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98-314Council File# O ' 7 � Ordinance # 0 R I G I N A t Green Sheet # LP60038 RESOLUTION CITY OF SAINT PAUL, MINNESOTA Z r7 / Presented By__��/�{�/�f��,��,/d!''�' Referred To Committee: Date RESOLVED: 1 2 3 4 That application (ID #19970000226) for a Malt Off Sale, Grocery (C), Ciqarette/Tobacco License(s) by VCK ORIENTAL MARKET INC DBA VCK ORIENTAL MARXET at 1377 ARCADE ST be and the same is hereby approved. Bos Yeas I� Nays �I Absent Adopted by Council: Date �� Adoption Certified by Council Secretary By App: By: Requested by Department of: Office o£ License,. Inspections and EnVironmental Protection �`I�.�' �4- ��?�' By : ��X � Form Approved by City Attorney By: Approved by Mayor for Submission to Council By: DEPARTMENT/OFFICE/COUNCIL DATE INITIATED LIEP/Licensing GREEN SHEET No. LP60038 �g ��,� ONTACT PERSON & PHONE InNaVDate IniOaVDate UNTHER WILLIAM (BILL) (612) 266-9132 1❑ City Attomey � U5T BE ON COUNCIL AGENDA BY (DATE) ASSIGH 4 f� 98 NUMBERFOR � Council Research ROUTING ORDER TOTAL # OF SIGNATURE PAGES (CUP ALL LOCATIONS FOR SIGNA7URE� ACTION RE�UESTED: Council approval ot the following license application: License # 19970000726, for VCK ORIENTAL MARKET INC, �oing Business As VCK ORIENTAL MARKET, at 1377 ARCADE ST, induding the following business type(s): Malt Off Sale, Grocery (C), Cigarette/Tobacco. RECOMMENDA710NS: Approve(A) RejeCt(R) ERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS: 1. HasthispersonKrmeverworkedundere contrectforihisdepaAmeni� PLANNING COMMISSION YES NO CIBCOMMITTEE 2. Hasthisperso�rmeverbeenacityemployee? CIVIL SVC CINN, YES NO 3. Does this personRrm possess a skill not normalfy possessed by any current city employee? YES NO 4. Is �his persoNfirm a targeted vendoR YES NO fxplain all yes answers on separate sheet and attach to green sheet INITIATING PROBLEM, ISSUE, OPPORTUNfTY (VJho, What, When, Where, Why): . Request Counctl approval for VCK Oriental Market Inc. DBA VCK Orierrtal Market for a Grxery (C), Oh Saie Malt & Cigarette/Tobacco License at 1377 Arcade St. ADVANTAGES IF APPROVED: DISADVANTAGES IF APPROVED� DISADVANTAGES IF NOT APPROVED: TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDING SOURC ACTIVITY NUMBER FINANCIAL INFORMATION: (EXPLAIN) �St343�'iU^?� P$S�?`:;t'� ��`2i FF4 : � � 7�� C� CLASS III LICENSE APPLICATION THIS APPLICATION IS SUR7ECT TO REVIEW BY THE PUBLIC C� �� PLEASE TYPE OR PR IN R3K Type of License(s) being applied fpr: �� `�f��Cvf �: `� '"Z � CompanyName: V C K ORIENTAL MARKET INC. CITY OF SAINT PAUL �x of License, Inspu.tions and Envuoim�rntal Protati� p � ^,� 350 SC PnaS4 Sule 300 6 r � Saint P¢ul, Mvmewh SStG2 (612)1669C90 tix(61])1649S2t $ � ( 9 O � S � � S �ti�� % , Corporetion / Parinership / Sole Proprietorship If business is incomorated, gve date of incorpotation: 0 7/ 14/ 9 3 DoingBusinessAs: FOODS RETAIL BusinessPhone: �612) 774-7999 IIusinessAddress: 1377 ARCADE ST ST. PAUL, MN 55106 Sircet Addixss CiTy Stnte Zip Betweenwhaterossstreetsisthebusinesslceated? ARCADE ST AND COTTAGE �chsideofthestreet? WEST ARCADE Arethepremisesnowoccupied? YF.S. WhatTypeofBusiness? FOOP.S RETAIT, MailToAddress: 1377 ARCADE ST ST. PAUL, MN 55106 S�et Addreas City State Zip Applicant InfoRnation: � NazneandTitle: XAI FENG (NONE) KUE PRESIDENT Fin[ bliddlc (!