Loading...
97-966Presented / ��S Council File #` � '� �o Ordinance � Green Sheet � 37955 �t�l� �a f`i Tu``t�— 8� c, �°�`� RESOLUT{ON CITY OF SAIN7 PAUL, MINNESOTA 1 2 3 4 $ 6 7 8 9 10 il 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Referred To Committee: Date � RESOLVED: That application, ID ,�49063, for a Cabaret-Class A License by Pangaca Coffee and Tea Aouse LI.0 DBA Pangaca Coffee and Tea House {Christine Simmons, owner) at 1811 Selby Avenue, be and same is hereby approved with the following condition: f'/tfG'v-fQi•JOV.E' � 1) There shall be no �e. a£ter 10:00 PM Requested by Department of: office of License Inspections and EnvirorLmental Protection By: ll�l�,.-a� � �`S�..s Form Approve by City At.� Adopted by Council: Date By: _ / , yJ ��_,,��� � Adoption Certified by Council 5ecretary Approved by ayor for Submission to ^ Council B7 '' -- a - r� j Approved by Mayor: Date / � tJtS�7' sY. BY� ` � � T Council File # �" ► � 14� Ordinance # Green Sheet # � �' 1 Q�I���!;�� Presented By Referred To Requested by Department ofs 1 RESOLVED: 2 3 4 5 6 a a�� a o� 9 Harrzs 10 Me� 11 Morton 12 T� 13 Co ins 14 15 16 Adopted by 17 18 Adoption C 19 20 21 By; 22 23 Approved , 24 25 26 By: 27 That application (ID #490b3) for a Cabaret-Class A License by LLC DBA Pangaea Coffce and Tea House (Christina Simmons, and the same is hereby approved. � Off'ce of Liaense Inn�ctiona and Envitonmental Protect�on Date RESOLUTION CITY OF SAINT PAUL, MINNESOTA Coffee and Tea House at 1811 Selby Avenue be by Council Secretary Mayore Date �/5 Committee: By: �� n ��� Form Approved by City Attorney BY� �/'.h9 � � �' �-„�t� Approved by Mayor for Submission to Council By: 9'� -9 L� DEPARTAENTpFFICE4COUNdL DATEINITIATED GREEN SHEE � � � � � LIEP/Licensing INITIAVDATE INITIAVDATE CONTACTPERSON & PHONE � DEPARTMENT DIRECTOR � CIN COUNqL Ghristine Rozek, 266-9108 ASSIGN OCT'ATfORNEV �qTYCIERK NUNBERFOA MUST BE ON CAUNCIL AGEN�A BY (0 TE) pOUTiNG O BUOGET DIRECTOR � FIN. & MGL SERVICES OIR. For hearin : �� �qDER O MAYOR (OR ASSI5TANT) � TOTAL # OF SIGNASURE PAGES (CLIP ALL IOCATIONS FOR SIGNATURE) ACTION REQUESTED' Pangaea Coffee and Tea House LLC DSA Pangaea Coffee and Tea House requests Council approval of its application for a Cabaret-Class A License located at 1811 Selby Avenue (ID �I49063). RECOMMENDA710N5: Approve (A) or Reject (R1 pERSONAL SERVICE CANTRACTS MUST ANSWER THE FOLLOWING QUESTIONS: _ PIANNING CAMMISS�ON _ C1VIL SERVICE COMMISS�ON �� Has tbis personBirm ever wwked mMer a contraa for this department? _ CIB COMMITfEE _ YES NO 2. Has this person/iirm ever been a city employee? _ STAFf — YES NO _ oIS75ilCT COUR7 _ 3. Does this person/firm possess a skill not normally possessed by any current city employee? SUPPORT$ WNICH COUNCIL O&IECTIVE> YES NO Explain all yea answers on separete sheet antl attaeh to green sheet INITIATING PROBI.EM, ISSUE, OPPORTUNITV (Who, What, When, Where. Why): ADVANTAGESIFAPPROVED: DISADVANTAGES IF APPRWED: DISA�VAN7AGES IF NOT APPflOVED. �O�L`� . . �f�t $�T ,i;�L 2 � s:;�7 TOiAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETEP (CIRCLE ONE) YES NO FUNDItOG SOURCE AC7IVITV NUMBER FINANCIAL INFORF3ATION: (EXPLAIN) Greensheet# 379s5 L.1.E.P. REVIEW CHECKLIST �ate: s/1zl97 / qZ'q�.L In TrackeYl q2 App'n Receivad / App'n Processed License 1D # 49063 License Type: Cabaret-Class A Company Name: Pangaea Coffee and Tea House LLC pgq: Pangaea Co£fee and Tea Aouse Business Addresss: 1811 Selbv Avenue Business Phona: 645-4883 Contact Name% Date to Council Public Hearing Notice Sent to Notice Sent to Christina Si�ons, 2447 W �aj9 f��i � Rd B Home Phone: 628-0843 5113 Labels Ordered: ��P� � District Council #: i Ward #: � Departmerrt/ Date lnspections Comments City Attorney �''2{` Y� Environmental Health � . t� . (,c. A �',. �'� Fire �- •'� �� � - K � License sce a�an Received:_ Lease Repived: �' l l9" � � Poiice �• 21 �9 �- C�. . Zoning ���"��� �,� . �� aa,��q��� �` �' � ` CLASS III �,. . �c,� fl F F i ��= "�-' '" ��ICENSE APPLICATION �4T � g 32 eM �9� �HIS APPLICATION IS SUBTECT TO REVIEW BY T[-IE PUBLIC ��o ��. CITY OF SAINT PAUL oe�� osL���, v+�;� and Em�ironmrnial Proteciion�� ` Q`1 3VStPqa5t5vne300 � � Sa'vaP�v�Ai'vmssota 35L02 (611) 3669090 Lx (613) 266913< PLEASE TYPE OR PRINT IN Ii�1C � T}pe of License(s) being applied for.��`!`�C – �.L�YJ��C � S�`�' �" — E Company Nazne: / Partnership / SoI< Propriatonhip If business is Doing Business As: Business Address: fl St�eet Addreu � Cin� ` Scem Zip BetN'cen w�hat cross sVeets is the business located? l� �� �/ 'r Fa � n//Z�''� �CGkl1tC r 1 VJhich side of the street? �'� Are the premises now occupied? U.P _� t � � T}pe of Business? _�lY�PQ 1^ O L� f ,` MailFoAddress: l��t C����l RZW car�� P�.p dM/I'IVl - 5���7_ __ Slrcei.4ddress Cin' Ststc Zip Applicant Infonnation: +� j ! (� NameandTitle: �i!/lriSilVLGI ��t�Q.bZ-�lt ��a,��1vt � /��•tinrr First Afiddle (Maidrn) La+t Tit(e HomeAddress: l ?c/�-/� in�. �:��a in� y /�(� � j� �(1 ��D (PN! ��G l}'�! rll�. _5���_ svKC aaa,� c,n ! s�c� z�p Date of Birth: {i ! � � ��. Ptace of Buth: � Y196 CL��I,M1n�"`9 r �L7 �T'"h l �eme Phone: �a� ' (Jf3 �/ �i Hace you e��er been concicted of any felony, crune or � iolation of an}' c�ty ordinance other than tr�c? YES NO � Date of anest: Chazge: _ Com�ction: Business Phone: Where? Sentence: List the nacnes and residences of three persons of good moral character; living � ithin the Twin Cities Metro Area, not related to ihe applicant or financiall}' interested in the pretnises or business, wfio may be refrned to as to the applicant's chua:ter: NAME give date of ADDRESS PHONE 2!IS/97 Ha�•e any of the above named licenxs e�•er bcen ret�oked? YL ✓ IQO If }'es, list Ihe dates and reasons for re� ocation: Are }'ou going to operate tivs business personaUy? � YES NO If not, �rho tri(1 operate it A^' n/ ( .. \ame �hiddie Lsst Home Addras: SVeei Are }'ou going to hace a manager or assistant in this business7 please complete the follo�sing informaaon: �� Home Address: Shee[ �'smc (�Saidrn) City � �$ f� (� Please list your emplo}inent history for the pre�=ious five (5) } eaz period: BusinesslEmnlo�znent Address If business is a partnership, please include the following informalion for each partner (use Fvat:��e .