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98-315OR(G1NAL Presented By Referred To RSSOLVSD: RESOLUTION Council File1� '�,S Ordinance # Green Sheet # LP60033 )TA 2 g Committee: Date 1 That application (ID #19980000408) for a Reataurant (B) more 2 than 12 seats, Liquor-Outdoor Change in Service Area��L�i�guor 3 On Sale - Sunday, Liquor On Sale - Over 100 seats (B), Gambling 4 Location (Class A), Entextainment (A), Cigarette/Tobacco License(s) 5 by RLA INC DBA AWADA'S ON PLATO at 199 PLATO BLVD E be and the 6 same is hereby approved. Yeas Navs Absent Requested by Department of: Office of License, Inspections and Environmental Protection By: � � � ��__� By Ap� By Form Approved by City Attorney By : (/ CJLQ'�/�(�i(�.v � �G�-/ i^^ Approved by Mayor for Submiasion to Council By: Adopted by Council: Date ,y� ��9 r '� 1 Adoption Certified by Council Secretary DEPARTMENT/OFFICFJCOUNCIL DATE INRIA7ED LIEP/Li�xr�sing GREEN SHEET No. LP60033 ��" �� ONTACT PERSON & PHONE Mieev� fi�a�me� OZEK CHRISTINE (61�266�9708 � CilYAnaneY UST BE ON COUNCIL AGENDA BY (DATE) ASSIGiI � IR�ERFOR � CouncilReswrch RdRfIG OR�! TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: camGi aavro�i a n,e r�� r� �q�au«,: ucense s� sse0000noe for IQA INC, Doing Business As AWADA'S ON PLATO, at 799 PLATO BLVD E, indWkig the follaving business type(s): RestauraM (B) - rtare than 12 seats, LiquorAutdaor CharLqe in Service Ar�, Uquor On Sale - Sunday, Liquor On Sale - Over 100 s�ts (B). Gambling Lacatbn (Cfass A)� ErtectainrtieM (Al. CigaretteJTobacco. RECOMMENDATIONS: Approve(A) Reject(R) RSONAL SERVICE CONTRACTS M&1ST ANSWER THE FOLLOWING OVESTIONS: t. HesthicpersoMrtneverwuksdundsra eontraciforMieEepertmeriYl PLANNING COMMISSION yEg Np —_ CIB COMMITTEE 2. Has Mis petsoNfirm ever been a ctiry empioyee7 ClVIL SVC GNN, �ES No 3. Ooes this persoMrm possess a sldll rwt namaly possessetl by arry curtent cily empbyee4 YES NO . Is this persoM`m e targeted vendo(� YES NO Explain ail yes anawers a� aeparffie sheet and ffitach to yreen sheet INITIATING PROBLEM, ISSUE, OPPORTUNI7Y (Who, What, When, Where, Why): Requesting Coundl approval fa KLA Inc DBA Axada's On Plato for a Uquw Outdoor Change of Servfce Area, Cigarette, L'puor On-Sale Sunday, Liquor On-Sale (8), Restau2M (B), EMertainmeM (A) and GamWing Location (A) Licenses at 199 Plato BNd. E. ADVANTAGESIFAPPROVED: i✓ri}id�i�i3i i a�Juv:;�;�1 L,i�:?:s,�' �1�� 3 d ��7�� DISADVANTAGES IP APPROVED: DISADVANTAGES IF NOT APPROVED: TOTAL AMOUNT OF TRANSACTION b COST/REVENUE BUDGETED (CIRCLE ONE) YES NO PUNDING SOURC . ACTIVITY NUMBER FINANCWL INFORMATION: (EXPLAIN) . �g•7�S CLASS III LICENSE APPLICATION THIS APPLICATIOV IS �L�BJECT I'O REVIEW BY I�NE PUBLIC Ttpe of License(s) beiag applied for: r� PLEASE TYPE OR PRlNT IN II�TK �!-C�Rn'�P,�iU�., LvG./�.5� �I��-�,s��R�,�-�' cs� E LtG� I ,�G?$l SF}, - Pa�r, c��r� � �n�fG_(� CITY OF SAINT PAUL Qffice of Licrnse, Inspectioas znd Emironmrnfal Protzction ?5� St P�ta SC Stite 30� Si.t?a.il,VSmesofe 351D2 (51:)365� fsx(611116SO1:d � �0.0 D ' S c�/7.Oh s `fa�S,�e aG-a.�6 ' av� S �FG �.c�t5 ;r�RETf S �� i . c c� Company :�Tamz: f'� L f-} � Z N C. _ Co:porztian / Psrtnership / So1e Proprietoiship If business is inco�porated, give date of incorporation: __ � D�e !