sale Company Name: Capital City Properties Liquor Gorporation f Paztnership 7 Sole Proprietorship If business is incorporated, give date of incorporation: 1991 - ZZ'z -18G� Doing Business As: Radisson Inn St. Paul Business Phone: 224-5686 Business Address: 411 Minnesota Street St. Paul Minnesota 55101 Sveet Addrees Ciry Sia�e Zip Berv+een what cross streets is the business located? 6th & Old 7th Which side of the street? West � Are the premises now occupied? No What T}pe of Business? Maii To Address: I900 Landmark Towers, 345 St. Peter Street, St, Paul, MN 55102 StTeei Address City State Zip Appiicant Information: Name and Title: Howard �� Firsc Middle Home Address: fi83 W. Wentworth AVenue Street Address Guthmann (Maiden) St. Paul Ciry ✓ President Last Tide Minnesota 55118 State Zip Date of Binh; Nov. 30 , 1922 Ptaee of Birth: Duiuth, MN Home Phone: 450-0111 Have you ever been convicted of any felony, c�ime or violation of any city ordinance other than traffic? YES � NO X Date of arrest: Char�e: ^ Conviction: Where? Sentence: List the names and residences of three pessons of �ood morai charactev, livin� within the Twin Cities Metro Area, not related to the app]icant ox financialty interested in the premises or business, who may be referred to as to the applicant's character: NAME ADDRESS PHONE List licenses which you currently hofd, formerly held, or may have an Interest in: None Have any of the above named ticenses ever been revoked? _ YES X NO If yes, list the dates and reasons for revocation: Are you �oing to operate this business perso�ally? _ YES X NO If not, who will operate it? John Carr �4arch 30, 1952 First Name Middle Initial (Maiden) Last Date of Birth 1773 Bromley Drive Woodbury Minnesota 55125 730-6022 Home Address: Sveet Name C � � State Zip Phone Number ' � L �`-� � �c-�-�� J :^.re you'goin� to have a mana�er or assistant in this business? X YES _ NO if the manager is no[ the same as the operator, � p{ease complete the fol{owing information: q� _�� First Name Middk Initial Home Address: Street Narnc (>faiden) Ciry Please list your employment history for the previous five (�) year period: Business/Emnlovment Laz[ S[ate . Zip Address List al] other officers of the corporation: OFFICER TITLE HOME HOME NAME Y(O�ce Heldl ADDRESS PHONE �1047 Beaver Dam Road Firs( Name Middte lnitial Home Address: Sveec Nam�e First Name Middie Initial Home Address: Sveet Name (Ataiden) Cin- (Maiden) e .� ry . BUSINESS PHONE Lazt Statc Zip Last State Zip Date of Birth Phone Numbet DATE OF BIR7'H Date of Binh Phone Number Date of Birth Fhone Number MIIVNESOTA TAX IDENTIFICA"tION NL3MHER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2 (270.72) (Tax Clearance; Issuance of Licenses), licensin� authorities are required to provide to the State of Minnesota Commissionar of Revenue, the Minnesota busi�ess tax identification number and the social security number of each license applicant. Under the Minnesota Govemment Data Practices Act and che Federal Privacy Act oF 1974, we are required to advise you of the fotlowing regardin� the use of the Minnesota Tax Identification Number: - This information may be used to deny the issuance or rene�val of your license in the event you owe Minnesota sales, employer's withholdin� or motor vehicle excise taxes; - Upon reeeivin� this information, the ]icensin� authority will supply it only to the Minnesota Department of Revenue. However, under the Federal Erchan�e of Information Agreement, the Department oF Revenue may supply this information to the Internal Revenue Service. Minnesota Tax Identification Numbers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records Department, 30 River Park Plaza (612-296-6181). Socia] Security Number: Minnesota Tax Identification Number: Applied For ��' � U�� '�"� �/5 f jr'�/ If a Minnesota Tax Identification Number is noi required for the business bein� operated, indicate so by placing an "X" in the box. _� If business is a partnership, please indade the fotlowin� information for each partner (use additional pages if necessary): - CERTIFICATION OF WORKERS' COMPENSATION COVERAGE PURSUANT TO M3NNESOTA STA'TUTE 776.182 1 hereby certify that i, or my company, am in compliance �vith ihe workers' compensation insurance covera�e requirements of Minnesota Stamte 176.182, subdivision 2. I also understand that provision of false information in this cettification constimtes sufficient �rounds for adverse action against all licenses held, including revocation and suspension of said licenses. Name of Insurance Company: American Compensation Insurance Co. PolicyNumber: AC—WC-000451—i Coveragefrom 3/1/95 to �/1/96 I have no employees covered under workers' compensation insurance ANY FALSIFICATSO� OF ANS\VERS GIVEIY OR MAT@RIAL SUBMITTED WILL RESULT IN DENIAL OF THIS APPLICATION ' q�-'�a� I hereby state that I have answered a33 of the precedin� questions, and that the information contained herein is true and correct to the best of my kno�vted;e and betiet. 1 hereby state further that I have received no money or other consideration, by way of loan, �ifr, contribution, or otherwise, other than afready disclosed in the application which I herewith submitted. I also understand this premise may be inspected by police, fire, health and other ciry officials at any and all timzs when the business is in operation. : , _� �//�� Si�namre (REQUIRED for all applicazions) y.. Date **Note; If this application is Food/Liquor re3ated, please contact a City of Saint Paul Health Inspector, Steve Otson (266-9139), to review plans. I£ any substantial chan�es to structure are anticipated, please contact a City of Saint Paul Plan Examiner at 266-9007 to apply for buildin� permits. If thare are any efian�es to the parking lot floor space, or for new operations, please cantaet a City of Saint Pau] Zonin� Inspector at 266-9008. Additionat appiication requirements, please attach. A detai{ed descripiion af the design, Iocation and square footage oF t6e premises to be licensed (site plan). The totto�t•ing data should be on Yhe site plan (preTerably on an 8 1/2" x 11" or 8 1{2" x I4" paper): - Name, address, and phone number. - The scale should be stated such as 1" = 20'. ^N should be indicated toward the top. - PlacemenC of a11 pertinent features of the interior of the licensed facility such as seating areas, kitchens, offices, repair area, parking, rest rooms, etc. - If a reguest is for an addition or expansion of the licensed facifity, indicate both the current area and the proposed eapansion. A copy of your lease agreement or proof of ownership of the property. FOR SPECIFIC APPLICATION REQUTREMENTS, PLEASE SEE REVERSE >>>> '.