�u�l� Ul. <.o Home Add=e�a: StTee[ �ame Fint\ame Home Address: Strect \nme \Siddle Initiel I-�k f D (!�faidrn) c�Ty Zip Stzte S�su nei� Pfionc \umber pages if necessary): ���2ol�C Il�Zal� Lsst Da4atBirth l� �i��j� (0�� �� ZiP Phon<:�umbcr i t,�� Datcof6'vil+ Zio Phon< \umber MINI3ESOTA TAX IDENTIFICATION NUMBER - Pursuant to the Lau�s of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tax Clearence; Issuance of Licenses), licensing authorities are required lo provide to the State of Mumesota Commissioner of Revenue, the Minnesota business tai iden�cation numbzr and the sceial security number of each license appiicant. Under the Minnesota Gocemmrnt Data Practices Act and the Federal Privacy Act of 1974, we aze required to advise you of the fotlou'ing regazding the use of the Minnesota Tax Ident�calion Number: - This information may be used to deny the issuance or renewal of your licrnse in the event you o«�e Minnesota sales, employer s a�it3il�olding or motor <<ehicle excise tazes; - Upon receiving this information, the licensing authority �a•ill supply it only to the Minnesota Department of Revenue. Hoc��e��er, under the Federal Exchange of Information Agreement, the Deparlment of Reeenue may supply ilus infoimation to the Intemal Revenue Sectitice. Minnesota Ta� Identificalian 13umbers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records Department, 10 Ri��er Pazk Plaza (612-296-6 ] 8]). Social Security Number: � ��� � i�� Minnesota Tax Ident�cation Number: �!u ��� 5 U'a Minnesota Tax Identification Number is not requ�red ior Ihe business being operated, indicate so b}' placing an "X" in the box. Siete ' t�p ¢. �y -�...,� h" �` �� � y i ��.� ,,'$ p ^o Detc o .�S � Z �Y �� � honc �umbcr Qo R NO If the manager is not the sazne as the operator, t�� State 2/7 S/97 List all other officers of the corporadon: OFFICER 7ITLE HQME HOME BUSINESS DATE OF hAME (Office Held) ADDRESS PHONE PHONB HIRTH Presented / ��S Council File #` � '� �o Ordinance � Green Sheet � 37955 �t�l� �a f`i Tu``t�— 8� c, �°�`� RESOLUT{ON CITY OF SAIN7 PAUL, MINNESOTA 1 2 3 4 $ 6 7 8 9 10 il 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Referred To Committee: Date � RESOLVED: That application, ID ,�49063, for a Cabaret-Class A License by Pangaca Coffee and Tea Aouse LI.0 DBA Pangaca Coffee and Tea House {Christine Simmons, owner) at 1811 Selby Avenue, be and same is hereby approved with the following condition: f'/tfG'v-fQi•JOV.E' � 1) There shall be no �e. a£ter 10:00 PM Requested by Department of: office of License Inspections and EnvirorLmental Protection By: ll�l�,.-a� � �`S�..s Form Approve by City At.