�9 "7 Doing Business As: A l� 7� ��S O+1J P L-/�'7"U _ Business Phone: � 13 �� I Business Address �q � �- �Lt�TU �j L l� � �° T Q'PrU L �� S s/O `� St-ct AdcLess CiTy State Zip Behczen what cross streets is the business located? PL A- i � E EU l� Which side ofthe street7 � .1re the prr.ruses aow� occupied? � V7hat T}pe of Business� R� S� A'�{ P�fI I✓`/ �,�i,i>- J� L� L/ ��t o lZ Mail To Address: f� C I E. (� L i� �O � L L� I� . �'1- � 1�'Gl L.. n� iL� S�t b"� Strxt AdBsess City State Zip Applicant Informatioa: \*zme and Tifle: _ � � LT� �_ � CDlZC t �W run �aa�� mv;am� rS�n rue HomeAddress: �� ,-C� (,PPPE2 CvLntit 1� L(�2, MEN•Po� /+j�, M1U SSI �� StrGt Addms City Siatc Zip Date of Birth: G Place of Birrh: ST. �1 ll L Home Phone: �5� "- �le �7 Have you ever been con�•icted of any felony, crime or ti�iolation of any city ordinance other than tra�c? YES NO � Date of azrest: Charge: _ Conviction: Sentence: List the names and residences of three persons of good moral character, living within the Twin Cities Metro Area, not related to the applicant or Snancially interested in the premises or business, who may be referred to as to the applicant's character: NAME ADDRESS PHONE Have any of the abov6 named licenses ever been revokedl �� Where7 YES ,-__� NO Ifyes, list the dates and reasons foz revocation: 2(18197 List licenses which you currentiy hold, foimerly held, or may have an interest in: Are you going to operate this business personallp7 � YES ATO If not, who will operate it? q��S Fust\xme Home Address: Shcct \eme \tiddle Initiet (`.laidrn) Ciry I,ast Dzte ota;nh State Zip PLonc:Sumber YES �, NO If the mz�aeer is not the sazne as the operatot, Are you going to hace a managa or assistasrt in this buiness? please complete tiz foilo«;ng informxtion: Firzt\ame .'.4iddleIn:tie1 (:Vlzidrn) Lsst Date of Birth Home Address: St=cct \�e CiTy State Zip Phone \��ber Please list }'our emplo}mrnt history for the pre�7ous fii (5) }'eaz period: Business/EmQlo�ment Address tlO,c. �..,\ 'T�.1r —�i..ar,A�G- iG'C FI - ST- i � List all othzr offic.,°rs of the coiporation: OFFICER TITLE HOME " HOME BUSINESS DATE OF I�TANE (Office Held) ADDRESS PHONE PHONE BIRTH fSR�s AwaDA- SEC=netns. - 7c:c�° w�'a�nR, `fso-4�2, �s�-�Y2z 69)��`�Co If business is a parmership, please include the folloN�ng information for each partner (use additional pages if necessary): First\ame ATidAelnitist (Mniden) LaSt DeteofBirth ! Home Add�ess: Strat \ame City Stnte � Zip Phove A'umber Firs[?��e Street'.�amc Middlc Initiil (!vfaidrn) City State ZSp N��7�1 Pl�one \*umber MINNESOTA TAX IDENT7FICATION NUMBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tax Clearance; Issuance of Licenses), licensing authorities are required to provide to the State of Minaesots Commissioner of Revenue, the Minnesota business ta�c identification number and the social security number of each liarnse applicant Under the Minnesota Govemment Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the fol]ow�ing regarding the use of the 2vtnnesota Tax Identification Number: - Tfris info:mation may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholding or motor vehicle excise taxes; - Upon recei��ing tivs information, the licensing authority will suppiy it only to the Minnesota Department of Revenue. However, undu the Federal Exchange of Information Agreement, t6e Department of Revenue may supply ttus information to tLe Internal Revenue Service. IvHnnesoffi Tax IdentificationN�mmbas (Sales & Use Tax Number) may be obtsined from the State of M'innesota, Business Records Departrnent, 10 River Park Plaza (612-296-6181). _ Social Security Number. Minnesota Tax Identification Number. 'J3 09 � q�- _ If a Minnesota Tax Identi5cation Number is not required for the business being operated, indicate so by placing an "X" in the box �� ` 2/1 S/97 I.sa q.� - � \5 CERTffICA"IION OF WORKERS' COVIPENSATION COVERAGE PURSUANT TO MINNESOTA STATUTE 176.182 I hereby certif}'that � or m}' compzny, un in compliance uith ihe n compensation insurance co�'erage requireme;�ts of Muuresota Statute 176.182, subdivision 2. I also understznd Lhat pm�ision of fals=, inYormation in this certification constitutes s�cient grounds for adverse action against zll lic..