�feidrn) Laet Title HomeAddress: 112 SKYLINE DR VADNAIS HGTS, MN 55127 srrennan�.. ccry s�u zsp DateofBirth: 06/14/59 PlaceofBirth: LAOS HomePhone: �512) 787-0 Have you ever been convicted of any felony, crime or violation of any city ordinance other than trafficT YES NO X Date of arrest: Charge: _ Conviction: VJhere? Sentence: list the names and residences of three persons of good moral chazacter, living within the Twin Cities Metro Area, not related to the applicant or fmancially interested in the premises or business, who may be referred to as to the applicanYs chazacter: NAME I.Zil�iri:l�ie� ADDRESS 555 TOPPING ST. PHONE 488-7187 DANG CHANG 933 WHITEBEAR AVE 771-3729 SU XIONG 515 E. YORK AVE 778-9309 List licenses which you cutrently hold, fonnerly Have any of the abo��e named licenses ever been ir�r��y'�av� an`mt�e�t jn: C7 ed�7S F�%��:�.".Y�S� X NO If yes, list ihe dates and reasons for revocaGon: `e v,;i (j 2/18/97 Are you going to operate this business personally? X 1'�S F'vst Neme Homc Addresa: Stre:t \ame ?.AiddleInitisl (!�iaidrn) City Are you going to have a manager or assistant in this business? X YES please wmplete the following information: rirs�;.am� M:aa��Inieal �!.Sesam) HomE Address: $trret \eme City NO If not, who will operate it? �� „� Lase DateofBi�ih State Zip Phone Number NO If the manager is not ihe sazne as the operator, Last �m otstnt S�te Zip Phone N�ber Please list your emplo}ment history for the previous five (5) year period: Business/Emplo«nent Address V C K ORIEi�tAi, MAR'_{nT I:vC. 82S E. HA:+T?:ORNE 'aVE. ST. PAUL, MN 551 List all other ofIicers of the coiporation: OPFICER TITLE HOMH HOME BUSINESS DATE OF NAME (Office Held) ADDRESS PHONE PHONE BII2TH XAI FENG KUE PRESIDENT 112 SKYLINE DR- 787-0723 774-7999 06/14/59 XANG VAND VICE—PRESIDENT 921 ROSE AVE 774-1466 774-7999 03/06/49 If business is a paMtrship, please include the following informalion for each partner (use additional pages if necessary): FirstName Iiome Addiesa: Middie Initiel (.Meiden) City Last $tatc Zip Date of8irth Phane Number First Name Middio Initiel (Meidrn) Last Dete of Bvtii Home Addrcss: Strcet I�eme City State Zip Phone Numbcr MINNESOTA TAX IDENTIFICATION N[JNBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tae Clearance; Issuance of Licenses), licrnsing authorities are required to provide to the State of Mumesota Commissioner of Revenue, the Minnesota business tax identification number znd the social security number of each license applicant. Under the Minnesota Govemment Data Practices Act and the Pederal Privacy Act of 1974, we are required to advise you of the following regarding the use of the Minnesota Tax Identification Number: - This information may be used to deny the issuance or rrnewal of yow license in the event you owe Minnesota sales, employet's withholding or motor vehicle excise taxes; - Upon receiving this information, the licensing authority will supply it only to the Minnesota Departrnent of Revenue. However, under the Federal Exchange of Information Agreement, the DeparUnent of Revenue may supp]y this information to the Intemal Revenue Sen�ice. Minnesota TaX Identiiicalion Numbets (Sales & Use TaY Number} may be obtained from ihe State of Minnesota, Business Records Departmrnt, 10 River Park Plaza (Gi 2-296-6181). SocialSecurityNumber: 586-58-0030 MinnesotaTaKIdentificationNumber: 1203245 _ If a Minnesota Tax Identification Number is not required for the business being operated, indicate so by placing an"X" in the box. 2/18197 CERTIFICATION OP WORKERS' CO;�IPENSATION COVERAGE PURSUANT TO MINNESOTA STATUTE 176.182 � o_ � ` � I hereby ceitify that I, or my company, am in compliance with the ��orkers compensation insurance coverage requirements of Minnesota Statute 176.182, subdivision 2. I also understand that pro��sion of false infoimation in ilvs cert�cation constitutes sufficient grounds for advetse action against all licenses held, including revocation and suspension of said licenses. . . ., Nazne of Insurance Company: J7CF7 C' ��liy/! fi/f Gf�1!