The URL can be used to link to this page

91-1491 t�RIGi�� C uncil File # �+Y C�reen Sheet ,� 16382 RESOLUTION F SAINT PAUL, MINNESOT�► Presented By II Referred To Commi�tee: Date I �.,y�, :�. �, � h�,. I '�`..yA�.,h�,• .>1'.. v�YM1S:': .. .� . +�.,., y� N/l ��h�{ � �� z°c�� •� .�`s.:.� .�,x. �.��s ��. RESOLVED: That Application (I.D. #91179; for an On Sale Liquor�B, Su "� � le Liquor, Entertainment-3 and Restaurant-D applied for by Ho ood of St. Paul Inc. DBA Hollywood, Hollywood (Dennis Gallassie,- t 175 E. Sth Street be and the same is hereby approved. I '"` � ��°��jw� ",� � ;�;: i �-� ..', :`� ' I 'q: �.#v � �s' . I -;;.' y. ,,.} Yeas Navs Absent Requested by Depar�tment of: ,' � � imon �,. �M:• onw1 z 1 � License & Plermit Division acca ee - e man -� une �- T �` i son � BY� � �'� k':. 3 F— v + :, ,_. r r Adopted by Council: Date _A�� $�� Form Approved by C�.ty Attorney Adoptio Certified by Council Secretary ' � r _ By: • � �� "� '' a;.� ,: sy: I .,� .� Approved by Mayor: Date AUG 1 2 1991 Approved by Mayor �or Submission to Council �� , By: �s��e�� li ' By: ' P��1S�6�D AUG 17'9 . � � ��N DEPARTMENT/OFFICFJCOUNCIL DATE IN�TIATED G R E E N SH E E �O �16 3 8 2 Finance/License CONTACT PERSON&PHONE INITIAUDATE ' INITIAUDATE DEPARTMENT DiRECTOR CITYCOUNCIL Kris Van Horn/298-5056 ASSIGN g CITYATfORNEY �CITYCLERK MUST BE ON COUNCIL AGENDA BY(DATE) NUMBER FOH ROUTING �BUD(iET DIRECTOR �FIN.�MGT.S�RVICES DIR. �11St�er�ogCity Clerk by I ORDER �MAYOR(OR ASSISTAN'n � COLIIIC�1 R2 ear h TOTAL#OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: Application (I.D. �1�91179) for an On Sale Liquor-B, Sunday On Sale iquor, Entertaimment-3 and Restaurant-D License. RECOMMENDATIONS:Approve(A)or Reject(R) PERSONAL SERVICE CONTRACTS MUST ANSWE THE, � .QUESTIONS: , _PLANNINO COMMISSION _ CIVIL SERVICE COMMISSION 1• Has this personlfirm ever wo►ked under a coMract r th'�` _CIB COMMITTEE YES NO '?ss. '� r ,, _STAFF 2• Has this person/firm ever been a city employee? �:, _ DISTRICT COURT YES NO �' - 3. Does this person/firm possess a skill not normally o � �'loyee? SUPPORTS WHICH COUNCIL OBJECTIVE? YES NO }l�` "='; �� ''." Explain all yes enswers on aeparate sheet and a ch to ,' INITIATINO PROBLEM,ISSUE,OPPORTUNITY(Who,What,When,Where,Why): Hollywood Hollywood of St. Paul Inc. DBA Hollywood, Hollywood (Den is Ga.l , Ta s`�dent) at 175 E. 5th Street (Galtier Plaza) requests Council approval of ts applics q� an On Sale Liquor-B, Entertainment-III, Sunday On Sale Liquor and Res aurant-D L_. �' Al1 applications and fees have been submitted. All required departmen s have rev3". `d approved this application. ADVANTAGES IF APPROVED: : ;L;�``... ,..:_ � ,q . . . . . ,;.;�"�Y, . DISADVANTAGES IF APPROVED: ",r., ° ��, ��",�',�. :� + � � 4+� DISADVANTAOES IF NOT APPROVED:, . ,�` ' � ��a�! fa��:��.{{` ��i�l�� ,�< €f F �� ..`. �: .lUl. 31 �991 h� :�� ,:;, �� , _:�� TOTAL AMOUNT OF TRANSACTION s COST/REVENUE BUDGETEP(CIR LE ONE) YES NO ,,-e FUNDING SOURCE ACTIVITY NUMBER *� .