�nses held, including reeocztion and suspension of said licenses. I�Tazne of Ins u ance Company: J I i`t l� fi N U Jl1 Li I Lf if L Policy Iv*umber: �� Ce �� 2 - Co� erage from I have no emplo}'ezs cocered undzr u compensation i*i.nrznce (IivITIALS) e�. to d7 O� �' AIQY FALSIFICATION OF �\SR'EI2S GIVEN OR Mr1TERIAL SUB;VIITTED VF'ILL REStiLT IN DE\7AL OF THIS APPLICATION I hereby state that I hace ans� ered z11 of the preceding questions, and that the information contained herein is hue and correct to the best of my know�ledee and belief. I hereby sczte further that I ha�-e received no monep or other consideralion, by ��•ay of loan, giR, conRibutio� or othen;-ise, other than already disclosed in the application v.$ich I herewith submitted I also understand this premise may be inspected by police, fire, health and other city officials at any and all times w�hen the business is in operation. Signature (REQUIRED for all applications) We Rill accept payment by casH, check (made pacable to Citc of Saint Pau� or credit card (1!1/C �or Visa). Date IFPAYIIJG BY CREDIT CARD PLEASE COMPLETE THE FOLLOWING INFORMATION: � MasterCard � Visa EXPIRATION DATE: ACCOUNT NIJ?vIBER: ❑Of�❑ ❑❑CI❑ ❑❑�❑ ❑��❑ ❑�0❑ of Cazd for all Date •'1�'ote: If this application is Food/Liquor related, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to re�iew plans. If any substantial changes to structure aze anticipated, please contact a City of Saint Paul Plan Examiner at 266-9007 to apply for building pemuts. If there are azry changes to the parking lo; floor space, or £or new operations, please contact a City of Saint Paul Zoning Inspector at 266-9008. All applications mquirn the following documents. Please attach these documents a�Len 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): - Name, address, and phone number. - The scale should be stated such as 1" = 20'. ^N should be indicated toward the top. - Placement of all pertinent features of the interior of the licensed facility such as seating areas, kitchens, offices, repair azea, pazking, rest rooms, etc. - - ffa request is for an addition or expansion of tbe licensed facility, indicate both the cuirent area and the proposed expansion. 2. A copy ofyour lease ageement or proof of ownecship of the property. SPECIFIC LICENSE APPLICATIONS REQUIItE ADDTTIONAL INFORMATION..: PLEASE SEE REVERSE FOR DETAII.S >>>> �� 2i l8/97 OR(G1NAL Presented By Referred To RSSOLVSD: RESOLUTION Council File1� '�,S Ordinance # Green Sheet # LP60033 )TA 2 g Committee: Date 1 That application (ID #19980000408) for a Reataurant (B) more 2 than 12 seats, Liquor-Outdoor Change in Service Area��L�i�guor 3 On Sale - Sunday, Liquor On Sale - Over 100 seats (B), Gambling 4 Location (Class A), Entextainment (A), Cigarette/Tobacco License(s) 5 by RLA INC DBA AWADA'S ON PLATO at 199 PLATO BLVD E be and the 6 same is hereby approved. Yeas Navs Absent Requested by Department of: Office of License, Inspections and Environmental Protection By: � � � ��__� By Ap� By Form Approved by City Attorney By : (/ CJLQ'�/�(�i(�.v � �G�-/ i^^ Approved by Mayor for Submiasion to Council By: Adopted by Council: Date ,y� ��9 r '� 1 Adoption Certified by Council Secretary DEPARTMENT/OFFICFJCOUNCIL DATE INRIA7ED LIEP/Li�xr�sing GREEN SHEET No. LP60033 ��" �� ONTACT PERSON & PHONE Mieev� fi�a�me� OZEK CHRISTINE (61�266�9708 � CilYAnaneY UST BE ON COUNCIL AGENDA BY (DATE) ASSIGiI � IR�ERFOR � CouncilReswrch RdRfIG OR�! TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: camGi aavro�i a n,e r�� r� �q�au«,: ucense s� sse0000noe for IQA INC, Doing Business As AWADA'S ON PLATO, at 