/ ( H.�r[*aG�/ wm�� i Policy ATUmber: �J �l' �G� � I� Coverage from � �-�/ -� 7 to i �-�- G� I have no employees covered under workers' compensation insurance X. K.(INITIALS) e�NY FALSIFICATION OF ANSWERS GIVEN OR MATERIAL SUBMITTED �VILL RESULT IN DENIAL OF THIS APPLICATION I hereby state that I have answered all of the p; eceding questions, and that the information contained herein is true and correct to the best of my lmowledge and belief. I hereby statz fiuther that I have received no money or other consideration, by way of loan, gift, conhibution, or otheiwise, o4Sa than aL-eady disclos�i in the zpplication which I he*e«zth submitted. I also understand this nremise may be inspected by police, fse, health and other city officials at any and all times when the business is in operation. �� Signature (RLfQUI12ED for all applications) ' Date We will accept payment by cash, check (made payable to City of Saint Paul) or credit card (M/C or Visa). IFPAYING BY CItEDIT G4RD PLEASE COMPLETE THE FOLLOWING INFORMATION: � MasteiCard � Visa EXPII2ATION DATE: ACCOUNT NUMBER: ❑o/❑❑ ❑oo❑ ❑oo❑ ❑oo❑ ❑❑o❑ of Cardholder for all charees) Date **Note: If this application is Food/Liquor re]ated, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review plans. If any substantial changes to structure are anticipated, please contact a City oF Saint Paul Plan Exazniner at 266-9007 to apply for building permi2s. If there are any changes to the parking lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at 266-9008. Atl applications require the following documents. Please attach these documents when submitting your application: 1. A detailed description of the design, location and square footage of the premises to be licensed (site plan). The following data should be on the site plan (preferably on an 8 1/2" x I 1" or 8 1/2" x 14" paper): - Nazne, address, and phone number. - The scale should be stated such as 1"= 20'. ^ N should be indicated to�vard the top. - Placement of all pertinent features of the interior of the licensed facility such as seating azeas, kitchens, offices, repair area, parking, rest rooms, ete. - If a request is for an addition or expansion of the licrnsed facility, indicate both the current uea and the proposed expansion. 2. A copy of your lease agreement or proof of ownership of the property. SPECIFIC LICEA�SE APPLICATIONS REQUIItE ADDITIONAL INFORMATION. PLEASE SEE REVERSE FOR DETAILS >>>> 2/18l97 Council File# O ' 7 � Ordinance # 0 R I G I N A t Green Sheet # LP60038 RESOLUTION CITY OF SAINT PAUL, MINNESOTA Z r7 / Presented By__��/�{�/�f��,��,/d!''�' Referred To Committee: Date RESOLVED: 1 2 3 4 That application (ID #19970000226) for a Malt Off Sale, Grocery (C), Ciqarette/Tobacco License(s) by VCK ORIENTAL MARKET INC DBA VCK ORIENTAL MARXET at 1377 ARCADE ST be and the same is hereby approved. Bos Yeas I� Nays �I Absent Adopted by Council: Date �� Adoption Certified by Council Secretary By App: By: Requested by Department of: Office o£ License,. Inspections and EnVironmental Protection �`I�.�' �4- ��?�' By : ��X � Form Approved by City Attorney By: Approved by Mayor for Submission to Council By: DEPARTMENT/OFFICE/COUNCIL DATE INITIATED LIEP/Licensing GREEN SHEET No. LP60038 �g ��,� ONTACT PERSON & PHONE InNaVDate IniOaVDate UNTHER WILLIAM (BILL) (612) 266-9132 1❑ City Attomey � U5T BE ON COUNCIL AGENDA BY (DATE) ASSIGH 4 f� 98 NUMBERFOR � Council Research ROUTING ORDER TOTAL # OF SIGNATURE PAGES (CUP ALL LOCATIONS FOR SIGNA7URE� ACTION RE�UESTED: Council approval ot the following license application: License # 19970000726, for VCK ORIENTAL MARKET INC, �oing Business As VCK