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97-786Council File # ��b Ordinance # Green Sheet # �� i z 3 4 s 6 � s 9 io ii iz 13 14 is 16 17 is 19 20 zl z2 C?��*dA;, � '�..� i� `..�i 3 3� i:� L Presented Referred RESOLUTION CITY OF SAINT PAUL, MINNESOTA � RESOLVED: That application (ID #23598) for a Second Hand Dealer-Motor Vehicle and Auto Repair Gazage License by Corp Auto Inc. DBA Corp Auto Inc. (Katayoun Mortezaee, Owner) at 353 Larch Street be and the same is hereby approved with the following conditions: 1. The vehicles for sale shall not exceed 12 and shall not be displayed outdoors. 2. Vehicles permitted to be pazked on the properiy shall be completely assembled with no missing parts. 3. Vehicle salvage is not permitted. 4. The licensee is responsible for managing the number of customer vehicles to that which may be repaired and retumed to their owners in the shortest period. Only customer vehicles and personal vehicles of the licensee may be parked on the lot. Vehicles awaiting repair shall not be parked ont he street. This condition is intended to prohibit long term storage of vehicles on the lot. 5. All vehicles parked outdoors on the lot must be completely assembled with no parts missing. 6. Vehicle parts, tires, oil or similar may not be stored outdoors. 7. No repair of vehicles may occur on the exterior of the lot or in the public right-of-way. 23 24 Requested by Department of: 25 Yea Nays Absent 26 Blakey 27 Bostrom Office of License Insnections and 28 Harris 29 M ard Environmental Protection 30 �z oli�.. 31 Thune 32 �, 33 � � �� 34 35 Adopted by Council: Date B �' = „ 36 � 37 Adoption Certified by Council Secretary 38 Form Approved by City Attorney 39 40 By: 4� � /3 7 $Y° `�/o,�,u.�z , a,0�. 42 Approved by � r: Date 43 �� gq Approved by Mayor for Submission to 45 By; Council 46 By: a�-�� DEPARTMEM/OFFICFJCqUNCiL DATEINR1AlED GREEN SHEE N� � S 4 O O LIEP/Licensing �NITIAVDATE INITIAVDATE GONTACf PERSON & PNONE � DEPARTMEM DIRECTOR � CflY CAUNCIL Christine ROZE�C� 266-9108 ASSIGN �CRVATfORNEY �CITYCLEflK NUYBER FOH MUST BE ON CAUNCIL AGENDA BY (DATE) q p�� O BUDGET DIRECTOp � FIN. & MGC SERVICES DIR. For hearing: 2 �� ORDER O Mpypp (pR ASSISTAM) � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION flEOUESiED: Corp Auto Inc. DBA Corp Auto Inc. requests Council approval of its application for a Second Hand Dealer-Motor Vehicle and Auto Repair Garage License located at 353 Larch Street (ID �I23598). FiECOMMENDA71oNS:Approve(Alapaject(R) pERSONALSEHVICECON7RACTSMUSTANSWER7HEFOLLOWINGQUESTIONS: _ PLANNING CqMMISSION _ CIVIL SEflVICE COMMISSION 1_ Has ttiis persoMirtn ever worketl under a coMrdct for this departrnen[? - _ CIBCOMMflTEE �'ES NO _ S7AFF 2. Has Nis personfirm ever been a city employee? — YES NO _ DISTRICT CAUR7 _ 3. Does this person/firm possess a skill not normall y possessed by any curteM city employee? SUPPoiiBWNIC47COUNqlO&fECTIVE4 YES NO Explain all yes answers on separate sheet and attaeh to green sheet INRIATING PXOBLEM, ISSUE, OPP0R7UNIT' (Who, What, Whan, Whare, Wtryg R`� •– E' ?', . –.-� � Y � �EB 25 1997 C�1`� A�`C��NEY ADVANTACaES IF APPROVED: DISADVANTAGES IPAPPROVED. �R�C4�I4i.`ti i?•�ti�• �es:i'il`�'Ja J�i� 3 2 i��7 _.- .