799 PLATO BLVD E, indWkig the follaving business type(s): RestauraM (B) - rtare than 12 seats, LiquorAutdaor CharLqe in Service Ar�, Uquor On Sale - Sunday, Liquor On Sale - Over 100 s�ts (B). Gambling Lacatbn (Cfass A)� ErtectainrtieM (Al. CigaretteJTobacco. RECOMMENDATIONS: Approve(A) Reject(R) RSONAL SERVICE CONTRACTS M&1ST ANSWER THE FOLLOWING OVESTIONS: t. HesthicpersoMrtneverwuksdundsra eontraciforMieEepertmeriYl PLANNING COMMISSION yEg Np —_ CIB COMMITTEE 2. Has Mis petsoNfirm ever been a ctiry empioyee7 ClVIL SVC GNN, �ES No 3. Ooes this persoMrm possess a sldll rwt namaly possessetl by arry curtent cily empbyee4 YES NO . Is this persoM`m e targeted vendo(� YES NO Explain ail yes anawers a� aeparffie sheet and ffitach to yreen sheet INITIATING PROBLEM, ISSUE, OPPORTUNI7Y (Who, What, When, Where, Why): Requesting Coundl approval fa KLA Inc DBA Axada's On Plato for a Uquw Outdoor Change of Servfce Area, Cigarette, L'puor On-Sale Sunday, Liquor On-Sale (8), Restau2M (B), EMertainmeM (A) and GamWing Location (A) Licenses at 199 Plato BNd. E. ADVANTAGESIFAPPROVED: i✓ri}id�i�i3i i a�Juv:;�;�1 L,i�:?:s,�' �1�� 3 d ��7�� DISADVANTAGES IP APPROVED: DISADVANTAGES IF NOT APPROVED: TOTAL AMOUNT OF TRANSACTION b COST/REVENUE BUDGETED (CIRCLE ONE) YES NO PUNDING SOURC . ACTIVITY NUMBER FINANCWL INFORMATION: (EXPLAIN) . �g•7�S CLASS III LICENSE APPLICATION THIS APPLICATIOV IS �L�BJECT I'O REVIEW BY I�NE PUBLIC Ttpe of License(s) beiag applied for: r� PLEASE TYPE OR PRlNT IN II�TK �!-C�Rn'�P,�iU�., LvG./�.5� �I��-�,s��R�,�-�' cs� E LtG� I ,�G?$l SF}, - Pa�r, c��r� � �n�fG_(� CITY OF SAINT PAUL Qffice of Licrnse, Inspectioas znd Emironmrnfal Protzction ?5� St P�ta SC Stite 30� Si.t?a.il,VSmesofe 351D2 (51:)365� fsx(611116SO1:d � �0.0 D ' S c�/7.Oh s `fa�S,�e aG-a.�6 ' av� S �FG �.c�t5 ;r�RETf S �� i . c c� Company :�Tamz: f'� L f-} � Z N C. _ Co:porztian / Psrtnership / So1e Proprietoiship If business is inco�porated, give date of incorporation: __ � D�e !�9 "7 Doing Business As: A l� 7� ��S O+1J P L-/�'7"U _ Business Phone: � 13 �� I Business Address �q � �- �Lt�TU �j L l� � �° T Q'PrU L �� S s/O `� St-ct AdcLess CiTy State Zip Behczen what cross streets is the business located? PL A- i � E EU l� Which side ofthe street7 � .1re the prr.ruses aow� occupied? � V7hat T}pe of Business� R� S� A'�{ P�fI I✓`/ �,�i,i>- J� L� L/ ��t o lZ Mail To Address: f� C I E. (� L i� �O � L L� I� . �'1- � 1�'Gl L.. n� iL� S�t b"� Strxt AdBsess City State Zip Applicant Informatioa: \*zme and Tifle: _ � � LT� �_ � CDlZC t �W run �aa�� mv;am� rS�n rue HomeAddress: �� ,-C� (,PPPE2 CvLntit 1� L(�2, MEN•Po� /+j�, M1U SSI �� StrGt Addms City Siatc Zip Date of Birth: G Place of Birrh: ST. �1 ll L Home Phone: �5� "- �le �7 Have you ever been con�•icted of any felony, crime or ti�iolation of any city ordinance other than tra�c? YES NO � Date of azrest: Charge: _ Conviction: Sentence: List the names and residences of three persons of good moral character, living within the Twin Cities Metro Area, not related to the applicant or Snancially interested in the premises or business, who may be referred to as to the applicant's character: NAME ADDRESS PHONE Have any of the abov6 named licenses ever been revokedl �� Where7 YES ,-__� NO Ifyes, list the dates and reasons foz revocation: 2(18197 List licenses which you currentiy hold, foimerly held, or may have an interest in: Are you going to operate this business personallp7 � YES ATO If not, who will operate it? q��S Fust\xme Home Address: Shcct \eme \tiddle Initiet (`.laidrn) Ciry I,ast Dzte ota;nh State Zip PLonc:Sumber YES �, NO If the mz�aeer is not the sazne as the operatot, Are you going to hace a managa or assistasrt in this buiness? please complete tiz foilo«;ng informxtion: Firzt\ame .'