� Adopted by Council: Date By: _ / , yJ ��_,,��� � Adoption Certified by Council 5ecretary Approved by ayor for Submission to ^ Council B7 '' -- a - r� j Approved by Mayor: Date / � tJtS�7' sY. BY� ` � � T Council File # �" ► � 14� Ordinance # Green Sheet # � �' 1 Q�I���!;�� Presented By Referred To Requested by Department ofs 1 RESOLVED: 2 3 4 5 6 a a�� a o� 9 Harrzs 10 Me� 11 Morton 12 T� 13 Co ins 14 15 16 Adopted by 17 18 Adoption C 19 20 21 By; 22 23 Approved , 24 25 26 By: 27 That application (ID #490b3) for a Cabaret-Class A License by LLC DBA Pangaea Coffce and Tea House (Christina Simmons, and the same is hereby approved. � Off'ce of Liaense Inn�ctiona and Envitonmental Protect�on Date RESOLUTION CITY OF SAINT PAUL, MINNESOTA Coffee and Tea House at 1811 Selby Avenue be by Council Secretary Mayore Date �/5 Committee: By: �� n ��� Form Approved by City Attorney BY� �/'.h9 � � �' �-„�t� Approved by Mayor for Submission to Council By: 9'� -9 L� DEPARTAENTpFFICE4COUNdL DATEINITIATED GREEN SHEE � � � � � LIEP/Licensing INITIAVDATE INITIAVDATE CONTACTPERSON & PHONE � DEPARTMENT DIRECTOR � CIN COUNqL Ghristine Rozek, 266-9108 ASSIGN OCT'ATfORNEV �qTYCIERK NUNBERFOA MUST BE ON CAUNCIL AGEN�A BY (0 TE) pOUTiNG O BUOGET DIRECTOR � FIN. & MGL SERVICES OIR. For hearin : �� �qDER O MAYOR (OR ASSI5TANT) � TOTAL # OF SIGNASURE PAGES (CLIP ALL IOCATIONS FOR SIGNATURE) ACTION REQUESTED' Pangaea Coffee and Tea House LLC DSA Pangaea Coffee and Tea House requests Council approval of its application for a Cabaret-Class A License located at 1811 Selby Avenue (ID �I49063). RECOMMENDA710N5: Approve (A) or Reject (R1 pERSONAL SERVICE CANTRACTS MUST ANSWER THE FOLLOWING QUESTIONS: _ PIANNING CAMMISS�ON _ C1VIL SERVICE COMMISS�ON �� Has tbis personBirm ever wwked mMer a contraa for this department? _ CIB COMMITfEE _ YES NO 2. Has this person/iirm ever been a city employee? _ STAFf — YES NO _ oIS75ilCT COUR7 _ 3. Does this person/firm possess a skill not normally possessed by any current city employee? SUPPORT$ WNICH COUNCIL O&IECTIVE> YES NO Explain all yea answers on separete sheet antl attaeh to green sheet INITIATING PROBI.EM, ISSUE, OPPORTUNITV (Who, What, When, Where. Why): ADVANTAGESIFAPPROVED: DISADVANTAGES IF APPRWED: DISA�VAN7AGES IF NOT APPflOVED. �O�L`� . . �f�t $�T ,i;�L 2 � s:;�7 TOiAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETEP (CIRCLE ONE) YES NO FUNDItOG SOURCE AC7IVITV NUMBER FINANCIAL INFORF3ATION: (EXPLAIN) Greensheet# 379s5 L.1.E.P. REVIEW CHECKLIST �ate: s/1zl97 / qZ'q�.L In TrackeYl q2 App'n Receivad / App'n Processed License 1D # 49063 License Type: Cabaret-Class A Company Name: Pangaea Coffee and Tea House LLC pgq: Pangaea Co£fee and Tea Aouse Business Addresss: 1811 Selbv Avenue Business Phona: 645-4883 Contact Name% Date to Council Public Hearing Notice Sent to Notice Sent to Christina Si�ons, 2447 W �aj9 f��i � Rd B Home Phone: 628-0843 5113 Labels Ordered: ��P� � District Council #: i Ward #: � Departmerrt/ Date lnspections Comments City Attorney �''2{` Y� Environmental Health � . t� . (,c. A �',. �'� Fire �- •'� �� � - K � License sce a�an Received:_ Lease Repived: �' l l9" � � Poiice �• 21 �9 �- C�. . Zoning ���"��� �,� . �� aa,��q��� �` �' � ` CLASS III �,. . �c,� fl F F i ��= "�-' '" ��ICENSE APPLICATION �4T � g 32 eM �9� �HIS APPLICATION IS SUBTECT TO REVIEW BY T[-IE PUBLIC ��o ��. CITY OF SAINT PAUL oe�� osL���, v+�;� and Em�ironmrnial Proteciion�� ` Q`1 3VStPqa5t5vne300 � � Sa'vaP�v�Ai'vmssota 35L02 (611) 3669090 Lx (613) 266913< PLEASE TYPE OR PRINT IN Ii�1C � T}pe of License(s) being applied for.