ORIENTAL MARKET, at 1377 ARCADE ST, induding the following business type(s): Malt Off Sale, Grocery (C), Cigarette/Tobacco. RECOMMENDA710NS: Approve(A) RejeCt(R) ERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS: 1. HasthispersonKrmeverworkedundere contrectforihisdepaAmeni� PLANNING COMMISSION YES NO CIBCOMMITTEE 2. Hasthisperso�rmeverbeenacityemployee? CIVIL SVC CINN, YES NO 3. Does this personRrm possess a skill not normalfy possessed by any current city employee? YES NO 4. Is �his persoNfirm a targeted vendoR YES NO fxplain all yes answers on separate sheet and attach to green sheet INITIATING PROBLEM, ISSUE, OPPORTUNfTY (VJho, What, When, Where, Why): . Request Counctl approval for VCK Oriental Market Inc. DBA VCK Orierrtal Market for a Grxery (C), Oh Saie Malt & Cigarette/Tobacco License at 1377 Arcade St. ADVANTAGES IF APPROVED: DISADVANTAGES IF APPROVED� DISADVANTAGES IF NOT APPROVED: TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDING SOURC ACTIVITY NUMBER FINANCIAL INFORMATION: (EXPLAIN) �St343�'iU^?� P$S�?`:;t'� ��`2i FF4 : � � 7�� C� CLASS III LICENSE APPLICATION THIS APPLICATION IS SUR7ECT TO REVIEW BY THE PUBLIC C� �� PLEASE TYPE OR PR IN R3K Type of License(s) being applied fpr: �� `�f��Cvf �: `� '"Z � CompanyName: V C K ORIENTAL MARKET INC. CITY OF SAINT PAUL �x of License, Inspu.tions and Envuoim�rntal Protati� p � ^,� 350 SC PnaS4 Sule 300 6 r � Saint P¢ul, Mvmewh SStG2 (612)1669C90 tix(61])1649S2t $ � ( 9 O � S � � S �ti�� % , Corporetion / Parinership / Sole Proprietorship If business is incomorated, gve date of incorpotation: 0 7/ 14/ 9 3 DoingBusinessAs: FOODS RETAIL BusinessPhone: �612) 774-7999 IIusinessAddress: 1377 ARCADE ST ST. PAUL, MN 55106 Sircet Addixss CiTy Stnte Zip Betweenwhaterossstreetsisthebusinesslceated? ARCADE ST AND COTTAGE �chsideofthestreet? WEST ARCADE Arethepremisesnowoccupied? YF.S. WhatTypeofBusiness? FOOP.S RETAIT, MailToAddress: 1377 ARCADE ST ST. PAUL, MN 55106 S�et Addreas City State Zip Applicant InfoRnation: � NazneandTitle: XAI FENG (NONE) KUE PRESIDENT Fin[ bliddlc (!�feidrn) Laet Title HomeAddress: 112 SKYLINE DR VADNAIS HGTS, MN 55127 srrennan�.. ccry s�u zsp DateofBirth: 06/14/59 PlaceofBirth: LAOS HomePhone: �512) 787-0 Have you ever been convicted of any felony, crime or violation of any city ordinance other than trafficT YES NO X Date of arrest: Charge: _ Conviction: VJhere? Sentence: list the names and residences of three persons of good moral chazacter, living within the Twin Cities Metro Area, not related to the applicant or fmancially interested in the premises or business, who may be referred to as to the applicanYs chazacter: NAME I.Zil�iri:l�ie� ADDRESS 555 TOPPING ST. PHONE 488-7187 DANG CHANG 933 WHITEBEAR AVE 771-3729 SU XIONG 515 E. YORK AVE 778-9309 List licenses which you cutrently hold, fonnerly Have any of the abo��e named licenses ever been ir�r��y'�av� an`mt�e�t jn: C7 ed�7S F�%��:�.".Y�S� X NO If yes, list ihe dates and reasons for revocaGon: `e v,;i (j 2/18/97 Are you going to operate this business personally? X 1'�S F'vst Neme Homc Addresa: Stre:t \ame ?.AiddleInitisl (!�iaidrn) City Are you going to have a manager or assistant in this business? X YES please wmplete the following information: rirs�;.am� M:aa��Inieal �!.Sesam) HomE Address: $trret \eme City NO If not, who will operate it? �� „� Lase DateofBi�ih State Zip Phone Number NO If the manager is not ihe sazne as the operator, Last �m otstnt S�te Zip Phone N�ber Please list your emplo}ment history for the previous five (5) year period: Business/Emplo«nent Address V C K ORIEi�tAi, MAR'_{nT I:vC. 82S E. HA:+T?:ORNE 'aVE. ST. PAUL, MN 551 List all other ofIicers