.4iddleIn:tie1 (:Vlzidrn) Lsst Date of Birth Home Address: St=cct \�e CiTy State Zip Phone \��ber Please list }'our emplo}mrnt history for the pre�7ous fii (5) }'eaz period: Business/EmQlo�ment Address tlO,c. �..,\ 'T�.1r —�i..ar,A�G- iG'C FI - ST- i � List all othzr offic.,°rs of the coiporation: OFFICER TITLE HOME " HOME BUSINESS DATE OF I�TANE (Office Held) ADDRESS PHONE PHONE BIRTH fSR�s AwaDA- SEC=netns. - 7c:c�° w�'a�nR, `fso-4�2, �s�-�Y2z 69)��`�Co If business is a parmership, please include the folloN�ng information for each partner (use additional pages if necessary): First\ame ATidAelnitist (Mniden) LaSt DeteofBirth ! Home Add�ess: Strat \ame City Stnte � Zip Phove A'umber Firs[?��e Street'.�amc Middlc Initiil (!vfaidrn) City State ZSp N��7�1 Pl�one \*umber MINNESOTA TAX IDENT7FICATION NUMBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tax Clearance; Issuance of Licenses), licensing authorities are required to provide to the State of Minaesots Commissioner of Revenue, the Minnesota business ta�c identification number and the social security number of each liarnse applicant Under the Minnesota Govemment Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the fol]ow�ing regarding the use of the 2vtnnesota Tax Identification Number: - Tfris info:mation may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholding or motor vehicle excise taxes; - Upon recei��ing tivs information, the licensing authority will suppiy it only to the Minnesota Department of Revenue. However, undu the Federal Exchange of Information Agreement, t6e Department of Revenue may supply ttus information to tLe Internal Revenue Service. IvHnnesoffi Tax IdentificationN�mmbas (Sales & Use Tax Number) may be obtsined from the State of M'innesota, Business Records Departrnent, 10 River Park Plaza (612-296-6181). _ Social Security Number. Minnesota Tax Identification Number. 'J3 09 � q�- _ If a Minnesota Tax Identi5cation Number is not required for the business being operated, indicate so by placing an "X" in the box �� ` 2/1 S/97 I.sa q.� - � \5 CERTffICA"IION OF WORKERS' COVIPENSATION COVERAGE PURSUANT TO MINNESOTA STATUTE 176.182 I hereby certif}'that � or m}' compzny, un in compliance uith ihe n compensation insurance co�'erage requireme;�ts of Muuresota Statute 176.182, subdivision 2. I also understznd Lhat pm�ision of fals=, inYormation in this certification constitutes s�cient grounds for adverse action against zll lic..�nses held, including reeocztion and suspension of said licenses. I�Tazne of Ins u ance Company: J I i`t l� fi N U Jl1 Li I Lf if L Policy Iv*umber: �� Ce �� 2 - Co� erage from I have no emplo}'ezs cocered undzr u compensation i*i.nrznce (IivITIALS) e�. to d7 O� �' AIQY FALSIFICATION OF �\SR'EI2S GIVEN OR Mr1TERIAL SUB;VIITTED VF'ILL REStiLT IN DE\7AL OF THIS APPLICATION I hereby state that I hace ans� ered z11 of the preceding questions, and that the information contained herein is hue and correct to the best of my know�ledee and belief. I hereby sczte further that I ha�-e received no monep or other consideralion, by ��•ay of loan, giR, conRibutio� or othen;-ise, other than already disclosed in the application v.