��`!`�C – �.L�YJ��C � S�`�' �" — E Company Nazne: / Partnership / SoI< Propriatonhip If business is Doing Business As: Business Address: fl St�eet Addreu � Cin� ` Scem Zip BetN'cen w�hat cross sVeets is the business located? l� �� �/ 'r Fa � n//Z�''� �CGkl1tC r 1 VJhich side of the street? �'� Are the premises now occupied? U.P _� t � � T}pe of Business? _�lY�PQ 1^ O L� f ,` MailFoAddress: l��t C����l RZW car�� P�.p dM/I'IVl - 5���7_ __ Slrcei.4ddress Cin' Ststc Zip Applicant Infonnation: +� j ! (� NameandTitle: �i!/lriSilVLGI ��t�Q.bZ-�lt ��a,��1vt � /��•tinrr First Afiddle (Maidrn) La+t Tit(e HomeAddress: l ?c/�-/� in�. �:��a in� y /�(� � j� �(1 ��D (PN! ��G l}'�! rll�. _5���_ svKC aaa,� c,n ! s�c� z�p Date of Birth: {i ! � � ��. Ptace of Buth: � Y196 CL��I,M1n�"`9 r �L7 �T'"h l �eme Phone: �a� ' (Jf3 �/ �i Hace you e��er been concicted of any felony, crune or � iolation of an}' c�ty ordinance other than tr�c? YES NO � Date of anest: Chazge: _ Com�ction: Business Phone: Where? Sentence: List the nacnes and residences of three persons of good moral character; living � ithin the Twin Cities Metro Area, not related to ihe applicant or financiall}' interested in the pretnises or business, wfio may be refrned to as to the applicant's chua:ter: NAME give date of ADDRESS PHONE 2!IS/97 Ha�•e any of the above named licenxs e�•er bcen ret�oked? YL ✓ IQO If }'es, list Ihe dates and reasons for re� ocation: Are }'ou going to operate tivs business personaUy? � YES NO If not, �rho tri(1 operate it A^' n/ ( .. \ame �hiddie Lsst Home Addras: SVeei Are }'ou going to hace a manager or assistant in this business7 please complete the follo�sing informaaon: �� Home Address: Shee[ �'smc (�Saidrn) City � �$ f� (� Please list your emplo}inent history for the pre�=ious five (5) } eaz period: BusinesslEmnlo�znent Address If business is a partnership, please include the following informalion for each partner (use Fvat:��e .�u�l� Ul. <.o Home Add=e�a: StTee[ �ame Fint\ame Home Address: Strect \nme \Siddle Initiel I-�k f D (!�faidrn) c�Ty Zip Stzte S�su nei� Pfionc \umber pages if necessary): ���2ol�C Il�Zal� Lsst Da4atBirth l� �i��j� (0�� �� ZiP Phon<:�umbcr i t,�� Datcof6'vil+ Zio Phon< \umber MINI3ESOTA TAX IDENTIFICATION NUMBER - Pursuant to the Lau�s of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tax Clearence; Issuance of Licenses), licensing authorities are required lo provide to the State of Mumesota Commissioner of Revenue, the Minnesota business tai iden�cation numbzr and the sceial security number of each license appiicant. Under the Minnesota Gocemmrnt Data Practices Act and the Federal Privacy Act of 1974, we aze required to advise you of the fotlou'ing regazding the use of the Minnesota Tax Ident�calion Number: - This information may be used to deny the issuance or renewal of your licrnse in the event you