� DISADVANTAGES IF NOTAPPHOVED. " TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUNDIfdG SOURCE ACTIVITY NUMBER PINANCIAL INFORMATION. (EXPLAIN) Greensheet # 35400 In Tracke�? License ID # 23598 L.I.E.P. REVIEW CHECKLIST Date: 2/20/9� Q/� — ��G APP�n Received / APP'n Processed LicenseType:Second Hand Dealer—Motar Vehicle and A�,to Re�a;r GaraQe Company Name: Corp Auto Inc. DBA: same Susiness Addresss: 353 Larch St Business Phone: 487-8101 Contact Date to i Public H Home Phone: 595-8423 abels Ordered: N/A Notice Sent to Appiicant: District Council Z`�/�1� �Z� Notice Sent to Public: �� Ward #: � Department/ Date Inspections Comments City Attorney 3�t1 •� o.K • Environmental Health i Y f'� • Fire (p J — F�' `�. � • License Site Plan Received: Lease Received: �� i�.�,�h C.c�-,c�,.,G-�J Police 3 � 4 I •9�- �.1C . Zoning 3• 2�''g O•� . � �a3s98 CLASS III C1TY OF SAINT P LICENSE APPLICATION �� ""�'�� and Environmrntai Rotection 35� SC PetaSt Svih 300 S�tPaN,Mvmeso4 35102 (61nI hx(61�3669136 � �� - THIS APPLICATION IS SUSJECT TO REVIEW BY THE PUBLIC �� " PLEASE TYPE OR PRIN'P IN INK Type of License(s) being applied Company Name: (... � ,--- aiay � �17� �� liii' �° � o,� �� / Partnenhip / Sole Proprietonhip If business is incoiporated, give d of inco �{=/ 3`- I�� Doing Business As: 7 O�' O� �� Business Phone: ,7 �l 7— C� 7�f i Business Address: 3 S3 l A R['_ H �� S'C' � f'��.�- C M n/ � C P(�- SGxet Addras City State Zip Between what cross streets is the business located7 W e1 T2YV� Which side of the sheet7 Are the premises now occupied? �_ What Type of Business? Mail To Address: 3 S 3 (_ � R� i/ �- ST P� � ,+� .✓ �T � 1'� sv�n naa�ns c�ry s�ai� z�p Applicant Information: NameandTitle: K�T�1Yo�h FAI�r2Hf}NpZ MoRT�ZAC-T Ow'h2'� F�� aai� ��am� i„� r�a� Home Address: � 7/ 6 rn e,,. � z C� t� o,.� � V'e .✓ G- V .Ut .✓ S S ti a� strKe nddRSS ciry s�m z�p Date oF Birth: ri — 10 — Fi �� Place of Bitth: � R� a✓ Home Phone: s�� t� �/�� Have you ever been convicted of any felony, crime or violation of any city ordinance other than traffic7 YES NO Date of arrest: Charge: _ Conviction: Where? Sentence: Lis[ lhe names and residences of three persons of good moral chazacter, living within the Twin Cities Metro Area, no[ related to the applicant or fmancially interested in the premises or business, who may be refecred to as to the applicanPs character: List licenses which you currently hold, formerly held, or may have an interest in: r Have any of the above named licenses ever been revoked'1 YES NO If yes, list the dates and reasons for revocation: 12/18/96 NAME ADDRESS PHONE yvu going to operate flris business personally7 YES ,�[� NO If not, who will operate it7 �� /(A.v!IPA�/ G MOnTC-Z�� "7-i- S�`� �FurtNeme h�fiddlelnitiat (Maidrn) La+t DatcofBirth 17 tb nn e,,. c�<<Cbt ,✓ ,[�✓� n! �'r-V- Nln/ �,�A�-'� S'�t)-8�(a3 HomeAddress: StredN�e City State Zip Y6omNumlxr A:e you going to have a maaager or assstant in this business7 U YES please complete the following infoimation: Fvrt Name IvLddle Initial (Mnidcn) Home Addtsv: Shcc[ Namc Please list your employment history for the previous five (5) year period: BusinessBmployment Address NO If the manager is not the same as the operator, I.ad S�atc Zip Date Phonc .. i. .. � i � r .a �. � i .a ' � f. A • L. List all other officers of the corporation: OFFICER TITLE HOME NAME (Office Held) ADDRESS HOME BUSINESS DATE OF PHONE PHONE BIl2TH If business is a partnership, please include fhe following infortnation for each paztner (use additional pages if necessary): Firat Name Middle Initial (Msidrn) La+t Datc of BiAh Home Address: Strcd Name City S�e[e Zip FintName MddlcInifiel (INaidrn) La+t DateoFButh Homc Address: Street Name City Smte Zip Phone Numbcr MII�INESOTA TAX IDENTIFICATION NUMBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Ta�t