� FINANCIAL INFORMATION:(EXPLAIN) �)j� w r e ,. NOTE: COMPLETF t�1fiECTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIONAL MANUAI,,AVAILABLE IN THE PURCHASING OFFICE(PHONE NO.298-4225). ROUTING ORDER: Below are correct routings for the five most frequent types of documents: CONTRACTS(assumes authorized budget exists) COUNCIL RESOLUTION (Amend Budgets/Accept.(3rants) 1. Outside Agency 1. Department Director 2. Department Director 2. Ciry Attorney 3. Clry i4#tor 3. Budget Director 4. Msyor` Vacts over$15,000) 4. Mayor/Assistant #; 5. (for c�pt�cts over$50,000) 5. City Council 6. Fi � Management�S6nrices Director 6. Chief Accountant, Finance and Management Services 7. Fina ,�� Ming �r� '�Sµ ;. �♦_. ADMINIST�'fIVE Revision) COUNCIL RESOLUTION(all others, and Ordfnances) ;�_,� 1. Activiry M 1. Department Director 2. Departwie �� 2. City Attorney 3. Depanm 3. Mayor Assistant 4. Budgef D . _�: 4. Ciry Council 5. City Clerk-'�� 6. Chief A ,d Management Services �.�;; ADMINISTRA �uthers) 1. Depart ;: 2. City A 3. Fina �Services Director 4. City ClArk ' �:<�' _ z -' TOTAL N NATURE PAGES Indicate `'on which signatures are required and paperclip or flag each of ACTION Describe ecUrequest seeics to accomplish in either chronologi- cal order portance,whichever is most appropriate for the issue. Do n plete sentences. Begin each item in your list with a verb. RECOM ��NS Complete e in question has been presented before any body,public or priv :_.�,',:�� ; ... �, �11CH C()tJNCIL OBJECTIVE? � Council objective(s)your projecUrequest supports by listing `�� s)(HOU8WG, RECREATION, NEIGHBORHOODS, ECONOMIC DEVELOPMENT, -$EWER SEPARATION). (SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.) �..., �"SERVICE CONTRACTS: '�ormatlon will be used to determine the city's liability for workers compensation claims,taxes and proper civil service hiring rules. �:�.. _.,-" PROBLEM, ISSUE,OPPORTUNITY situation or conditions that created a need for your project �Y . i.AGES IF APPROVED 'v�:,;.F: �whether this is simply an annual budget procedure required by law/ � °`-_ or whether there are specific ways in which the Ciry of Saint Paul ,g�_,.', � citizens will benefit from this projecUaction. ;�:� a�= DVANTAGES IF APPROVED negative effects or major changes to existing or past processes might rojecUrequest produce if it is passed(e.g.,traffic delays, noise, creases or assessments)?To Whom?When7 For how long? �`�" ; DI. �� ANTAGES IF NOT APPROVED � � WIH be the negative consequences if the promised action is not ;��-_:. . .,,, ; ved?Inabiliry to deliver service?Continued high traffic, noise, .� 'dent rate?Loss of revenue? ��NANCIAL IMPACT '`'Although you must tailor the information you provide here to the issue you �� are addressing, in ge�eral you must answer two questions: How much is it going to cost?Who is going to pay? 4.; ' ,�� DIVISION OF LICENSE AND PERMIT ADMINISTRATION DATE / INTERDEPARTMENTAL REVIEW CHECKLIST App Processed/Received by I.ic Enf Aud Applicant � � Home Address � ��,�,,�, Business Name ��Home Phone ]�u-��Q 1$ ( �� Business Address �� 4 -!�� _ ��(.,�(� Type of License(s) �'+'1` ' ,L.