of the coiporation: OPFICER TITLE HOMH HOME BUSINESS DATE OF NAME (Office Held) ADDRESS PHONE PHONE BII2TH XAI FENG KUE PRESIDENT 112 SKYLINE DR- 787-0723 774-7999 06/14/59 XANG VAND VICE—PRESIDENT 921 ROSE AVE 774-1466 774-7999 03/06/49 If business is a paMtrship, please include the following informalion for each partner (use additional pages if necessary): FirstName Iiome Addiesa: Middie Initiel (.Meiden) City Last $tatc Zip Date of8irth Phane Number First Name Middio Initiel (Meidrn) Last Dete of Bvtii Home Addrcss: Strcet I�eme City State Zip Phone Numbcr MINNESOTA TAX IDENTIFICATION N[JNBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tae Clearance; Issuance of Licenses), licrnsing authorities are required to provide to the State of Mumesota Commissioner of Revenue, the Minnesota business tax identification number znd the social security number of each license applicant. Under the Minnesota Govemment Data Practices Act and the Pederal Privacy Act of 1974, we are required to advise you of the following regarding the use of the Minnesota Tax Identification Number: - This information may be used to deny the issuance or rrnewal of yow license in the event you owe Minnesota sales, employet's withholding or motor vehicle excise taxes; - Upon receiving this information, the licensing authority will supply it only to the Minnesota Departrnent of Revenue. However, under the Federal Exchange of Information Agreement, the DeparUnent of Revenue may supp]y this information to the Intemal Revenue Sen�ice. Minnesota TaX Identiiicalion Numbets (Sales & Use TaY Number} may be obtained from ihe State of Minnesota, Business Records Departmrnt, 10 River Park Plaza (Gi 2-296-6181). SocialSecurityNumber: 586-58-0030 MinnesotaTaKIdentificationNumber: 1203245 _ If a Minnesota Tax Identification Number is not required for the business being operated, indicate so by placing an"X" in the box. 2/18197 CERTIFICATION OP WORKERS' CO;�IPENSATION COVERAGE PURSUANT TO MINNESOTA STATUTE 176.182 � o_ � ` � I hereby ceitify that I, or my company, am in compliance with the ��orkers compensation insurance coverage requirements of Minnesota Statute 176.182, subdivision 2. I also understand that pro��sion of false infoimation in ilvs cert�cation constitutes sufficient grounds for advetse action against all licenses held, including revocation and suspension of said licenses. . . ., Nazne of Insurance Company: J7CF7 C' ��liy/! fi/f Gf�1!/ ( H.�r[*aG�/ wm�� i Policy ATUmber: �J �l' �G� � I� Coverage from � �-�/ -� 7 to i �-�- G� I have no employees covered under workers' compensation insurance X. K.(INITIALS) e�NY FALSIFICATION OF ANSWERS GIVEN OR MATERIAL SUBMITTED �VILL RESULT IN DENIAL OF THIS APPLICATION I hereby state that I have answered all of the p; eceding questions, and that the information contained herein is true and correct to the best of my lmowledge and belief. I hereby statz fiuther that I have received no money or other consideration, by way of loan, gift, conhibution, or otheiwise, o4Sa than aL-eady disclos�i in the zpplication which I he*e«zth submitted. I also understand this nremise may be inspected by police, fse, health and other city officials at any and all times when the business is in operation. �� Signature (RLfQUI12ED for all applications) ' Date We will accept payment by cash, check (made payable to City of Saint Paul) or credit card (M/C or Visa). IFPAYING BY CItEDIT G4RD PLEASE COMPLETE THE FOLLOWING INFORMATION: � MasteiCard � Visa EXPII2ATION DATE: ACCOUNT NUMBER: ❑o/❑❑ ❑oo❑ ❑oo❑ ❑oo❑ ❑❑o❑ of Cardholder for all charees) Date **Note: If this application is Food/Liquor re]ated, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review