-f zppl}'ing for, • Cabaret adult, please attach written proof that each employee is at least ]8 years old. �� ConversationlRap parlor adutt, please attach written proof that each employee is at IeasT 18 yeazs old. Entertainment, please specify class A, B, or C license; obtain and attach signatures of approval from 90% of your neighbors within 350 feet of the establishment. This license must be applied for �n conjunction with a Liquor, Wine, Malt On Sale or RentaUDance Hal] license. Firearms, please attach a letter µ ith the following information: state if setling or only repairin�, Federal Firearms License Number, type of Armed Services dischar�e (Honorable, General, Bad Conduct, Undesirable, Dishonorab3e, or no military service. (NOTE: Establishment must be commercially zoned.) Game room, piease provide the followin� information: name of machine and list price. (NOT'E: A Pool Hall license is required if there are any pool tabies in the establishmentJ Health/Sports club adult, please attach ��ritten proof that each employee is at least 18 years old. Liquor aftlon sale, refer to attached liquor app]ication. Lock openin; sen�ices, ptease attach a list of all empioyees {with home address and telephone number) who will be doing the {ock opening service. � � Q� Qp(� S ��y�t�l (�j;�� . .� Massage center, please attach a detailed description of the services bein� provided. Massage eenter adult, please attach written proof that each employee is at least 18 years old. Massage practitioner, pleasa attach a copy of letter for approval from Health; proof of insurance coverage of $],000,000.00 each �enesai liab+lity and professionat tiabiliEy with the City of Saini Pacil aamed as an additiaiat insured, and a 30 day notice af cancellatian; a ietter from pour empiayer to verify employment �+ith a iicense massage center. Motorcycle dealer, pleasz include State of Minnesota Dealer Number. New motor vehide dealer, please incfude State of Minnesota Dealer Number. Parfiing toUramp, please include the number of par};in; spaces,and attaeh �lans containin� a general description of the security provided at che toc�ramp, a site plan showing drive�i�ays of the proposed lot and the le�al descriptipn of the property (this requirement necessary only if no site plan is cusently on file). Attach a cover letter describing your plans to comply with the lighting and paincin� requirements. Pawnbrol:er, please attach 55,900.Q0 Surety Bond. Second hand deater-motor vehicle, please include State of Minnesota Dealer NumUer. Secand hand dealer-motor ��ehicte parts, please attach �5,000.00 Surety Bond. Steamroom/bath house adult, please attach written proof that each employee is at least 18 years old. Theater aduit, pleasa attach written proof that each employee is at least I& years old. ��•�ao � �� .�� MinAesota txparanent of r„b�io safet} LIQUOR CONTROL DIVISION 190 Sth St. E., Sui[e 105, St. Paul, MN 55101 (672)296-6330 TTY(612)282-b555 �°l�s'��,. �'�"�-'�.e ��&� `'��=. APPLICATION FOI2 OFF SALE Il�ITOXICATIl\'G LIQUOR LICENSE :._:�__--_-__--_— _-- --- _ -- . _ __ .. . __ - -_-- . . _ - - � -- lYo licease witI be appro�•ed or reteased until t6e S2Q RetaHer If? Card fee is recei�•ed by MN Liquor CoatroL �-_ ------ - - _ American Canoensation Workers compensation insurance company. Name . Polic}#_ ��_wt'_nn�451-'t LICEAiSEE'S SALES & USE TAX ID�t nn? =,� �na � To app�y for sales sax #, call Z96-06181 or 1-800-b57-3777 If a corporation, an officer shall execute Yhis Licensee Nazne (Individual, Corporarion, Partnership) Capital City Properti°s License Location (Street Address & Block NoJ 47.i Minnesota Street Ciry Sa�nt Pa�al Name of Score Manager 3ohn Carr Trade Name or DBA � Radiss�n Inn Saint Paul Licenx Period From 1- 31-97 Cnunry Ramsey To 1-31-98 State Minnesota ( 5 ].?. ) 291-88p0 �xecute this application. AppGcant's Home Phone ( 61?. ) 791-8800 • Zip Code 55101 �dividual Applicaut) N/A If a carporation, state name, date of birth, address, title, and shares held by each officer. If a partnership, state names, address and date of birth of each partner. Listinc� at*_a�hed Partner Farmer pii3cet (Pirst, middlc, lasz) (Fitst, middlc, lastj DQ8 Title DOB Title � Pazmer Qfficer (F¢st, tniddle, tast) � DOB Shares Shares Cale Address, Cih�, 3tate, Zip Cade Address, City, State, Zip Code 1. If a eorporation, date of incorporation .1u7.�, 31, 1991, state incotporated in Minne�ota , amount paid iu cagital , If a subsidiary of any oESer cosporation, sa state and gi��e purpose of corporaiion . If inwrgorated under tl�e laws of anotl�er state, is co�poration auihorized to do bnsiness in the state of M'tnuesota? 0 Yes 0 No 2. Describe premises to H'hich 6cense applies; such as (first floor, second floor, basement, etc.) or if enYue building, so state. 3. 4. 5. 6. 7. Is establishmeat Iocated near any state university, state hospital, training school, refotmator}• or grison? ❑ Yes $ No ff yes state approzimate distauce. Name and nddress af baiidiug o�+aer: ra.,; +,-y1. r' r�'�� r L; o�-,_. t t ��,�; ,�o p t„ ,; �,� ;, Has o�aver of brulding auy connection, d'uectly or induectly, �virh appiicant? 0 Yes ❑ No Is applitant or aay of She associates in tUis application, a member of the govemiug body of thz municipaliTy� in wtiich this license is to be issued? p Yes � hTO If ges, in �ti'hat capacity? State wLethet any person otLer than applicants has any right, title or interest in the furniture, fi�ctures or equipment fQr �vhich license is applied and if so, gi�e name and details. _�Fa Have applicaats any interest �r�hatscsever, d'uectty or indirectly, in any ot5er li uor establiglu� t inihe state of Minnesota7 � Yes p No If yes, give name aud address of estatalisluaent. Rad�.sson t�e�te1 5a in,.`�aur 11 E<�st K�� ogg �v . .� . t � a� -�ao �.�. 8. Are tLe premises now occupied or to be occupied by the applicant entirely separate and e�clusi�'e &om any otfier business establishment? � Yes p No • 9. State whet6er applicant has or ticill be granted, an pu sale Liquor License in conjunction writh tlris Off Sale Liquor License and for the same premises. � Ycs ❑ No ❑ Will be grantad . 