$ich I herewith submitted I also understand this premise may be inspected by police, fire, health and other city officials at any and all times w�hen the business is in operation. Signature (REQUIRED for all applications) We Rill accept payment by casH, check (made pacable to Citc of Saint Pau� or credit card (1!1/C �or Visa). Date IFPAYIIJG BY CREDIT CARD PLEASE COMPLETE THE FOLLOWING INFORMATION: � MasterCard � Visa EXPIRATION DATE: ACCOUNT NIJ?vIBER: ❑Of�❑ ❑❑CI❑ ❑❑�❑ ❑��❑ ❑�0❑ of Cazd for all Date •'1�'ote: If this application is Food/Liquor related, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to re�iew plans. If any substantial changes to structure aze anticipated, please contact a City of Saint Paul Plan Examiner at 266-9007 to apply for building pemuts. If there are azry changes to the parking lo; floor space, or £or new operations, please contact a City of Saint Paul Zoning Inspector at 266-9008. All applications mquirn the following documents. Please attach these documents a�Len 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): - Name, address, and phone number. - The scale should be stated such as 1" = 20'. ^N should be indicated toward the top. - Placement of all pertinent features of the interior of the licensed facility such as seating areas, kitchens, offices, repair azea, pazking, rest rooms, etc. - - ffa request is for an addition or expansion of tbe licensed facility, indicate both the cuirent area and the proposed expansion. 2. A copy ofyour lease ageement or proof of ownecship of the property. SPECIFIC LICENSE APPLICATIONS REQUIItE ADDTTIONAL INFORMATION..: PLEASE SEE REVERSE FOR DETAII.S >>>> �� 2i l8/97 OR(G1NAL Presented By Referred To RSSOLVSD: RESOLUTION Council File1� '�,S Ordinance # Green Sheet # LP60033 )TA 2 g Committee: Date 1 That application (ID #19980000408) for a Reataurant (B) more 2 than 12 seats, Liquor-Outdoor Change in Service Area��L�i�guor 3 On Sale - Sunday, Liquor On Sale - Over 100 seats (B), Gambling 4 Location (Class A), Entextainment (A), Cigarette/Tobacco License(s) 5 by RLA INC DBA AWADA'S ON PLATO at 199 PLATO BLVD E be and the 6 same is hereby approved. Yeas Navs Absent Requested by Department of: Office of License, Inspections and Environmental Protection By: � � � ��__� By Ap� By Form Approved by City Attorney By : (/ CJLQ'�/�(�i(�.v � �G�-/ i^^ Approved by Mayor for Submiasion to Council By: Adopted by Council: Date ,y� ��9 r '� 1 Adoption Certified by Council Secretary DEPARTMENT/OFFICFJCOUNCIL DATE INRIA7ED LIEP/Li�xr�sing GREEN SHEET No. LP60033 ��" �� ONTACT PERSON & PHONE Mieev� fi�a�me� OZEK CHRISTINE (61�266�9708 � CilYAnaneY UST BE ON COUNCIL AGENDA BY (DATE) ASSIGiI � IR�ERFOR � CouncilReswrch RdRfIG OR�! TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: camGi aavro�i a n,e r�� r� �q�au«,: ucense s� sse0000noe for IQA INC, Doing Business As AWADA'S ON PLATO, at 799 PLATO BLVD E, indWkig the follaving business type(s): RestauraM (B) - rtare than 12 seats, LiquorAutdaor CharLqe in Service Ar�, Uquor On Sale - Sunday, Liquor On Sale - Over 100 s�ts (B). Gambling Lacatbn (Cfass A)� ErtectainrtieM (Al. CigaretteJTobacco. RECOMMENDATIONS: Approve(A) Reject(R) RSONAL SERVICE CONTRACTS M&1ST ANSWER THE FOLLOWING OVESTIONS: t. HesthicpersoMrtneverwuksdundsra eontraciforMieEepertmeriYl PLANNING COMMISSION yEg Np —_ CIB COMMITTEE 2. Has Mis petsoNfirm ever been a ctiry empioyee7 ClVIL SVC GNN, �ES No 3. Ooes this persoMrm possess a sldll rwt namaly possessetl by arry curtent cily empbyee4 YES NO . Is this persoM`m e targeted vendo(� YES NO Explain ail yes anawers a� aeparffie sheet and ffitach to yreen sheet INITIATING PROBLEM, ISSUE, OPPORTUNI7Y (Who, What, When, Where, Why): Requesting Coundl approval fa KLA Inc DBA Axada's On Plato for a Uquw Outdoor Change of Servfce Area, Cigarette, L'puor On-Sale Sunday, Liquor On-Sale (8), Restau2M (B), EMertainmeM (A) and GamWing Location (A) Licenses at 199 Plato BNd. E. ADVANTAGESIFAPPROVED: i✓ri}id�i�i3i i a�Juv:;�;�1 L,i�:?:s,�' �1�� 3 d ��7�� DISADVANTAGES IP APPROVED: DISADVANTAGES IF NOT APPROVED: TOTAL AMOUNT OF TRANSACTION b COST/REVENUE BUDGETED (CIRCLE ONE) YES NO PUNDING SOURC . ACTIVITY NUMBER FINANCWL INFORMATION: (EXPLAIN) . �g•7�S CLASS III LICENSE APPLICATION THIS APPLICATIOV IS �L�BJECT I'O REVIEW BY I�NE PUBLIC Ttpe of License(s) beiag applied for: r� PLEASE TYPE OR PRlNT IN II�TK �!