o«�e Minnesota sales, employer s a�it3il�olding or motor <<ehicle excise tazes; - Upon receiving this information, the licensing authority �a•ill supply it only to the Minnesota Department of Revenue. Hoc��e��er, under the Federal Exchange of Information Agreement, the Deparlment of Reeenue may supply ilus infoimation to the Intemal Revenue Sectitice. Minnesota Ta� Identificalian 13umbers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records Department, 10 Ri��er Pazk Plaza (612-296-6 ] 8]). Social Security Number: � ��� � i�� Minnesota Tax Ident�cation Number: �!u ��� 5 U'a Minnesota Tax Identification Number is not requ�red ior Ihe business being operated, indicate so b}' placing an "X" in the box. Siete ' t�p ¢. �y -�...,� h" �` �� � y i ��.� ,,'$ p ^o Detc o .�S � Z �Y �� � honc �umbcr Qo R NO If the manager is not the sazne as the operator, t�� State 2/7 S/97 List all other officers of the corporadon: OFFICER 7ITLE HQME HOME BUSINESS DATE OF hAME (Office Held) ADDRESS PHONE PHONB HIRTH Presented / ��S Council File #` � '� �o Ordinance � Green Sheet � 37955 �t�l� �a f`i Tu``t�— 8� c, �°�`� RESOLUT{ON CITY OF SAIN7 PAUL, MINNESOTA 1 2 3 4 $ 6 7 8 9 10 il 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Referred To Committee: Date � RESOLVED: That application, ID ,�49063, for a Cabaret-Class A License by Pangaca Coffee and Tea Aouse LI.0 DBA Pangaca Coffee and Tea House {Christine Simmons, owner) at 1811 Selby Avenue, be and same is hereby approved with the following condition: f'/tfG'v-fQi•JOV.E' � 1) There shall be no �e. a£ter 10:00 PM Requested by Department of: office of License Inspections and EnvirorLmental Protection By: ll�l�,.-a� � �`S�..s Form Approve by City At.� Adopted by Council: Date By: _ / , yJ ��_,,��� � Adoption Certified by Council 5ecretary Approved by ayor for Submission to ^ Council B7 '' -- a - r� j Approved by Mayor: Date / � tJtS�7' sY. BY� ` � � T Council File # �" ► � 14� Ordinance # Green Sheet # � �' 1 Q�I���!;�� Presented By Referred To Requested by Department ofs 1 RESOLVED: 2 3 4 5 6 a a�� a o� 9 Harrzs 10 Me� 11 Morton 12 T� 13 Co ins 14 15 16 Adopted by 17 18 Adoption C 19 20 21 By; 22 23 Approved , 24 25 26 By: 27 That application (ID #490b3) for a Cabaret-Class A License by LLC DBA Pangaea Coffce and Tea House (Christina Simmons, and the same is hereby approved. � Off'ce of Liaense Inn�ctiona and Envitonmental Protect�on Date RESOLUTION CITY OF SAINT PAUL, MINNESOTA Coffee and Tea House at 1811 Selby Avenue be by Council Secretary Mayore Date �/5 Committee: By: �� n ��� Form Approved by City Attorney BY� �/'.h9 � � �' �-„�t� Approved by Mayor for Submission to Council By: 9'� -9 L� DEPARTAENTpFFICE4COUNdL DATEINITIATED GREEN SHEE � � � � � LIEP/Licensing INITIAVDATE INITIAVDATE CONTACTPERSON & PHONE � DEPARTMENT DIRECTOR � CIN COUNqL Ghristine Rozek, 266-9108 ASSIGN OCT'ATfORNEV �qTYCIERK NUNBERFOA MUST BE ON CAUNCIL AGEN�A BY (0 TE) pOUTiNG O BUOGET DIRECTOR � FIN. & MGL SERVICES OIR. For hearin : �� �qDER O MAYOR (OR ASSI5TANT) � TOTAL # OF SIGNASURE PAGES (CLIP