plans. If any substantial changes to structure are anticipated, please contact a City oF Saint Paul Plan Exazniner at 266-9007 to apply for building permi2s. If there are any changes to the parking lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at 266-9008. Atl applications require the following documents. Please attach these documents when submitting your application: 1. A detailed description of the design, location and square footage of the premises to be licensed (site plan). The following data should be on the site plan (preferably on an 8 1/2" x I 1" or 8 1/2" x 14" paper): - Nazne, address, and phone number. - The scale should be stated such as 1"= 20'. ^ N should be indicated to�vard the top. - Placement of all pertinent features of the interior of the licensed facility such as seating azeas, kitchens, offices, repair area, parking, rest rooms, ete. - If a request is for an addition or expansion of the licrnsed facility, indicate both the current uea and the proposed expansion. 2. A copy of your lease agreement or proof of ownership of the property. SPECIFIC LICEA�SE APPLICATIONS REQUIItE ADDITIONAL INFORMATION. PLEASE SEE REVERSE FOR DETAILS >>>> 2/18l97 Council File# O ' 7 � Ordinance # 0 R I G I N A t Green Sheet # LP60038 RESOLUTION CITY OF SAINT PAUL, MINNESOTA Z r7 / Presented By__��/�{�/�f��,��,/d!''�' Referred To Committee: Date RESOLVED: 1 2 3 4 That application (ID #19970000226) for a Malt Off Sale, Grocery (C), Ciqarette/Tobacco License(s) by VCK ORIENTAL MARKET INC DBA VCK ORIENTAL MARXET at 1377 ARCADE ST be and the same is hereby approved. Bos Yeas I� Nays �I Absent Adopted by Council: Date �� Adoption Certified by Council Secretary By App: By: Requested by Department of: Office o£ License,. Inspections and EnVironmental Protection �`I�.�' �4- ��?�' By : ��X � Form Approved by City Attorney By: Approved by Mayor for Submission to Council By: DEPARTMENT/OFFICE/COUNCIL DATE INITIATED LIEP/Licensing GREEN SHEET No. LP60038 �g ��,� ONTACT PERSON & PHONE InNaVDate IniOaVDate UNTHER WILLIAM (BILL) (612) 266-9132 1❑ City Attomey � U5T BE ON COUNCIL AGENDA BY (DATE) ASSIGH 4 f� 98 NUMBERFOR � Council Research ROUTING ORDER TOTAL # OF SIGNATURE PAGES (CUP ALL LOCATIONS FOR SIGNA7URE� ACTION RE�UESTED: Council approval ot the following license application: License # 19970000726, for VCK ORIENTAL MARKET INC, �oing Business As VCK ORIENTAL MARKET, at 1377 ARCADE ST, induding the following business type(s): Malt Off Sale, Grocery (C), Cigarette/Tobacco. RECOMMENDA710NS: Approve(A) RejeCt(R) ERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS: 1. HasthispersonKrmeverworkedundere contrectforihisdepaAmeni� PLANNING COMMISSION YES NO CIBCOMMITTEE 2. Hasthisperso�rmeverbeenacityemployee? CIVIL SVC CINN, YES NO 3. Does this personRrm possess a skill not normalfy possessed by any current city employee? YES NO 4. Is �his persoNfirm a targeted vendoR YES NO fxplain all yes answers on separate sheet and attach to green sheet INITIATING PROBLEM, ISSUE, OPPORTUNfTY (VJho, What, When, Where, Why): . Request Counctl approval for VCK Oriental Market Inc. DBA VCK Orierrtal Market for a Grxery (C), Oh Saie Malt & Cigarette/Tobacco License at 1377 Arcade St. ADVANTAGES IF APPROVED: DISADVANTAGES IF APPROVED� DISADVANTAGES IF NOT APPROVED: TOTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDING SOURC ACTIVITY NUMBER FINANCIAL INFORMATION: (EXPLAIN) �St343�'iU^?� P$S�?