Cleazance; Issuance of Licenses), licensing authorities aze required to provide to lhe State of Minnesota Commissioner of Revenue, the Minnesota business tax ident�cation number and the social security number of each license applicant. Under the Minnesota Govenunent Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the following regarding ihe use of the Minnesota Tax Ident�caGon Number: - This information may be used to drny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholding or motor vehicle excise ta�es; - Upon receiving this information, the licensing authority will supply it only to the Minnesota Department of Revenue. However, under the Federal Exchange of Infortnation Agreement, the Departrnent of Revrnue may supply this information to the Intemal Revenue Service. Minnesota Ta+t Identification Numbers (Sales & Use Tae Nianber) may be obtained from the State of Minnesota, Business Records Departrnent, 10 River Pazk Plaza (612-296-61 Sl). Social Security Number: � 1 S — a? 3� S 6 I� Minnesota Ta�c Iden�cation Number: .� (� �� I _ If a Minnesota Tax Identification Number is not required for the business being operated, indicate so by placing an "X" in the box. ] 2/1 S/96 Council File # ��b Ordinance # Green Sheet # �� i z 3 4 s 6 � s 9 io ii iz 13 14 is 16 17 is 19 20 zl z2 C?��*dA;, � '�..� i� `..�i 3 3� i:� L Presented Referred RESOLUTION CITY OF SAINT PAUL, MINNESOTA � RESOLVED: That application (ID #23598) for a Second Hand Dealer-Motor Vehicle and Auto Repair Gazage License by Corp Auto Inc. DBA Corp Auto Inc. (Katayoun Mortezaee, Owner) at 353 Larch Street be and the same is hereby approved with the following conditions: 1. The vehicles for sale shall not exceed 12 and shall not be displayed outdoors. 2. Vehicles permitted to be pazked on the properiy shall be completely assembled with no missing parts. 3. Vehicle salvage is not permitted. 4. The licensee is responsible for managing the number of customer vehicles to that which may be repaired and retumed to their owners in the shortest period. Only customer vehicles and personal vehicles of the licensee may be parked on the lot. Vehicles awaiting repair shall not be parked ont he street. This condition is intended to prohibit long term storage of vehicles on the lot. 5. All vehicles parked outdoors on the lot must be completely assembled with no parts missing. 6. Vehicle parts, tires, oil or similar may not be stored outdoors. 7. No repair of vehicles may occur on the exterior of the lot or in the public right-of-way. 23 24 Requested by Department of: 25 Yea Nays Absent 26 Blakey 27 Bostrom Office of License Insnections and 28 Harris 29 M ard Environmental Protection 30 �z oli�.. 31 Thune 32 �, 33 � � �� 34 35 Adopted by Council: Date B �' = „ 36 � 37 Adoption Certified by Council Secretary 38 Form Approved by City Attorney 39 40 By: 4� � /3 7 $Y° `�/o,�,u.�z , a,0�. 42 Approved by � r: Date 43 �� gq Approved by Mayor for Submission to 45 By; Council 46 By: a�-�� DEPARTMEM/OFFICFJCqUNCiL DATEINR1AlED GREEN SHEE N� � S 4 O O LIEP/Licensing �NITIAVDATE INITIAVDATE GONTACf PERSON & PNONE � DEPARTMEM DIRECTOR � CflY CAUNCIL Christine ROZE�C� 266-9108 ASSIGN �CRVATfORNEY �CITYCLEflK NUYBER FOH MUST BE ON CAUNCIL AGENDA BY (DATE) q p�� O BUDGET DIRECTOp � FIN. & MGC SERVICES DIR. For hearing: 2 �� ORDER O Mpypp (pR ASSISTAM) � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION flEOUESiED: Corp Auto Inc. DBA Corp Auto Inc. requests Council approval of its application for a Second Hand