ALL IOCATIONS FOR SIGNATURE) ACTION REQUESTED' Pangaea Coffee and Tea House LLC DSA Pangaea Coffee and Tea House requests Council approval of its application for a Cabaret-Class A License located at 1811 Selby Avenue (ID �I49063). RECOMMENDA710N5: Approve (A) or Reject (R1 pERSONAL SERVICE CANTRACTS MUST ANSWER THE FOLLOWING QUESTIONS: _ PIANNING CAMMISS�ON _ C1VIL SERVICE COMMISS�ON �� Has tbis personBirm ever wwked mMer a contraa for this department? _ CIB COMMITfEE _ YES NO 2. Has this person/iirm ever been a city employee? _ STAFf — YES NO _ oIS75ilCT COUR7 _ 3. Does this person/firm possess a skill not normally possessed by any current city employee? SUPPORT$ WNICH COUNCIL O&IECTIVE> YES NO Explain all yea answers on separete sheet antl attaeh to green sheet INITIATING PROBI.EM, ISSUE, OPPORTUNITV (Who, What, When, Where. Why): ADVANTAGESIFAPPROVED: DISADVANTAGES IF APPRWED: DISA�VAN7AGES IF NOT APPflOVED. �O�L`� . . �f�t $�T ,i;�L 2 � s:;�7 TOiAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETEP (CIRCLE ONE) YES NO FUNDItOG SOURCE AC7IVITV NUMBER FINANCIAL INFORF3ATION: (EXPLAIN) Greensheet# 379s5 L.1.E.P. REVIEW CHECKLIST �ate: s/1zl97 / qZ'q�.L In TrackeYl q2 App'n Receivad / App'n Processed License 1D # 49063 License Type: Cabaret-Class A Company Name: Pangaea Coffee and Tea House LLC pgq: Pangaea Co£fee and Tea Aouse Business Addresss: 1811 Selbv Avenue Business Phona: 645-4883 Contact Name% Date to Council Public Hearing Notice Sent to Notice Sent to Christina Si�ons, 2447 W �aj9 f��i � Rd B Home Phone: 628-0843 5113 Labels Ordered: ��P� � District Council #: i Ward #: � Departmerrt/ Date lnspections Comments City Attorney �''2{` Y� Environmental Health � . t� . (,c. A �',. �'� Fire �- •'� �� � - K � License sce a�an Received:_ Lease Repived: �' l l9" � � Poiice �• 21 �9 �- C�. . Zoning ���"��� �,� . �� aa,��q��� �` �' � ` CLASS III �,. . �c,� fl F F i ��= "�-' '" ��ICENSE APPLICATION �4T � g 32 eM �9� �HIS APPLICATION IS SUBTECT TO REVIEW BY T[-IE PUBLIC ��o ��. CITY OF SAINT PAUL oe�� osL���, v+�;� and Em�ironmrnial Proteciion�� ` Q`1 3VStPqa5t5vne300 � � Sa'vaP�v�Ai'vmssota 35L02 (611) 3669090 Lx (613) 266913< PLEASE TYPE OR PRINT IN Ii�1C � T}pe of License(s) being applied for.��`!`�C – �.L�YJ��C � S�`�' �" — E Company Nazne: / Partnership / SoI< Propriatonhip If business is Doing Business As: Business Address: fl St�eet Addreu � Cin� ` Scem Zip BetN'cen w�hat cross sVeets is the business located? l� �� �/ 'r Fa � n//Z�''� �CGkl1tC r 1 VJhich side of the street? �'� Are the premises now occupied? U.P _� t � � T}pe of Business? _�lY�PQ 1^ O L� f ,` MailFoAddress: l��t C����l RZW car�� P�.p dM/I'IVl - 5���7_ __ Slrcei.4ddress Cin' Ststc Zip Applicant Infonnation: +� j ! (� NameandTitle: �i!