10. State n�heilier applicant has or «•ill be granted a Sunda�• On Sale Liquor License in co¢junction w'ith the regular On Sale Liquor License. � Yes � i�Io � Will 6e granted 11. If this application is for a County Boazd Off Sale License, sta[e the distance in milcs to the neazest municipaliry. N/A 1. State wbetIter applicant or any of the associates in this applicarion, have ever fiad an application for a liquor licwse rejected by any municipality or state authoriry; if so, give dates and details. No 2. Has the applicant or any of the associates in this application, during the five years immediately preceding this application ever had a license under the Minnesota Liquor Control Act re�•oked for any �7olation of sucl� laws or local ordinances; if so, give dates aad details. No 3. Has appficant, partaers, o$icers, or emplo}'ees ecer had any liquor ta�v violations in Mianesota or elseti�$ere, including State Liquor Control penaltirs? ❑ Yes � No If �'es, gi��e dates, cbacges and fma! outcqme. �. I?uring the pasi Hcause }'eat, Las a summons been is;ued under the Liquor Cri•il Liabilit}� Lao (Dtam Shop) M.S. 340A.802. a Yes � Nn If }�es, attach a capy of the summons. 17ris licensea must have onz of t6c fotto« ing: (ATTACH CERTIFICATE OF INSURANCE TO THIS FORM.) Chedcane W A. Liquor Liabilit}• Insurance (Dram Shop) -$50.000 per person, 5100,000 more tlian one pctsou; $10,000 propzrty d�struotion; SSQ,000 and S] 00.900 for loss of ineans of support. ' a ❑ B. A surety bond from a surety companr� titi ith minimnnt coaezage as spec�ed in A. or 0 C. A cerE�cate from tite State Treasurer that t}te licensee has deposited w ith the s�ate, trvst funds haeing mazket ��alue of $100,000 ot S 100,000 in cash or securities. I certitv that i ha� e read the above uestiona and that t6e aoswers are true aod correct of mv ow�n knowted e. Print name of appGcant & title Signn�z re of Iicant Date �uss t/vn,vE2, CanriRc«tfL �" S-J�-i� REPORT BY POLICEISHERIFF'S DEPARTMENT This is to certify tltat tha apglicant and the associates named herein have not been convicted within t8e past frve yeazs for any violation of laws of tlte State af Minnesata or municipal ordinances mlating to intmioating liquor except as follows: PoliceJSheriB's arhneat TiUe Si ature PS 9136•44 CounNAttornev's Siffianue IMPORTANT iVOTICE A31 retail liquor liceusees must have a current Federal Special Occupational Stamp. This staznp is issued by the Bureau of NcoLol, To6acco, and Fueazms. For information call (612)290-3496. . Council Eile # �" l � l�� ordinance # Green Sheet # RESOLUTION OF SAINT PAUL, MINNESO7A Presented By Referred To Co[nmittee: Date 3 75'(� �! 1 RESOLVED: That application (ID #25581) for a Liquor-Off Sale License by Capital City Properties DAB 2 Radisson Inn St Paul (John Carr) at 411 Minnesota Street be and the same is hereby approved 3 4 Requested by Department of: 5 Yeas a s Ab__ s ent 6 B a�Tcev ✓ 7 Bostr�_m � Office of License Inspections and 8 Harris �� 9 Meaa� �^ Fnvironmental Protection 10 Morton 11 T un� t�'e 1 3 Co ins � q 14 O �`iY� Tl �� 15 Adopted by Council: Date �`qq B Y' 16 17 Adoption Certified by Council 5ecretary 18 Form Approved by City Attorney 19 \ g /� � � 2� BYe ._-�., c3 , � cv--.l�ai.fa-� y: `/l' 21 t 22 Approved by Mayor: Date �`tb�4`l� 23 � 24 Approved by Mayor for Submission to 25 By: � Council 26 By: q� - � ao DEW1XiMENLDFFlCE/COUNdL DATE INITIATED �� V �,j LIEPJLicensing GREEN SHEE CONTACTPERSON 8 PHONE INITIAVDATE INRIAVDATE ODEPARTMENTDIRECTOR �CITYCOONCII Christine Aozek, 266-9108 p� CfT'/ATTOANEY CiTYCLERK MI1ST BE ON CAUNCIL AGENDA BY (DATE) NUNBER FOfl O BUDGEf DIRECTOfl O FIN_ & MGT. SEqVICES DIR. ROUTING For hearin : � ORDEH O MAYOR (ORASSISTANn � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS POR SIGNATURE) ACTfON AEQUE5TED: Capital City Properties DBA Radisson Inn St. Pau1 requests Council approval of its application for a Liquor-Off Sale License located at 411 Minnesota Stxeet (ID ��25581). FECOMMENDATIONS: Approve (A) or Reject iR) pERSONAL SERVICE CONTRACTS MUST ANSW ER THE FOLLOWING �UESTIONS: _ PLANNING COMMISSION _ CIVI� SERVICE COMMISSION �� Has this personffirm e�er worketl under a contrac[ for this department? _ CIB COMMfITEE _ YES NO _ S7AFF 2. Has this personttirm ever been a ciry employee? — YES NO _ DISTRICT COURT _ 3. D025 thls ersonrtirm o552ss 8 Skill nOt nOfinell � p p y possessed by any curreM city employee. SUPPOFiTS WHICH COUNCIL O&IECTIVE? YES NO Explain all yea answers on separete sheet and anaeh to green aheet INITIATING PROBLEM. ISSUE, OPPORTUNITV (VJho, What, VJhen, Where, Why): �� MAY 2 8 199T ADVANTAGES IFAPPROVED' DISADVANTAGES IF APPROVED. DISADVANTAGES IF NOTAPPROVED: � ,��1 n � 1'�n7 TOTAL AMOUN70F TFANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDIWG SOURCE ACTIVITY NUMBER FINANCIAL INFORFnATION� (EXPLAIN) Greensneet # 37960 L.I.E.P. REVIEW CHECKLIST Date: 5/23/97 / q1 �1a0 in Tracke�?� App'n aeceived / npp�n arocessed License ID # 25581 License Type: Liquor—Off Sale CompBny Name: Capital City Properties DBA: Radisson Inn St. Paul Business Addresss: 411 Minnesota Sereet Business Phone: 224-5686 Contact Name/Addresx John Carr, 1773 Bromlev Drive Home Phone: 730-6022 Woodbury, 55125 Date to Council Research: Public Hearing Date: �� /� Notice Sent to Applicant:� SF.�� Labels Ordered: District Council #: /� �/!� �'CC L % b Notice Sent to Public: ��/'I Ward #: Department/ Date Inspections Commenis City Attorney .� • � Environmental Health � � � 0 • `k . Fire �v 3,�' �-- � � � License Site Plan Received: tsase Received: � �� . Police � 3 �j �- o� . Zoning ��3 �cf 2 � . �. . = ��.0 .... - 1 "� � �Jt� ��` � ,� S y� CLASS III (�� CITY OF SAINT PAUL LICENSE APPLICATION `1 Office of License, Inspections ^/� and Environmental Protection C IL',� �( 350 5� Pnv 5� Svim i00 V� ^ �� _� (� Saim P�ul, Ninnezou ssmz ` J �1 � {� —� G (613)=669090 fu(612)'66-91?4 � �-C' _ n ��1 �Gt 5� 1� ) � � THIS APPLICATION IS SUBJECT TO REVIE�V BY THE PUBLIC PLEASfi TYPE OR PRINT IN INK T}pe of License(s) bein� applied for: Hotel/Motel, On-5ale Liquor, Restaurant, Cigarettes, Swimming Pooi (Indoor), Entertainmenf Ciass B, Sunday On-Sale Company Name: Capital City Properties Liquor Gorporation f Paztnership 7 Sole Proprietorship If business is incorporated, give date of incorporation: 1991 - ZZ'z -18G� Doing Business As: Radisson Inn St. Paul Business Phone: 224-5686 Business Address: 411 Minnesota Street St. Paul Minnesota 55101 Sveet Addrees Ciry Sia�e Zip Berv+een what cross streets is the business located? 