Dealer-Motor Vehicle and Auto Repair Garage License located at 353 Larch Street (ID �I23598). FiECOMMENDA71oNS:Approve(Alapaject(R) pERSONALSEHVICECON7RACTSMUSTANSWER7HEFOLLOWINGQUESTIONS: _ PLANNING CqMMISSION _ CIVIL SEflVICE COMMISSION 1_ Has ttiis persoMirtn ever worketl under a coMrdct for this departrnen[? - _ CIBCOMMflTEE �'ES NO _ S7AFF 2. Has Nis personfirm ever been a city employee? — YES NO _ DISTRICT CAUR7 _ 3. Does this person/firm possess a skill not normall y possessed by any curteM city employee? SUPPoiiBWNIC47COUNqlO&fECTIVE4 YES NO Explain all yes answers on separate sheet and attaeh to green sheet INRIATING PXOBLEM, ISSUE, OPP0R7UNIT' (Who, What, Whan, Whare, Wtryg R`� •– E' ?', . –.-� � Y � �EB 25 1997 C�1`� A�`C��NEY ADVANTACaES IF APPROVED: DISADVANTAGES IPAPPROVED. �R�C4�I4i.`ti i?•�ti�• �es:i'il`�'Ja J�i� 3 2 i��7 _.- .� DISADVANTAGES IF NOTAPPHOVED. " TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUNDIfdG SOURCE ACTIVITY NUMBER PINANCIAL INFORMATION. (EXPLAIN) Greensheet # 35400 In Tracke�? License ID # 23598 L.I.E.P. REVIEW CHECKLIST Date: 2/20/9� Q/� — ��G APP�n Received / APP'n Processed LicenseType:Second Hand Dealer—Motar Vehicle and A�,to Re�a;r GaraQe Company Name: Corp Auto Inc. DBA: same Susiness Addresss: 353 Larch St Business Phone: 487-8101 Contact Date to i Public H Home Phone: 595-8423 abels Ordered: N/A Notice Sent to Appiicant: District Council Z`�/�1� �Z� Notice Sent to Public: �� Ward #: � Department/ Date Inspections Comments City Attorney 3�t1 •� o.K • Environmental Health i Y f'� • Fire (p J — F�' `�. � • License Site Plan Received: Lease Received: �� i�.�,�h C.c�-,c�,.,G-�J Police 3 � 4 I •9�- �.1C . Zoning 3• 2�''g O•� . � �a3s98 CLASS III C1TY OF SAINT P LICENSE APPLICATION �� ""�'�� and Environmrntai Rotection 35� SC PetaSt Svih 300 S�tPaN,Mvmeso4 35102 (61nI hx(61�3669136 � �� - THIS APPLICATION IS SUSJECT TO REVIEW BY THE PUBLIC �� " PLEASE TYPE OR PRIN'P IN INK Type of License(s) being applied Company Name: (... � ,--- aiay � �17� �� liii' �° � o,� �� / Partnenhip / Sole Proprietonhip If business is incoiporated, give d of inco �{=/ 3`- I�� Doing Business As: 7 O�' O� �� Business Phone: ,7 �l 7— C� 7�f i Business Address: 3 S3 l A R['_ H �� S'C' � f'��.�- C M n/ � C P(�- SGxet Addras City State Zip Between what cross streets is the business located7 W e1 T2YV� Which side of the sheet7 Are the premises now occupied? �_ What Type of Business? Mail To Address: 3 S 3 (_ � R� i/ �- ST P� � ,+� .✓ �T � 1'� sv�n naa�ns c�ry s�ai� z�p Applicant Information: NameandTitle: K�T�1Yo�h FAI�r2Hf}NpZ MoRT�ZAC-T Ow'h2'� F�� aai� ��am� i„� r�a� Home Address: � 7/ 6 rn e,,. � z C� t� o,.� � V'e .✓ G- V .Ut .✓ S S ti a� strKe nddRSS ciry s�m z�p Date oF Birth: ri — 10 — Fi �� Place of Bitth: � R� a✓ Home Phone: s�� t� �/�� Have you ever been convicted of any felony, crime or violation of any city ordinance other than traffic7 YES NO Date of arrest: Charge: _ Conviction: Where? Sentence: Lis[ lhe names and residences of three persons of good moral chazacter, living within the Twin Cities Metro Area, no[ related to the applicant or fmancially interested in the premises or business, who may be refecred to as to the applicanPs character: List licenses which you currently hold, formerly held, or may have an interest in: r Have any of the above named licenses ever been revoked'1 YES NO If yes, list the dates and reasons for revocation: 12/18/96 NAME ADDRESS PHONE yvu going to operate flris business personally7 YES ,�[� NO If