� . ,, V,� � Business Phone •'r y Public Hearing Date License I.D. 4i (� i ` �� '• � � at 9:00 a.m. in the Counci Chambers, � 3rd floor City Hall and Courthouse State Tax I.D. �� Z �,;=�;�7.. �. ':,,,,. Date Notice Sent; Dealer 4� ��' to Applicant �� Federal Firearms � �. �;� Public Hearing � - ;y.,` DATE INSPECTION `" A�� REVIEW VERFIED (COMPUTER) COTIlKENTS .�' A roved Not A roved ' � Bldg I & D �' � r, �.� �t, ��. Health Divn. � �:�� ( •:.� . K� � .: y� uYr�ip�'.�'i�j� Fire Dept. � � R��t;� � � �� ,,�, I �� C,k �� -� d�,..�--..� , i Police Dept. I ��, �( � I I �; � �� t'�R .Y . � tl r �� License Divn. '�� 6� � �^ l `, I I ' ��»�.� � _�� City Attorney .�I � �� a� F� Date Received: Site Plan ;� To Council Resea ch � Lease or Letter Date from Landlord , 'A . � ;,,,, � � '��'�'`+�� . y CIT7C OF SAIIPT PAUL, MINIIESOTA APPLICATION FOR ON SALE INT07CICATIPG LIQU LICEASE � SUNDAY ON SALE INTO'RICA?IFG LIQDOR LI SE , .;�'�� 4` � INTOJCZCATING CLUB LIQDOR LICENSE t � '��it � ��. OFF SALE IPTOICICATING LIQt10R LICEN ��' � �' ' • 'ON SALE MALT BEVE1tAGE LICENSE �� A� F;�� ' ON SALE WINE LICENSE � �. . •- � `�, Directiona: THIS FORM MQST BE FILLED OUT WITH TYPEWRITER OR BY PR�NT ` SOLE OWNER, BY EACg PARTNER, BY EACH PERSON W�0 HAS I�TERE$T IN ;: IN THE CORPORATION AND/OR ASSOCIATION IN WHICH THE NAI� �OF LI �ISSUED. �; . THIS APPLICATION IS SUBJECT TO REVIEW BY 1) Application for (type of license) �� s il/�x L� , � 2) Located at (business addresa) /7 � r� �' • ^ � STREET: Number Name Type, c,'; ction 3) Business Name o� � - c,►� d� Corporation, ar ership or ole Propri torship ' w�:�: 4) If buainesa ia incorporated, give data of incorporatioa .•�?'. • �. 5) Doiag Busineee As .�✓a�/e.��,�t� ��// �vov� � Dusines Phone / ' . �- �� . � � � �;`; 6) Mail to Address (if different than bueineas address) �5.14 1 k ' � 4 5 � D v � / O STREET: Number Name Tppe irection '`z,. � c S� � R a, City . State Zip Code ;, i c� ..�•--�--^ �-- 7) Your Name and Title -21Q � ' Qrn � //� (Firat) Middle Maiden Laa Title 8) Homa Address d ` �OIIa� STREET: Number N e Type Diract < � /�, /v .-, :.:r;. - Cit Stats Zip Cods ;�:; 9) Data of Birth � � Plac� o! Sirth U� ,� . (Month Day, Ysar) � � � r :� :�,,; . �� , _ � - � _ IO) Are you a citizen of the Uaited States? 1 � Native Naturalized � —.� � � . 11) Married? If answer is "qes", list name and addre s of spou�se. 'y� �.�_ Y ,� ;��t �� , .x ,. , � ,, . , „�� -. Y4� ' � ��; I�-'�� s:: � 12) Have you ever been convicted of any felony, crime, or violati n Q � `� *, . ordinance other than traffic? YES NO __�C�� k' , x. Date of arrest , 19 Where � � Charge � t:' "� Conviction Sent�nce �°;.' ' ,�•� `�:� ��! 'R Date of arrest , 19 Where �- '� YR� Charge '' � Conviction Sentence � ." :� 13) List the names and residences of three persons within the Met o Area of g �k"` moral character, not related to the applicant or financially nterested in premises or business, who may be referred to as to the applic nt's characte ; . NAME _ � ADDRESS � • ' ' ;.a� oA'1 � l ' , �. < � /� � r-' f1 S �� ;x. � "'� ` �:�� 14) List Iiceases which you curreatly hold, or formerly hald, or may have aa interest �;�,.