-C�Rn'�P,�iU�., LvG./�.5� �I��-�,s��R�,�-�' cs� E LtG� I ,�G?$l SF}, - Pa�r, c��r� � �n�fG_(� CITY OF SAINT PAUL Qffice of Licrnse, Inspectioas znd Emironmrnfal Protzction ?5� St P�ta SC Stite 30� Si.t?a.il,VSmesofe 351D2 (51:)365� fsx(611116SO1:d � �0.0 D ' S c�/7.Oh s `fa�S,�e aG-a.�6 ' av� S �FG �.c�t5 ;r�RETf S �� i . c c� Company :�Tamz: f'� L f-} � Z N C. _ Co:porztian / Psrtnership / So1e Proprietoiship If business is inco�porated, give date of incorporation: __ � D�e !�9 "7 Doing Business As: A l� 7� ��S O+1J P L-/�'7"U _ Business Phone: � 13 �� I Business Address �q � �- �Lt�TU �j L l� � �° T Q'PrU L �� S s/O `� St-ct AdcLess CiTy State Zip Behczen what cross streets is the business located? PL A- i � E EU l� Which side ofthe street7 � .1re the prr.ruses aow� occupied? � V7hat T}pe of Business� R� S� A'�{ P�fI I✓`/ �,�i,i>- J� L� L/ ��t o lZ Mail To Address: f� C I E. (� L i� �O � L L� I� . �'1- � 1�'Gl L.. n� iL� S�t b"� Strxt AdBsess City State Zip Applicant Informatioa: \*zme and Tifle: _ � � LT� �_ � CDlZC t �W run �aa�� mv;am� rS�n rue HomeAddress: �� ,-C� (,PPPE2 CvLntit 1� L(�2, MEN•Po� /+j�, M1U SSI �� StrGt Addms City Siatc Zip Date of Birth: G Place of Birrh: ST. �1 ll L Home Phone: �5� "- �le �7 Have you ever been con�•icted of any felony, crime or ti�iolation of any city ordinance other than tra�c? YES NO � Date of azrest: Charge: _ Conviction: Sentence: List the names and residences of three persons of good moral character, living within the Twin Cities Metro Area, not related to the applicant or Snancially interested in the premises or business, who may be referred to as to the applicant's character: NAME ADDRESS PHONE Have any of the abov6 named licenses ever been revokedl �� Where7 YES ,-__� NO Ifyes, list the dates and reasons foz revocation: 2(18197 List licenses which you currentiy hold, foimerly held, or may have an interest in: Are you going to operate this business personallp7 � YES ATO If not, who will operate it? q��S Fust\xme Home Address: Shcct \eme \tiddle Initiet (`.laidrn) Ciry I,ast Dzte ota;nh State Zip PLonc:Sumber YES �, NO If the mz�aeer is not the sazne as the operatot, Are you going to hace a managa or assistasrt in this buiness? please complete tiz foilo«;ng informxtion: Firzt\ame .'.4iddleIn:tie1 (:Vlzidrn) Lsst Date of Birth Home Address: St=cct \�e CiTy State Zip Phone \��ber Please list }'our emplo}mrnt history for the pre�7ous fii (5) }'eaz period: Business/EmQlo�ment Address tlO,c. �..,\ 'T�.1r —�i..ar,A�G- iG'C FI - ST- i � List all othzr offic.,°rs of the coiporation: OFFICER TITLE HOME " HOME BUSINESS DATE OF I�TANE (Office Held) ADDRESS PHONE PHONE BIRTH fSR�s AwaDA- SEC=netns. - 7c:c�° w�'a�nR, `fso-4�2, �s�-�Y2z 69)��`�Co If business is a parmership, please include the folloN�ng information for each partner (use additional pages if necessary): First\ame ATidAelnitist (Mniden) LaSt DeteofBirth ! Home Add�ess: Strat \ame City Stnte � Zip Phove A'umber Firs[?��e Street'.