6th & Old 7th Which side of the street? West � Are the premises now occupied? No What T}pe of Business? Maii To Address: I900 Landmark Towers, 345 St. Peter Street, St, Paul, MN 55102 StTeei Address City State Zip Appiicant Information: Name and Title: Howard �� Firsc Middle Home Address: fi83 W. Wentworth AVenue Street Address Guthmann (Maiden) St. Paul Ciry ✓ President Last Tide Minnesota 55118 State Zip Date of Binh; Nov. 30 , 1922 Ptaee of Birth: Duiuth, MN Home Phone: 450-0111 Have you ever been convicted of any felony, c�ime or violation of any city ordinance other than traffic? YES � NO X Date of arrest: Char�e: ^ Conviction: Where? Sentence: List the names and residences of three pessons of �ood morai charactev, livin� within the Twin Cities Metro Area, not related to the app]icant ox financialty interested in the premises or business, who may be referred to as to the applicant's character: NAME ADDRESS PHONE List licenses which you currently hofd, formerly held, or may have an Interest in: None Have any of the above named ticenses ever been revoked? _ YES X NO If yes, list the dates and reasons for revocation: Are you �oing to operate this business perso�ally? _ YES X NO If not, who will operate it? John Carr �4arch 30, 1952 First Name Middle Initial (Maiden) Last Date of Birth 1773 Bromley Drive Woodbury Minnesota 55125 730-6022 Home Address: Sveet Name C � � State Zip Phone Number ' � L �`-� � �c-�-�� J :^.re you'goin� to have a mana�er or assistant in this business? X YES _ NO if the manager is no[ the same as the operator, � p{ease complete the fol{owing information: q� _�� First Name Middk Initial Home Address: Street Narnc (>faiden) Ciry Please list your employment history for the previous five (�) year period: Business/Emnlovment Laz[ S[ate . Zip Address List al] other officers of the corporation: OFFICER TITLE HOME HOME NAME Y(O�ce Heldl ADDRESS PHONE �1047 Beaver Dam Road Firs( Name Middte lnitial Home Address: Sveec Nam�e First Name Middie Initial Home Address: Sveet Name (Ataiden) Cin- (Maiden) e .� ry . BUSINESS PHONE Lazt Statc Zip Last State Zip Date of Birth Phone Numbet DATE OF BIR7'H Date of Binh Phone Number Date of Birth Fhone Number MIIVNESOTA TAX IDENTIFICA"tION NL3MHER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2 (270.72) (Tax Clearance; Issuance of Licenses), licensin� authorities are required to provide to the State of Minnesota Commissionar of Revenue, the Minnesota busi�ess tax identification number and the social security number of each license applicant. Under the Minnesota Govemment Data Practices Act and che Federal Privacy Act oF 1974, we are required to advise you of the fotlowing regardin� the use of the Minnesota Tax Identification Number: - This information may be used to deny the issuance or rene�val of your license in the event you owe Minnesota sales, employer's withholdin� or motor vehicle excise taxes; - Upon reeeivin� this information, the ]icensin� authority will supply it only to the Minnesota Department of Revenue. However, under the Federal Erchan�e of Information Agreement, the Department oF Revenue may supply this information to the Internal Revenue Service. Minnesota Tax Identification Numbers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records Department, 30 River Park Plaza (612-296-6181). Socia] Security Number: Minnesota Tax Identification Number: Applied For ��' � U�� '�"� �/5 f jr'�/ If a Minnesota Tax Identification Number is noi required for the business bein� operated, indicate so by placing an "X" in the box. _� If business is a partnership, please indade the fotlowin� information for each partner (use additional pages if necessary): - CERTIFICATION OF WORKERS' COMPENSATION COVERAGE PURSUANT TO M3NNESOTA STA'TUTE 776.182 1 hereby certify that i, or my company, am in compliance �vith ihe workers' compensation insurance covera�e requirements of Minnesota Stamte 176.182, subdivision 2. I also understand that provision of false information in this cettification constimtes sufficient �rounds for adverse action against all licenses held, including revocation and suspension of said licenses. Name of Insurance Company: American Compensation Insurance Co. PolicyNumber: AC—WC-000451—i Coveragefrom 3/1/95 to �/1/96 I have no employees covered under workers' compensation insurance ANY FALSIFICATSO� OF ANS\VERS GIVEIY OR MAT@RIAL SUBMITTED WILL RESULT IN DENIAL OF THIS APPLICATION ' q�-'�a� I hereby state that I have answered a33 of the precedin� questions, and that the information contained herein is true and correct to the best of my kno�vted;e and betiet. 1 hereby state further that I have received no money or other consideration, by way of loan, �ifr, contribution, or otherwise, other than afready disclosed in the application which I herewith submitted. I also understand this premise may be inspected by police, fire, health and other ciry officials at any and all timzs when the business is in operation. : , _� �//�� Si�namre (REQUIRED for all applicazions) y.. Date **Note; If this application is Food/Liquor re3ated, please contact a City of Saint Paul Health Inspector, Steve Otson (266-9139), to review plans. I£ any substantial chan�es to structure are anticipated, please contact a City of Saint Paul Plan Examiner at 266-9007 to apply for buildin� permits. If thare are any efian�es to the parking lot floor space, or for new operations, please cantaet a City of Saint Pau] Zonin� Inspector at 266-9008. Additionat appiication requirements, please attach. A detai{ed descripiion af the design, Iocation and square footage oF t6e premises to be licensed (site plan). The totto�t•ing data should be on Yhe site plan (preTerably on an 8 1/2" x 11" or 8 1{2" x I4" paper): - Name, address, and phone number. - The scale should be stated such as 1" = 20'. ^N should be indicated toward the top. - PlacemenC of a11 pertinent features of the interior of the licensed facility such as seating areas, kitchens, offices, repair area, parking, rest rooms, etc. - If a reguest is for an addition or expansion of the licensed facifity, indicate both the current area and the proposed eapansion. A copy of your lease agreement or proof of ownership of the property. FOR SPECIFIC APPLICATION REQUTREMENTS, PLEASE SEE REVERSE >>>> '.-f zppl}'ing for, • Cabaret adult, please attach written proof that each employee is at least ]8 years old. �� ConversationlRap parlor adutt, please attach written proof that each employee is at IeasT 18 yeazs old. Entertainment, please specify class A, B, or C license; obtain and attach signatures of approval from 90% of your neighbors within 350 feet of the establishment. This license must be applied for �n conjunction with a Liquor, Wine, Malt On Sale or RentaUDance Hal] license. Firearms, please attach a letter µ ith the following information: state if setling or only repairin�, Federal Firearms License Number, type of Armed Services dischar�e (Honorable, General, Bad Conduct, Undesirable, Dishonorab3e, or no military service. (NOTE: Establishment must be commercially zoned.) Game room, piease provide the followin� information: name of machine and list price. (NOT'E: A Pool Hall license is required if there are any pool tabies in the establishmentJ Health/Sports club adult, please attach ��ritten proof that each employee is at least 18 years old. Liquor aftlon sale, refer to attached liquor app]ication. Lock openin; sen�ices, ptease attach a list of all empioyees {with home address and telephone number) who will be doing the {ock opening service. � � Q� Qp(� S ��y�t�l (�j;�� . .