`:;t'� ��`2i FF4 : � � 7�� C� CLASS III LICENSE APPLICATION THIS APPLICATION IS SUR7ECT TO REVIEW BY THE PUBLIC C� �� PLEASE TYPE OR PR IN R3K Type of License(s) being applied fpr: �� `�f��Cvf �: `� '"Z � CompanyName: V C K ORIENTAL MARKET INC. CITY OF SAINT PAUL �x of License, Inspu.tions and Envuoim�rntal Protati� p � ^,� 350 SC PnaS4 Sule 300 6 r � Saint P¢ul, Mvmewh SStG2 (612)1669C90 tix(61])1649S2t $ � ( 9 O � S � � S �ti�� % , Corporetion / Parinership / Sole Proprietorship If business is incomorated, gve date of incorpotation: 0 7/ 14/ 9 3 DoingBusinessAs: FOODS RETAIL BusinessPhone: �612) 774-7999 IIusinessAddress: 1377 ARCADE ST ST. PAUL, MN 55106 Sircet Addixss CiTy Stnte Zip Betweenwhaterossstreetsisthebusinesslceated? ARCADE ST AND COTTAGE �chsideofthestreet? WEST ARCADE Arethepremisesnowoccupied? YF.S. WhatTypeofBusiness? FOOP.S RETAIT, MailToAddress: 1377 ARCADE ST ST. PAUL, MN 55106 S�et Addreas City State Zip Applicant InfoRnation: � NazneandTitle: XAI FENG (NONE) KUE PRESIDENT Fin[ bliddlc (!�feidrn) Laet Title HomeAddress: 112 SKYLINE DR VADNAIS HGTS, MN 55127 srrennan�.. ccry s�u zsp DateofBirth: 06/14/59 PlaceofBirth: LAOS HomePhone: �512) 787-0 Have you ever been convicted of any felony, crime or violation of any city ordinance other than trafficT YES NO X Date of arrest: Charge: _ Conviction: VJhere? Sentence: list the names and residences of three persons of good moral chazacter, living within the Twin Cities Metro Area, not related to the applicant or fmancially interested in the premises or business, who may be referred to as to the applicanYs chazacter: NAME I.Zil�iri:l�ie� ADDRESS 555 TOPPING ST. PHONE 488-7187 DANG CHANG 933 WHITEBEAR AVE 771-3729 SU XIONG 515 E. YORK AVE 778-9309 List licenses which you cutrently hold, fonnerly Have any of the abo��e named licenses ever been ir�r��y'�av� an`mt�e�t jn: C7 ed�7S F�%��:�.".Y�S� X NO If yes, list ihe dates and reasons for revocaGon: `e v,;i (j 2/18/97 Are you going to operate this business personally? X 1'�S F'vst Neme Homc Addresa: Stre:t \ame ?.AiddleInitisl (!�iaidrn) City Are you going to have a manager or assistant in this business? X YES please wmplete the following information: rirs�;.am� M:aa��Inieal �!.Sesam) HomE Address: $trret \eme City NO If not, who will operate it? �� „� Lase DateofBi�ih State Zip Phone Number NO If the manager is not ihe sazne as the operator, Last �m otstnt S�te Zip Phone N�ber Please list your emplo}ment history for the previous five (5) year period: Business/Emplo«nent Address V C K ORIEi�tAi, MAR'_{nT I:vC. 82S E. HA:+T?:ORNE 'aVE. ST. PAUL, MN 551 List all other ofIicers of the coiporation: OPFICER TITLE HOMH HOME BUSINESS DATE OF NAME (Office Held) ADDRESS PHONE PHONE BII2TH XAI FENG KUE PRESIDENT 112 SKYLINE DR- 787-0723 774-7999 06/14/59 XANG VAND VICE—PRESIDENT 921 ROSE AVE 774-1466 774-7999 03/06/49 If business is a paMtrship, please include the following informalion for each partner (use additional pages if necessary): FirstName Iiome Addiesa: Middie Initiel (.Meiden) City Last $tatc Zip Date of8irth Phane Number First Name Middio Initiel (Meidrn) Last Dete of Bvtii Home Addrcss: Strcet I�eme City State Zip Phone Numbcr MINNESOTA TAX IDENTIFICATION N[JNBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tae Clearance; Issuance of Licenses), licrnsing authorities are required to provide to the State of Mumesota Commissioner of Revenue, the Minnesota business tax identification number znd the social security number of each license applicant. Under the Minnesota Govemment Data Practices Act and the Pederal Privacy Act of 1974, we are required to advise you of the following regarding the use of the Minnesota Tax Identification Number: - This information may be used to deny the issuance or rrnewal of yow license in the event you owe Minnesota sales, employet's withholding or motor vehicle excise