not, who will operate it7 �� /(A.v!IPA�/ G MOnTC-Z�� "7-i- S�`� �FurtNeme h�fiddlelnitiat (Maidrn) La+t DatcofBirth 17 tb nn e,,. c�<<Cbt ,✓ ,[�✓� n! �'r-V- Nln/ �,�A�-'� S'�t)-8�(a3 HomeAddress: StredN�e City State Zip Y6omNumlxr A:e you going to have a maaager or assstant in this business7 U YES please complete the following infoimation: Fvrt Name IvLddle Initial (Mnidcn) Home Addtsv: Shcc[ Namc Please list your employment history for the previous five (5) year period: BusinessBmployment Address NO If the manager is not the same as the operator, I.ad S�atc Zip Date Phonc .. i. .. � i � r .a �. � i .a ' � f. A • L. List all other officers of the corporation: OFFICER TITLE HOME NAME (Office Held) ADDRESS HOME BUSINESS DATE OF PHONE PHONE BIl2TH If business is a partnership, please include fhe following infortnation for each paztner (use additional pages if necessary): Firat Name Middle Initial (Msidrn) La+t Datc of BiAh Home Address: Strcd Name City S�e[e Zip FintName MddlcInifiel (INaidrn) La+t DateoFButh Homc Address: Street Name City Smte Zip Phone Numbcr MII�INESOTA TAX IDENTIFICATION NUMBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Ta�t Cleazance; Issuance of Licenses), licensing authorities aze required to provide to lhe State of Minnesota Commissioner of Revenue, the Minnesota business tax ident�cation number and the social security number of each license applicant. Under the Minnesota Govenunent Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the following regarding ihe use of the Minnesota Tax Ident�caGon Number: - This information may be used to drny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholding or motor vehicle excise ta�es; - Upon receiving this information, the licensing authority will supply it only to the Minnesota Department of Revenue. However, under the Federal Exchange of Infortnation Agreement, the Departrnent of Revrnue may supply this information to the Intemal Revenue Service. Minnesota Ta+t Identification Numbers (Sales & Use Tae Nianber) may be obtained from the State of Minnesota, Business Records Departrnent, 10 River Pazk Plaza (612-296-61 Sl). Social Security Number: � 1 S — a? 3� S 6 I� Minnesota Ta�c Iden�cation Number: .� (� �� I _ If a Minnesota Tax Identification Number is not required for the business being operated, indicate so by placing an "X" in the box. ] 2/1 S/96 Council File # ��b Ordinance # Green Sheet # �� i z 3 4 s 6 � s 9 io ii iz 13 14 is 16 17 is 19 20 zl z2 C?��*dA;, � '�..� i� `..�i 3 3� i:� L Presented Referred RESOLUTION CITY OF SAINT PAUL, MINNESOTA � RESOLVED: That application (ID #23598) for a Second Hand Dealer-Motor Vehicle and Auto Repair Gazage License by Corp Auto Inc. DBA Corp Auto Inc. (Katayoun Mortezaee, Owner) at 353 Larch Street be and the same is hereby approved with the following conditions: 1. The vehicles for sale shall not exceed 12 and shall not be displayed outdoors. 2. Vehicles permitted to be pazked on the properiy shall be completely assembled with no missing parts. 3. Vehicle salvage is not permitted. 4. The licensee is responsible for managing the number of customer vehicles to that which may be repaired and retumed to their owners in the shortest period. Only customer vehicles and personal vehicles of the licensee may be parked on the lot. Vehicles awaiting repair shall not be parked ont he street. This condition is intended to prohibit long term storage of vehicles on the lot. 5. All vehicles parked outdoors on the lot must be completely assembled with no parts missing. 