� Massage center, please attach a detailed description of the services bein� provided. Massage eenter adult, please attach written proof that each employee is at least 18 years old. Massage practitioner, pleasa attach a copy of letter for approval from Health; proof of insurance coverage of $],000,000.00 each �enesai liab+lity and professionat tiabiliEy with the City of Saini Pacil aamed as an additiaiat insured, and a 30 day notice af cancellatian; a ietter from pour empiayer to verify employment �+ith a iicense massage center. Motorcycle dealer, pleasz include State of Minnesota Dealer Number. New motor vehide dealer, please incfude State of Minnesota Dealer Number. Parfiing toUramp, please include the number of par};in; spaces,and attaeh �lans containin� a general description of the security provided at che toc�ramp, a site plan showing drive�i�ays of the proposed lot and the le�al descriptipn of the property (this requirement necessary only if no site plan is cusently on file). Attach a cover letter describing your plans to comply with the lighting and paincin� requirements. Pawnbrol:er, please attach 55,900.Q0 Surety Bond. Second hand deater-motor vehicle, please include State of Minnesota Dealer NumUer. Secand hand dealer-motor ��ehicte parts, please attach �5,000.00 Surety Bond. Steamroom/bath house adult, please attach written proof that each employee is at least 18 years old. Theater aduit, pleasa attach written proof that each employee is at least I& years old. ��•�ao � �� .�� MinAesota txparanent of r„b�io safet} LIQUOR CONTROL DIVISION 190 Sth St. E., Sui[e 105, St. Paul, MN 55101 (672)296-6330 TTY(612)282-b555 �°l�s'��,. �'�"�-'�.e ��&� `'��=. APPLICATION FOI2 OFF SALE Il�ITOXICATIl\'G LIQUOR LICENSE :._:�__--_-__--_— _-- --- _ -- . _ __ .. . __ - -_-- . . _ - - � -- lYo licease witI be appro�•ed or reteased until t6e S2Q RetaHer If? Card fee is recei�•ed by MN Liquor CoatroL �-_ ------ - - _ American Canoensation Workers compensation insurance company. Name . Polic}#_ ��_wt'_nn�451-'t LICEAiSEE'S SALES & USE TAX ID�t nn? =,� �na � To app�y for sales sax #, call Z96-06181 or 1-800-b57-3777 If a corporation, an officer shall execute Yhis Licensee Nazne (Individual, Corporarion, Partnership) Capital City Properti°s License Location (Street Address & Block NoJ 47.i Minnesota Street Ciry Sa�nt Pa�al Name of Score Manager 3ohn Carr Trade Name or DBA � Radiss�n Inn Saint Paul Licenx Period From 1- 31-97 Cnunry Ramsey To 1-31-98 State Minnesota ( 5 ].?. ) 291-88p0 �xecute this application. AppGcant's Home Phone ( 61?. ) 791-8800 • Zip Code 55101 �dividual Applicaut) N/A If a carporation, state name, date of birth, address, title, and shares held by each officer. If a partnership, state names, address and date of birth of each partner. Listinc� at*_a�hed Partner Farmer pii3cet (Pirst, middlc, lasz) (Fitst, middlc, lastj DQ8 Title DOB Title � Pazmer Qfficer (F¢st, tniddle, tast) � DOB Shares Shares Cale Address, Cih�, 3tate, Zip Cade Address, City, State, Zip Code 1. If a eorporation, date of incorporation .1u7.�, 31, 1991, state incotporated in Minne�ota , amount paid iu cagital , If a subsidiary of any oESer cosporation, sa state and gi��e purpose of corporaiion . If inwrgorated under tl�e laws of anotl�er state, is co�poration auihorized to do bnsiness in the state of M'tnuesota? 0 Yes 0 No 2. Describe premises to H'hich 6cense applies; such as (first floor, second floor, basement, etc.) or if enYue building, so state. 3. 4. 5. 6. 7. Is establishmeat Iocated near any state university, state hospital, training school, refotmator}• or grison? ❑ Yes $ No ff yes state approzimate distauce. Name and nddress af baiidiug o�+aer: ra.,; +,-y1. r' r�'�� r L; o�-,_. t t ��,�; ,�o p t„ ,; �,� ;, Has o�aver of brulding auy connection, d'uectly or induectly, �virh appiicant? 0 Yes ❑ No Is applitant or aay of She associates in tUis application, a member of the govemiug body of thz municipaliTy� in wtiich this license is to be issued? p Yes � hTO If ges, in �ti'hat capacity? State wLethet any person otLer than applicants has any right, title or interest in the furniture, fi�ctures or equipment fQr �vhich license is applied and if so, gi�e name and details. _�Fa Have applicaats any interest �r�hatscsever, d'uectty or indirectly, in any ot5er li uor establiglu� t inihe state of Minnesota7 � Yes p No If yes, give name aud address of estatalisluaent. Rad�.sson t�e�te1 5a in,.`�aur 11 E<�st K�� ogg �v . .� . t � a� -�ao �.�. 8. Are tLe premises now occupied or to be occupied by the applicant entirely separate and e�clusi�'e &om any otfier business establishment? � Yes p No • 9. State whet6er applicant has or ticill be granted, an pu sale Liquor License in conjunction writh tlris Off Sale Liquor License and for the same premises. � Ycs ❑ No ❑ Will be grantad . 10. State n�heilier applicant has or «•ill be granted a Sunda�• On Sale Liquor License in co¢junction w'ith the regular On Sale Liquor License. � Yes � i�Io � Will 6e granted 11. If this application is for a County Boazd Off Sale License, sta[e the distance in milcs to the neazest municipaliry. N/A 1. State wbetIter applicant or any of the associates in this applicarion, have ever fiad an application for a liquor licwse rejected by any municipality or state authoriry; if so, give dates and details. No 2. Has the applicant or any of the associates in this application, during the five years immediately preceding this application ever had a license under the Minnesota Liquor Control Act re�•oked for any �7olation of sucl� laws or local ordinances; if so, give dates aad details. No 3. Has appficant, partaers, o$icers, or emplo}'ees ecer had any liquor ta�v violations in Mianesota or elseti�$ere, including State Liquor Control penaltirs? ❑ Yes � No If �'es, gi��e dates, cbacges and fma! outcqme. �. I?uring the pasi Hcause }'eat, Las a summons been is;ued under the Liquor Cri•il Liabilit}� Lao (Dtam Shop) M.S. 340A.802. a Yes � Nn If }�es, attach a capy of the summons. 