�amc Middlc Initiil (!vfaidrn) City State ZSp N��7�1 Pl�one \*umber MINNESOTA TAX IDENT7FICATION NUMBER - Pursuant to the Laws of Minnesota, 1984, Chapter 502, Article 8, Section 2(270.72) (Tax Clearance; Issuance of Licenses), licensing authorities are required to provide to the State of Minaesots Commissioner of Revenue, the Minnesota business ta�c identification number and the social security number of each liarnse applicant Under the Minnesota Govemment Data Practices Act and the Federal Privacy Act of 1974, we are required to advise you of the fol]ow�ing regarding the use of the 2vtnnesota Tax Identification Number: - Tfris info:mation may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employer's withholding or motor vehicle excise taxes; - Upon recei��ing tivs information, the licensing authority will suppiy it only to the Minnesota Department of Revenue. However, undu the Federal Exchange of Information Agreement, t6e Department of Revenue may supply ttus information to tLe Internal Revenue Service. IvHnnesoffi Tax IdentificationN�mmbas (Sales & Use Tax Number) may be obtsined from the State of M'innesota, Business Records Departrnent, 10 River Park Plaza (612-296-6181). _ Social Security Number. Minnesota Tax Identification Number. 'J3 09 � q�- _ If a Minnesota Tax Identi5cation Number is not required for the business being operated, indicate so by placing an "X" in the box �� ` 2/1 S/97 I.sa q.� - � \5 CERTffICA"IION OF WORKERS' COVIPENSATION COVERAGE PURSUANT TO MINNESOTA STATUTE 176.182 I hereby certif}'that � or m}' compzny, un in compliance uith ihe n compensation insurance co�'erage requireme;�ts of Muuresota Statute 176.182, subdivision 2. I also understznd Lhat pm�ision of fals=, inYormation in this certification constitutes s�cient grounds for adverse action against zll lic..�nses held, including reeocztion and suspension of said licenses. I�Tazne of Ins u ance Company: J I i`t l� fi N U Jl1 Li I Lf if L Policy Iv*umber: �� Ce �� 2 - Co� erage from I have no emplo}'ezs cocered undzr u compensation i*i.nrznce (IivITIALS) e�. to d7 O� �' AIQY FALSIFICATION OF �\SR'EI2S GIVEN OR Mr1TERIAL SUB;VIITTED VF'ILL REStiLT IN DE\7AL OF THIS APPLICATION I hereby state that I hace ans� ered z11 of the preceding questions, and that the information contained herein is hue and correct to the best of my know�ledee and belief. I hereby sczte further that I ha�-e received no monep or other consideralion, by ��•ay of loan, giR, conRibutio� or othen;-ise, other than already disclosed in the application v.$ich I herewith submitted I also understand this premise may be inspected by police, fire, health and other city officials at any and all times w�hen the business is in operation. Signature (REQUIRED for all applications) We Rill accept payment by casH, check (made pacable to Citc of Saint Pau� or credit card (1!1/C �or Visa). Date IFPAYIIJG BY CREDIT CARD PLEASE COMPLETE THE FOLLOWING INFORMATION: � MasterCard � Visa EXPIRATION DATE: ACCOUNT NIJ?vIBER: ❑Of�❑ ❑❑CI❑ ❑❑�❑ ❑��❑ ❑�0❑ of Cazd for all Date •'1�'ote: If this application is Food/Liquor related, please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to re�iew plans. If any substantial changes to structure aze anticipated, please contact a City of Saint Paul Plan Examiner at 266-9007 to apply for building pemuts. If there are azry changes to the parking lo; floor space, or £or new operations, please contact a City of Saint Paul Zoning Inspector at 266-9008. All applications mquirn the following documents. Please attach these documents a�Len 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): - Name, address, and phone number. - The scale should be stated such as 1" = 20'. ^N should be indicated toward the top. - Placement of all pertinent features of the interior of the licensed facility such as seating areas, kitchens, offices, repair azea, pazking, rest rooms, etc. - - ffa request is for an addition or expansion of tbe licensed facility, indicate both the cuirent area and the proposed expansion. 2. A copy ofyour lease ageement or proof of ownecship of the property. SPECIFIC LICENSE APPLICATIONS REQUIItE ADDTTIONAL INFORMATION..: PLEASE SEE REVERSE FOR DETAII.S >>>> �� 2i l8/97