6. Vehicle parts, tires, oil or similar may not be stored outdoors. 7. No repair of vehicles may occur on the exterior of the lot or in the public right-of-way. 23 24 Requested by Department of: 25 Yea Nays Absent 26 Blakey 27 Bostrom Office of License Insnections and 28 Harris 29 M ard Environmental Protection 30 �z oli�.. 31 Thune 32 �, 33 � � �� 34 35 Adopted by Council: Date B �' = „ 36 � 37 Adoption Certified by Council Secretary 38 Form Approved by City Attorney 39 40 By: 4� � /3 7 $Y° `�/o,�,u.�z , a,0�. 42 Approved by � r: Date 43 �� gq Approved by Mayor for Submission to 45 By; Council 46 By: a�-�� DEPARTMEM/OFFICFJCqUNCiL DATEINR1AlED GREEN SHEE N� � S 4 O O LIEP/Licensing �NITIAVDATE INITIAVDATE GONTACf PERSON & PNONE � DEPARTMEM DIRECTOR � CflY CAUNCIL Christine ROZE�C� 266-9108 ASSIGN �CRVATfORNEY �CITYCLEflK NUYBER FOH MUST BE ON CAUNCIL AGENDA BY (DATE) q p�� O BUDGET DIRECTOp � FIN. & MGC SERVICES DIR. For hearing: 2 �� ORDER O Mpypp (pR ASSISTAM) � TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION flEOUESiED: Corp Auto Inc. DBA Corp Auto Inc. requests Council approval of its application for a Second Hand Dealer-Motor Vehicle and Auto Repair Garage License located at 353 Larch Street (ID �I23598). FiECOMMENDA71oNS:Approve(Alapaject(R) pERSONALSEHVICECON7RACTSMUSTANSWER7HEFOLLOWINGQUESTIONS: _ PLANNING CqMMISSION _ CIVIL SEflVICE COMMISSION 1_ Has ttiis persoMirtn ever worketl under a coMrdct for this departrnen[? - _ CIBCOMMflTEE �'ES NO _ S7AFF 2. Has Nis personfirm ever been a city employee? — YES NO _ DISTRICT CAUR7 _ 3. Does this person/firm possess a skill not normall y possessed by any curteM city employee? SUPPoiiBWNIC47COUNqlO&fECTIVE4 YES NO Explain all yes answers on separate sheet and attaeh to green sheet INRIATING PXOBLEM, ISSUE, OPP0R7UNIT' (Who, What, Whan, Whare, Wtryg R`� •– E' ?', . –.-� � Y � �EB 25 1997 C�1`� A�`C��NEY ADVANTACaES IF APPROVED: DISADVANTAGES IPAPPROVED. �R�C4�I4i.`ti i?•�ti�• �es:i'il`�'Ja J�i� 3 2 i��7 _.- .� DISADVANTAGES IF NOTAPPHOVED. " TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUNDIfdG SOURCE ACTIVITY NUMBER PINANCIAL INFORMATION. (EXPLAIN) Greensheet # 35400 In Tracke�? License ID # 23598 L.I.E.P. REVIEW CHECKLIST Date: 2/20/9� Q/� — ��G APP�n Received / APP'n Processed LicenseType:Second Hand Dealer—Motar Vehicle and A�,to Re�a;r GaraQe Company Name: Corp Auto Inc. DBA: same Susiness Addresss: 353 Larch St Business Phone: 487-8101 Contact Date to i Public H Home Phone: 595-8423 abels Ordered: N/A Notice Sent to Appiicant: District Council Z`�/�1� �Z� Notice Sent to Public: �� Ward #: � Department/ Date Inspections Comments City Attorney 3�t1 •� o.K • Environmental Health i Y f'� • Fire (p J — F�' `�. � • License Site Plan Received: Lease Received: �� i�.�,�h C.c�-,c�,.,G-�J Police 3 � 4 I •9�- �.1C . Zoning 3• 2�''g O•� . � �a3s98 CLASS III C1TY OF SAINT P LICENSE APPLICATION �� ""�'�� and Environmrntai Rotection 35� SC PetaSt Svih 300 S�tPaN,Mvmeso4 35102 (61nI hx(61�3669136 � �� - THIS APPLICATION IS SUSJECT TO REVIEW BY THE PUBLIC �� " PLEASE TYPE OR PRIN'P IN INK Type of License(s) being applied Company Name: (... � ,--- aiay � �17� �� liii' �° � o,� �� / Partnenhip / Sole Proprietonhip If business is incoiporated, give d of inco �{=/ 3`- I�� Doing Business As: 7 O�' O� �� Business Phone: ,7 �l 7— C� 7�f i Business Address: 3 S3 l A R['_ H �� S'C' � f'��.