17ris licensea must have onz of t6c fotto« ing: (ATTACH CERTIFICATE OF INSURANCE TO THIS FORM.) Chedcane W A. Liquor Liabilit}• Insurance (Dram Shop) -$50.000 per person, 5100,000 more tlian one pctsou; $10,000 propzrty d�struotion; SSQ,000 and S] 00.900 for loss of ineans of support. ' a ❑ B. A surety bond from a surety companr� titi ith minimnnt coaezage as spec�ed in A. or 0 C. A cerE�cate from tite State Treasurer that t}te licensee has deposited w ith the s�ate, trvst funds haeing mazket ��alue of $100,000 ot S 100,000 in cash or securities. I certitv that i ha� e read the above uestiona and that t6e aoswers are true aod correct of mv ow�n knowted e. Print name of appGcant & title Signn�z re of Iicant Date �uss t/vn,vE2, CanriRc«tfL �" S-J�-i� REPORT BY POLICEISHERIFF'S DEPARTMENT This is to certify tltat tha apglicant and the associates named herein have not been convicted within t8e past frve yeazs for any violation of laws of tlte State af Minnesata or municipal ordinances mlating to intmioating liquor except as follows: PoliceJSheriB's arhneat TiUe Si ature PS 9136•44 CounNAttornev's Siffianue IMPORTANT iVOTICE A31 retail liquor liceusees must have a current Federal Special Occupational Stamp. This staznp is issued by the Bureau of NcoLol, To6acco, and Fueazms. For information call (612)290-3496. . Council Eile # �" l � l�� ordinance # Green Sheet # RESOLUTION OF SAINT PAUL, MINNESO7A Presented By Referred To Co[nmittee: Date 3 75'(� �! 1 RESOLVED: That application (ID #25581) for a Liquor-Off Sale License by Capital City Properties DAB 2 Radisson Inn St Paul (John Carr) at 411 Minnesota Street be and the same is hereby approved 3 4 Requested by Department of: 5 Yeas a s Ab__ s ent 6 B a�Tcev ✓ 7 Bostr�_m � Office of License Inspections and 8 Harris �� 9 Meaa� �^ Fnvironmental Protection 10 Morton 11 T un� t�'e 1 3 Co ins � q 14 O �`iY� Tl �� 15 Adopted by Council: Date �`qq B Y' 16 17 Adoption Certified by Council 5ecretary 18 Form Approved by City Attorney 19 \ g /� � � 2� BYe ._-�., c3 , � cv--.l�ai.fa-� y: `/l' 21 t 22 Approved by Mayor: Date �`tb�4`l� 23 � 24 Approved by Mayor for Submission to 25 By: � Council 26 By: q� - � ao DEW1XiMENLDFFlCE/COUNdL DATE INITIATED �� V �,j LIEPJLicensing GREEN SHEE CONTACTPERSON 8 PHONE INITIAVDATE INRIAVDATE ODEPARTMENTDIRECTOR �CITYCOONCII Christine Aozek, 266-9108 p� CfT'/ATTOANEY CiTYCLERK MI1ST BE ON CAUNCIL AGENDA BY (DATE) NUNBER FOfl O BUDGEf DIRECTOfl O FIN_ & MGT. SEqVICES DIR. ROUTING For hearin : � ORDEH O MAYOR (ORASSISTANn � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS POR SIGNATURE) ACTfON AEQUE5TED: Capital City Properties DBA Radisson Inn St. Pau1 requests Council approval of its application for a Liquor-Off Sale License located at 411 Minnesota Stxeet (ID ��25581). FECOMMENDATIONS: Approve (A) or Reject iR) pERSONAL SERVICE CONTRACTS MUST ANSW ER THE FOLLOWING �UESTIONS: _ PLANNING COMMISSION _ CIVI� SERVICE COMMISSION �� Has this personffirm e�er worketl under a contrac[ for this department? _ CIB COMMfITEE _ YES NO _ S7AFF 2. Has this personttirm ever been a ciry employee? — YES NO _ DISTRICT COURT _ 3. D025 thls ersonrtirm o552ss 8 Skill nOt nOfinell � p p y possessed by any curreM city employee. SUPPOFiTS WHICH COUNCIL O&IECTIVE? YES NO Explain all yea answers on separete sheet and anaeh to green aheet INITIATING PROBLEM. ISSUE, OPPORTUNITV (VJho, What, VJhen, Where, Why): �� MAY 2 8 199T ADVANTAGES IFAPPROVED' DISADVANTAGES IF APPROVED. DISADVANTAGES IF NOTAPPROVED: � ,��1 n � 1'�n7 TOTAL AMOUN70F TFANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDIWG SOURCE ACTIVITY NUMBER FINANCIAL INFORFnATION� (EXPLAIN) Greensneet # 37960 L.I.E.P. REVIEW CHECKLIST Date: 5/23/97 / q1 �1a0 in Tracke�?� App'n aeceived / npp�n arocessed License ID # 25581 License Type: Liquor—Off Sale CompBny Name: Capital City Properties DBA: Radisson Inn St. Paul Business Addresss: 411 Minnesota Sereet Business Phone: 224-5686 Contact Name/Addresx John Carr, 1773 Bromlev Drive Home Phone: 730-6022 Woodbury, 55125 Date to Council Research: Public Hearing Date: �� /� Notice Sent to Applicant:� SF.�� Labels Ordered: District Council #: /� �/!� �'CC L % b Notice Sent to Public: ��/'I Ward #: Department/ Date Inspections Commenis City Attorney .� • � Environmental Health � � � 0 • `k . Fire �v 3,�' �-- � � � License Site Plan Received: tsase Received: � �� . Police � 3 �j �- o� . Zoning ��3 �cf 2 � . �. . = ��.0 .... - 1 "� � �Jt� ��` � ,� S y� CLASS III (�� CITY OF SAINT PAUL LICENSE APPLICATION `1 Office of License, Inspections ^/� and Environmental Protection C IL',� �( 350 5� Pnv 5� Svim i00 V� ^ �� _� (� Saim P�ul, Ninnezou ssmz ` J �1 � {� —� G (613)=669090 fu(612)'66-91?4 � �-C' _ n ��1 �Gt 5� 1� ) � � THIS APPLICATION IS SUBJECT TO REVIE�V BY THE PUBLIC PLEASfi TYPE OR PRINT IN INK T}pe of License(s) bein� applied for: Hotel/Motel, On-5ale Liquor, Restaurant, Cigarettes, Swimming Pooi (Indoor), Entertainmenf Ciass B, Sunday On-Sale Company Name: Capital City Properties Liquor Gorporation f Paztnership 7 Sole Proprietorship If business is incorporated, give date of incorporation: 1991 - ZZ'z -18G� Doing Business As: Radisson Inn St. Paul Business Phone: 224-5686 Business Address: 411 Minnesota Street St. Paul Minnesota 55101 Sveet Addrees Ciry Sia�e Zip Berv+een what cross streets is the business located? 6th & Old 7th Which side of the street? West � Are the premises now occupied? No What T}pe of Business? Maii To Address: I900 Landmark Towers, 345 St. Peter Street, St, Paul, MN 55102 StTeei Address City State Zip Appiicant Information: Name and Title: Howard �� Firsc Middle Home Address: fi83 W. Wentworth AVenue Street Address Guthmann (Maiden) St. Paul Ciry ✓ President Last Tide Minnesota 55118 State Zip Date of Binh; Nov. 30 , 1922 Ptaee of Birth: Duiuth, MN Home Phone: 450-0111 Have you ever been convicted of any felony, c�ime or violation of any city ordinance other than traffic? YES � NO X Date of arrest: Char�e: ^ Conviction: Where? Sentence: List the names and residences of three pessons of �ood morai charactev, livin� within the Twin Cities Metro Area, not related to the app]icant ox financialty interested in the premises or business, who may be referred to as to the applicant's character: NAME ADDRESS PHONE List licenses which you currently hofd, formerly held, or may have an Interest in: None Have any of the above named ticenses ever been revoked? _ YES X NO If yes, list the dates and reasons for revocation: Are you �oing to operate this business perso�ally? _ YES X NO If not, who will operate it? John Carr �4arch 30, 1952 First Name Middle Initial (Maiden) Last Date of Birth 1773 Bromley Drive Woodbury Minnesota 55125 730-6022 Home Address: Sveet Name C � � State Zip Phone Number ' � L �`-� � �c-�-�� J :^.re you'goin� to have a mana�er or assistant in this business? X YES _ NO if the manager is no[ the same as the operator, � p{ease complete the fol{owing information: q� _�� First Name Middk Initial Home Address: Street Narnc (>faiden) Ciry Please list your employment history for the previous five (�) year period: Business/Emnlovment Laz[ S[ate . Zip Address List al] other officers of the corporation: OFFICER TITLE HOME HOME NAME Y(O�ce Heldl ADDRESS PHONE �1047 Beaver Dam Road Firs( Name Middte lnitial Home Address: Sveec Nam�e First Name Middie Initial Home Address: Sveet Name (Ataiden) Cin- (Maiden) e .