/lriSilVLGI ��t�Q.bZ-�lt ��a,��1vt � /��•tinrr First Afiddle (Maidrn) La+t Tit(e HomeAddress: l ?c/�-/� in�. �:��a in� y /�(� � j� �(1 ��D (PN! ��G l}'�! rll�. _5���_ svKC aaa,� c,n ! s�c� z�p Date of Birth: {i ! � � ��. Ptace of Buth: � Y196 CL��I,M1n�"`9 r �L7 �T'"h l �eme Phone: �a� ' (Jf3 �/ �i Hace you e��er been concicted of any felony, crune or � iolation of an}' c�ty ordinance other than tr�c? YES NO � Date of anest: Chazge: _ Com�ction: Business Phone: Where? Sentence: List the nacnes and residences of three persons of good moral character; living � ithin the Twin Cities Metro Area, not related to ihe applicant or financiall}' interested in the pretnises or business, wfio may be refrned to as to the applicant's chua:ter: NAME give date of ADDRESS PHONE 2!IS/97 Ha�•e any of the above named licenxs e�•er bcen ret�oked? YL ✓ IQO If }'es, list Ihe dates and reasons for re� ocation: Are }'ou going to operate tivs business personaUy? � YES NO If not, �rho tri(1 operate it A^' n/ ( .. \ame �hiddie Lsst Home Addras: SVeei Are }'ou going to hace a manager or assistant in this business7 please complete the follo�sing informaaon: �� Home Address: Shee[ �'smc (�Saidrn) City � �$ f� (� Please list your emplo}inent history for the pre�=ious five (5) } eaz period: BusinesslEmnlo�znent Address If business is a partnership, please include the following informalion for each partner (use Fvat:��e .�u�l� Ul. <.o Home Add=e�a: StTee[ �ame Fint\ame Home Address: Strect \nme \Siddle Initiel I-�k f D (!�faidrn) c�Ty Zip Stzte S�su nei� Pfionc \umber pages if necessary): ���2ol�C Il�Zal� Lsst Da4atBirth l� �i��j� (0�� �� ZiP Phon<:�umbcr i t,�� Datcof6'vil+ Zio Phon< \umber MINI3ESOTA TAX IDENTIFICATION NUMBER - Pursuant to the Lau�s of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tax Clearence; Issuance of Licenses), licensing authorities are required lo provide to the State of Mumesota Commissioner of Revenue, the Minnesota business tai iden�cation numbzr and the sceial security number of each license appiicant. Under the Minnesota Gocemmrnt Data Practices Act and the Federal Privacy Act of 1974, we aze required to advise you of the fotlou'ing regazding the use of the Minnesota Tax Ident�calion Number: - This information may be used to deny the issuance or renewal of your licrnse in the event you o«�e Minnesota sales, employer s a�it3il�olding or motor <<ehicle excise tazes; - Upon receiving this information, the licensing authority �a•ill supply it only to the Minnesota Department of Revenue. Hoc��e��er, under the Federal Exchange of Information Agreement, the Deparlment of Reeenue may supply ilus infoimation to the Intemal Revenue Sectitice. Minnesota Ta� Identificalian 13umbers (Sales & Use Tax Number) may be obtained from the State of Minnesota, Business Records Department, 10 Ri��er Pazk Plaza (612-296-6 ] 8]). Social Security Number: � ��� � i�� Minnesota Tax Ident�cation Number: �!u ��� 5 U'a Minnesota Tax Identification Number is not requ�red ior Ihe business being operated, indicate so b}' placing an "X" in the box. Siete ' t�p ¢. �y -�...,� h" �` �� � y i ��.� ,,'$ p ^o Detc o .�S � Z �Y �� � honc �umbcr Qo R NO If the manager is not the sazne as the operator, t�� State 2/7 S/97 List all other officers of the corporadon: OFFICER 7ITLE HQME HOME BUSINESS DATE OF hAME (Office Held) ADDRESS PHONE PHONB HIRTH