�- C M n/ � C P(�- SGxet Addras City State Zip Between what cross streets is the business located7 W e1 T2YV� Which side of the sheet7 Are the premises now occupied? �_ What Type of Business? Mail To Address: 3 S 3 (_ � R� i/ �- ST P� � ,+� .✓ �T � 1'� sv�n naa�ns c�ry s�ai� z�p Applicant Information: NameandTitle: K�T�1Yo�h FAI�r2Hf}NpZ MoRT�ZAC-T Ow'h2'� F�� aai� ��am� i„� r�a� Home Address: � 7/ 6 rn e,,. � z C� t� o,.� � V'e .✓ G- V .Ut .✓ S S ti a� strKe nddRSS ciry s�m z�p Date oF Birth: ri — 10 — Fi �� Place of Bitth: � R� a✓ Home Phone: s�� t� �/�� Have you ever been convicted of any felony, crime or violation of any city ordinance other than traffic7 YES NO Date of arrest: Charge: _ Conviction: Where? Sentence: Lis[ lhe names and residences of three persons of good moral chazacter, living within the Twin Cities Metro Area, no[ related to the applicant or fmancially interested in the premises or business, who may be refecred to as to the applicanPs character: List licenses which you currently hold, formerly held, or may have an interest in: r Have any of the above named licenses ever been revoked'1 YES NO If yes, list the dates and reasons for revocation: 12/18/96 NAME ADDRESS PHONE yvu going to operate flris business personally7 YES ,�[� NO If not, who will operate it7 �� /(A.v!IPA�/ G MOnTC-Z�� "7-i- S�`� �FurtNeme h�fiddlelnitiat (Maidrn) La+t DatcofBirth 17 tb nn e,,. c�<<Cbt ,✓ ,[�✓� n! �'r-V- Nln/ �,�A�-'� S'�t)-8�(a3 HomeAddress: StredN�e City State Zip Y6omNumlxr A:e you going to have a maaager or assstant in this business7 U YES please complete the following infoimation: Fvrt Name IvLddle Initial (Mnidcn) Home Addtsv: Shcc[ Namc Please list your employment history for the previous five (5) year period: BusinessBmployment Address NO If the manager is not the same as the operator, I.ad S�atc Zip Date Phonc .. i. .. � i � r .a �. � i .a ' � f. A • L. List all other officers of the corporation: OFFICER TITLE HOME NAME (Office Held) ADDRESS HOME BUSINESS DATE OF PHONE PHONE BIl2TH If business is a partnership, please include fhe following infortnation for each paztner (use additional pages if necessary): Firat Name Middle Initial (Msidrn) La+t Datc of BiAh Home Address: Strcd Name City S�e[e Zip FintName MddlcInifiel (INaidrn) La+t DateoFButh Homc Address: Street Name City Smte Zip Phone Numbcr MII�INESOTA TAX IDENTIFICATION NUMBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Ta�t Cleazance; Issuance of Licenses), licensing authorities aze required to provide to lhe State of Minnesota Commissioner of Revenue, the Minnesota business tax ident�cation number and the social security number of each license applicant. Under the Minnesota Govenunent Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the following regarding ihe use of the Minnesota Tax Ident�caGon Number: - This information may be used to drny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholding or motor vehicle excise ta�es; - Upon receiving this information, the licensing authority will supply it only to the Minnesota Department of Revenue. However, under the Federal Exchange of Infortnation Agreement, the Departrnent of Revrnue may supply this information to the Intemal Revenue Service. Minnesota Ta+t Identification Numbers (Sales & Use Tae Nianber) may be obtained from the State of Minnesota, Business Records Departrnent, 10 River Pazk Plaza (612-296-61 Sl). Social Security Number: � 1 S — a? 3� S 6 I� Minnesota Ta�c Iden�cation Number: .� (� �� I _ If a Minnesota Tax Identification Number is not required for the business being operated, indicate so by placing an "X" in the box. ] 2/1 S/96