� ry . BUSINESS PHONE Lazt Statc Zip Last State Zip Date of Birth Phone Numbet DATE OF BIR7'H Date of Binh Phone Number Date of Birth Fhone Number MIIVNESOTA TAX IDENTIFICA"tION NL3MHER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2 (270.72) (Tax Clearance; Issuance of Licenses), licensin� authorities are required to provide to the State of Minnesota Commissionar of Revenue, the Minnesota busi�ess tax identification number and the social security number of each license applicant. Under the Minnesota Govemment Data Practices Act and che Federal Privacy Act oF 1974, we are required to advise you of the fotlowing regardin� the use of the Minnesota Tax Identification Number: - This information may be used to deny the issuance or rene�val of your license in the event you owe Minnesota sales, employer's withholdin� or motor vehicle excise taxes; - Upon reeeivin� this information, the ]icensin� authority will supply it only to the Minnesota Department of Revenue. However, under the Federal Erchan�e of Information Agreement, the Department oF Revenue may supply this information to the Internal Revenue Service. Minnesota Tax Identification Numbers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records Department, 30 River Park Plaza (612-296-6181). Socia] Security Number: Minnesota Tax Identification Number: Applied For ��' � U�� '�"� �/5 f jr'�/ If a Minnesota Tax Identification Number is noi required for the business bein� operated, indicate so by placing an "X" in the box. _� If business is a partnership, please indade the fotlowin� information for each partner (use additional pages if necessary): - CERTIFICATION OF WORKERS' COMPENSATION COVERAGE PURSUANT TO M3NNESOTA STA'TUTE 776.182 1 hereby certify that i, or my company, am in compliance �vith ihe workers' compensation insurance covera�e requirements of Minnesota Stamte 176.182, subdivision 2. I also understand that provision of false information in this cettification constimtes sufficient �rounds for adverse action against all licenses held, including revocation and suspension of said licenses. Name of Insurance Company: American Compensation Insurance Co. PolicyNumber: AC—WC-000451—i Coveragefrom 3/1/95 to �/1/96 I have no employees covered under workers' compensation insurance ANY FALSIFICATSO� OF ANS\VERS GIVEIY OR MAT@RIAL SUBMITTED WILL RESULT IN DENIAL OF THIS APPLICATION ' q�-'�a� I hereby state that I have answered a33 of the precedin� questions, and that the information contained herein is true and correct to the best of my kno�vted;e and betiet. 1 hereby state further that I have received no money or other consideration, by way of loan, �ifr, contribution, or otherwise, other than afready disclosed in the application which I herewith submitted. I also understand this premise may be inspected by police, fire, health and other ciry officials at any and all timzs when the business is in operation. : , _� �//�� Si�namre (REQUIRED for all applicazions) y.. Date **Note; If this application is Food/Liquor re3ated, please contact a City of Saint Paul Health Inspector, Steve Otson (266-9139), to review plans. I£ any substantial chan�es to structure are anticipated, please contact a City of Saint Paul Plan Examiner at 266-9007 to apply for buildin� permits. If thare are any efian�es to the parking lot floor space, or for new operations, please cantaet a City of Saint Pau] Zonin� Inspector at 266-9008. Additionat appiication requirements, please attach. A detai{ed descripiion af the design, Iocation and square footage oF t6e premises to be licensed (site plan). The totto�t•ing data should be on Yhe site plan (preTerably on an 8 1/2" x 11" or 8 1{2" x I4" paper): - Name, address, and phone number. - The scale should be stated such as 1" = 20'. ^N should be indicated toward the top. - PlacemenC of a11 pertinent features of the interior of the licensed facility such as seating areas, kitchens, offices, repair area, parking, rest rooms, etc. - If a reguest is for an addition or expansion of the licensed facifity, indicate both the current area and the proposed eapansion. A copy of your lease agreement or proof of ownership of the property. FOR SPECIFIC APPLICATION REQUTREMENTS, PLEASE SEE REVERSE >>>> '.-f zppl}'ing for, • Cabaret adult, please attach written proof that each employee is at least ]8 years old. �� ConversationlRap parlor adutt, please attach written proof that each employee is at IeasT 18 yeazs old. Entertainment, please specify class A, B, or C license; obtain and attach signatures of approval from 90% of your neighbors within 350 feet of the establishment. This license must be applied for �n conjunction with a Liquor, Wine, Malt On Sale or RentaUDance Hal] license. Firearms, please attach a letter µ ith the following information: state if setling or only repairin�, Federal Firearms License Number, type of Armed Services dischar�e (Honorable, General, Bad Conduct, Undesirable, Dishonorab3e, or no military service. (NOTE: Establishment must be commercially zoned.) Game room, piease provide the followin� information: name of machine and list price. (NOT'E: A Pool Hall license is required if there are any pool tabies in the establishmentJ Health/Sports club adult, please attach ��ritten proof that each employee is at least 18 years old. Liquor aftlon sale, refer to attached liquor app]ication. Lock openin; sen�ices, ptease attach a list of all empioyees {with home address and telephone number) who will be doing the {ock opening service. � � Q� Qp(� S ��y�t�l (�j;�� . .