taxes; - Upon receiving this information, the licensing authority will supply it only to the Minnesota Departrnent of Revenue. However, under the Federal Exchange of Information Agreement, the DeparUnent of Revenue may supp]y this information to the Intemal Revenue Sen�ice. Minnesota TaX Identiiicalion Numbets (Sales & Use TaY Number} may be obtained from ihe State of Minnesota, Business Records Departmrnt, 10 River Park Plaza (Gi 2-296-6181). SocialSecurityNumber: 586-58-0030 MinnesotaTaKIdentificationNumber: 1203245 _ If a Minnesota Tax Identification Number is not required for the business being operated, indicate so by placing an"X" in the box. 2/18197 CERTIFICATION OP WORKERS' CO;�IPENSATION COVERAGE PURSUANT TO MINNESOTA STATUTE 176.182 � o_ � ` � I hereby ceitify that I, or my company, am in compliance with the ��orkers compensation insurance coverage requirements of Minnesota Statute 176.182, subdivision 2. I also understand that pro��sion of false infoimation in ilvs cert�cation constitutes sufficient grounds for advetse action against all licenses held, including revocation and suspension of said licenses. . . ., Nazne of Insurance Company: J7CF7 C' ��liy/! fi/f Gf�1!/ ( H.�r[*aG�/ wm�� i Policy ATUmber: �J �l' �G� � I� Coverage from � �-�/ -� 7 to i �-�- G� I have no employees covered under workers' compensation insurance X. K.(INITIALS) e�NY FALSIFICATION OF ANSWERS GIVEN OR MATERIAL SUBMITTED �VILL RESULT IN DENIAL OF THIS APPLICATION I hereby state that I have answered all of the p; eceding questions, and that the information contained herein is true and correct to the best of my lmowledge and belief. I hereby statz fiuther that I have received no money or other consideration, by way of loan, gift, conhibution, or otheiwise, o4Sa than aL-eady disclos�i in the zpplication which I he*e«zth submitted. I also understand this nremise may be inspected by police, fse, health and other city officials at any and all times when the business is in operation. �� Signature (RLfQUI12ED for all applications) ' Date We will accept payment by cash, check (made payable to City of Saint Paul) or credit card (M/C or Visa). IFPAYING BY CItEDIT G4RD PLEASE COMPLETE THE FOLLOWING INFORMATION: � MasteiCard � Visa EXPII2ATION DATE: ACCOUNT NUMBER: ❑o/❑❑ ❑oo❑ ❑oo❑ ❑oo❑ ❑❑o❑ of Cardholder for all charees) Date **Note: If this application is Food/Liquor re]ated, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to review plans. If any substantial changes to structure are anticipated, please contact a City oF Saint Paul Plan Exazniner at 266-9007 to apply for building permi2s. If there are any changes to the parking lot, floor space, or for new operations, please contact a City of Saint Paul Zoning Inspector at 266-9008. Atl applications require the following documents. Please attach these documents when submitting your application: 1. A detailed description of the design, location and square footage of the premises to be licensed (site plan). The following data should be on the site plan (preferably on an 8 1/2" x I 1" or 8 1/2" x 14" paper): - Nazne, address, and phone number. - The scale should be stated such as 1"= 20'. ^ N should be indicated to�vard the top. - Placement of all pertinent features of the interior of the licensed facility such as seating azeas, kitchens, offices, repair area, parking, rest rooms, ete. - If a request is for an addition or expansion of the licrnsed facility, indicate both the current uea and the proposed expansion. 2. A copy of your lease agreement or proof of ownership of the property. SPECIFIC LICEA�SE APPLICATIONS REQUIItE ADDITIONAL INFORMATION. PLEASE SEE REVERSE FOR DETAILS >>>> 2/18l97