� Massage center, please attach a detailed description of the services bein� provided. Massage eenter adult, please attach written proof that each employee is at least 18 years old. Massage practitioner, pleasa attach a copy of letter for approval from Health; proof of insurance coverage of $],000,000.00 each �enesai liab+lity and professionat tiabiliEy with the City of Saini Pacil aamed as an additiaiat insured, and a 30 day notice af cancellatian; a ietter from pour empiayer to verify employment �+ith a iicense massage center. Motorcycle dealer, pleasz include State of Minnesota Dealer Number. New motor vehide dealer, please incfude State of Minnesota Dealer Number. Parfiing toUramp, please include the number of par};in; spaces,and attaeh �lans containin� a general description of the security provided at che toc�ramp, a site plan showing drive�i�ays of the proposed lot and the le�al descriptipn of the property (this requirement necessary only if no site plan is cusently on file). Attach a cover letter describing your plans to comply with the lighting and paincin� requirements. Pawnbrol:er, please attach 55,900.Q0 Surety Bond. Second hand deater-motor vehicle, please include State of Minnesota Dealer NumUer. Secand hand dealer-motor ��ehicte parts, please attach �5,000.00 Surety Bond. Steamroom/bath house adult, please attach written proof that each employee is at least 18 years old. Theater aduit, pleasa attach written proof that each employee is at least I& years old. ��•�ao � �� .�� MinAesota txparanent of r„b�io safet} LIQUOR CONTROL DIVISION 190 Sth St. E., Sui[e 105, St. Paul, MN 55101 (672)296-6330 TTY(612)282-b555 �°l�s'��,. �'�"�-'�.e ��&� `'��=. APPLICATION FOI2 OFF SALE Il�ITOXICATIl\'G LIQUOR LICENSE :._:�__--_-__--_— _-- --- _ -- . _ __ .. . __ - -_-- . . _ - - � -- lYo licease witI be appro�•ed or reteased until t6e S2Q RetaHer If? Card fee is recei�•ed by MN Liquor CoatroL �-_ ------ - - _ American Canoensation Workers compensation insurance company. Name . Polic}#_ ��_wt'_nn�451-'t LICEAiSEE'S SALES & USE TAX ID�t nn? =,� �na � To app�y for sales sax #, call Z96-06181 or 1-800-b57-3777 If a corporation, an officer shall execute Yhis Licensee Nazne (Individual, Corporarion, Partnership) Capital City Properti°s License Location (Street Address & Block NoJ 47.i Minnesota Street Ciry Sa�nt Pa�al Name of Score Manager 3ohn Carr Trade Name or DBA � Radiss�n Inn Saint Paul Licenx Period From 1- 31-97 Cnunry Ramsey To 1-31-98 State Minnesota ( 5 ].?. ) 291-88p0 �xecute this application. AppGcant's Home Phone ( 61?. ) 791-8800 • Zip Code 55101 �dividual Applicaut) N/A If a carporation, state name, date of birth, address, title, and shares held by each officer. If a partnership, state names, address and date of birth of each partner. Listinc� at*_a�hed Partner Farmer pii3cet (Pirst, middlc, lasz) (Fitst, middlc, lastj DQ8 Title DOB Title � Pazmer Qfficer (F¢st, tniddle, tast) � DOB Shares Shares Cale Address, Cih�, 3tate, Zip Cade Address, City, State, Zip Code 1. If a eorporation, date of incorporation .1u7.�, 31, 1991, state incotporated in Minne�ota , amount paid iu cagital , If a subsidiary of any oESer cosporation, sa state and gi��e purpose of corporaiion . If inwrgorated under tl�e laws of anotl�er state, is co�poration auihorized to do bnsiness in the state of M'tnuesota? 0 Yes 0 No 2. Describe premises to H'hich 6cense applies; such as (first floor, second floor, basement, etc.) or if enYue building, so state. 3. 4. 5. 6. 7. Is establishmeat Iocated near any state university, state hospital, training school, refotmator}• or grison? ❑ Yes $ No ff yes state approzimate distauce. Name and nddress af baiidiug o�+aer: ra.,; +,-y1. r' r�'�� r L; o�-,_. t t ��,�; ,�o p t„ ,; �,� ;, Has o�aver of brulding auy connection, d'uectly or induectly, �virh appiicant? 0 Yes ❑ No Is applitant or aay of She associates in tUis application, a member of the govemiug body of thz municipaliTy� in wtiich this license is to be issued? p Yes � hTO If ges, in �ti'hat capacity? State wLethet any person otLer than applicants has any right, title or interest in the furniture, fi�ctures or equipment fQr �vhich license is applied and if so, gi�e name and details. _�Fa Have applicaats any interest �r�hatscsever, d'uectty or indirectly, in any ot5er li uor establiglu� t inihe state of Minnesota7 � Yes p No If yes, give name aud address of estatalisluaent. Rad�.sson t�e�te1 5a in,.`�aur 11 E<�st K�� ogg �v . .� . t � a� -�ao �.�. 8. Are tLe premises now occupied or to be occupied by the applicant entirely separate and e�clusi�'e &om any otfier business establishment? � Yes p No • 9. State whet6er applicant has or ticill be granted, an pu sale Liquor License in conjunction writh tlris Off Sale Liquor License and for the same premises. � Ycs ❑ No ❑ Will be grantad . 10. State n�heilier applicant has or «•ill be granted a Sunda�• On Sale Liquor License in co¢junction w'ith the regular On Sale Liquor License. � Yes � i�Io � Will 6e granted 11. If this application is for a County Boazd Off Sale License, sta[e the distance in milcs to the neazest municipaliry. N/A 1. State wbetIter applicant or any of the associates in this applicarion, have ever fiad an application for a liquor licwse rejected by any municipality or state authoriry; if so, give dates and details. No 2. Has the applicant or any of the associates in this application, during the five years immediately preceding this application ever had a license under the Minnesota Liquor Control Act re�•oked for any �7olation of sucl� laws or local ordinances; if so, give dates aad details. No 3. Has appficant, partaers, o$icers, or emplo}'ees ecer had any liquor ta�v violations in Mianesota or elseti�$ere, including State Liquor Control penaltirs? ❑ Yes � No If �'es, gi��e dates, cbacges and fma! outcqme. �. I?uring the pasi Hcause }'eat, Las a summons been is;ued under the Liquor Cri•il Liabilit}� Lao (Dtam Shop) M.S. 340A.802. a Yes � Nn If }�es, attach a capy of the summons. 17ris licensea must have onz of t6c fotto« ing: (ATTACH CERTIFICATE OF INSURANCE TO THIS FORM.) Chedcane W A. Liquor Liabilit}• Insurance (Dram Shop) -$50.000 per person, 5100,000 more tlian one pctsou; $10,000 propzrty d�struotion; SSQ,000 and S] 00.900 for loss of ineans of support. ' a ❑ B. A surety bond from a surety companr� titi ith minimnnt coaezage as spec�ed in A. or 0 C. A cerE�cate from tite State Treasurer that t}te licensee has deposited w ith the s�ate, trvst funds haeing mazket ��alue of $100,000 ot S 100,000 in cash or securities. I certitv that i ha� e read the above uestiona and that t6e aoswers are true aod correct of mv ow�n knowted e. Print name of appGcant & title Signn�z re of Iicant Date �uss t/vn,vE2, CanriRc«tfL �" S-J�-i� REPORT BY POLICEISHERIFF'S DEPARTMENT This is to certify tltat tha apglicant and the associates named herein have not been convicted within t8e past frve yeazs for any violation of laws of tlte State af Minnesata or municipal ordinances mlating to intmioating liquor except as follows: PoliceJSheriB's arhneat TiUe Si ature PS 9136•44 CounNAttornev's Siffianue IMPORTANT iVOTICE A31 retail liquor liceusees must have a current Federal Special Occupational Stamp. This staznp is issued by the Bureau of NcoLol, To6acco, and Fueazms. For information call (612)290-3496. .