}: in � / �,,,'j "'�'� O /,��/'d N _ � V� �t � 15) Have anq of the. liceases listed by you in No. 14 ever been r�volced? Yes No :�":� If answer is "qes", list the dates and reasons ;� �_. �� 16) Are you going to operate this business personally? If aot. who will , :A, �� operate it? � - / � � �, , Home Addrass Phons � 7 �'- Name ��-6 M a i � � ,�5�� ' � �� y � 17) Are you goiag to have a manag�r or assistaat ia thia buainess �`�'P S Ig answer is "qe�", giv nama, hama add�Cess, ho�e phon�, and te of bizth. ` , � :. ,� Name`I�.X__�„((�,�(��/�4S 1�P Addresa 1 � �d ��4"/.� ��x ' � 1 Phoae �- DOB . �Ra' - R:�' 18) Iacludiag your prsa�nt busia�sa/�mployment. What ba�ins�s/�mp oys�a�5� �� followed for tha past five yearsZ ��'` �� Busiaess/Employment Address . ,.� �, � ` / �• y,:.�, � , �. G 1 �-y�• .y 19) List all other officers of the corporatioa. NAt�: TITLE HOME ADDRESS HOME BUSINE (Office Held) , PHQN� PHONE ,'� . � � � � Y1� n� � . - � �3�� r� {:.. .,y,,� 20) If bueinesa is partnarship list partner(s), addreas, home andi, business phoae aumber. �.� Nams Addr�as � Home Phone Busiaesa Phone �_ Name , Address _., ;. Hom� Phona Buainsss Phoaa � � 21) Liquor will be served ia the follawing areas (roams) 22) Batween what cross atreets is busiaess located? ��Y��r'.�� /�'�/1__ Which sida of street? � .• r�y '. ` ----r- �, *: �. 23) Ars pramisaa now occupled? �� tahst Typs B siaass? � �a gow Long? y ,� . �;;. m I ��a.� �!�b°. � ,� � r �b , �� r, . 9. _i, ,, G,��4 t �.�i,� t ,. �� : , J ��1 �� , * �., �r� P �� ::��i`�"�� . i4. � � � ,'b }'� •wy K ..! :._�,a "'�,r' r .:.:k:4�F. �• 'A= d`' �J �.. ��!� f f , �,.,,� ' . I� ;v,:. .: ` ,'A-' � � � 4' �r�, � � ��'� ��,_��r�'! 24) Closest 3.2 Place Church Scho�l �S) Cloa�ot intoxicating liquor placs. Oa� Sale �ft Ssls '6) You vill b• r�quir�d to obtain a Rstail Liquor Dssl�rs Tas St�p. ( ,Atta�i` ` d r � , , � . - �; r,):,i.°-. -�>`;j• ,t y�, ANY FALSIFICAIZON OF ANSWERS GZVEN OR MATERIAL SIIBMZTTID WILL BESULT IN DENIAL OF THIS APPLICAT�Op ` � �: ' ' � ��` ,�° I hereby state under oath that I have ansWered all of the above qukstiona . the information contained haraia is true and correct to the best olE sy lcri ��_��isf. I hereby state further under oath that I have received no money or o�her con� . °,b�r Wap of loan. gift. contribution, or otherwiae� other than already disclosad in tl�e app ' '' which I h�rewith submitted. '�� '- .1' • �; Stata o£ Miaasaota) DaF(o{�- ) • • ' County of �aay ) � ' Subscrib�d and swora to bafore �.this s � _��(T� , • • S aatura of pl cant D a ' day of �� , 19q� •;�� " ;i Notary Public °�" _ County, MN �-��. . Mq Commission expires h°�c"�' y�'" ZS� 1 qq! ""` 5 : � . ,� �"��,. �.OE AI.JAEfVtS , � �� NOTMY PVBUC-11AINMESdTA � oAKOra counmr �.�' .`�.. M„con,m�a.�a,Exp�s.Nar.zd.1 ss, � ;s . , ;�::,' ;.;: REV. 2/90 y . � � . I � ,�{'( � - , . �� ':ri i R�t a V,�'�� }� ; .. 1� Y,�1 i+,' Y . ' ��' �','� ' .. 1 ��.Y. �,'<. Z' �. -�,, .!'.�` '..w '.�, Q ��' ��r i'� . �'+�?.,.p, V. ,� �r:lf� � F� 1� �y i � } , � �. .:_ �'z,. � i: '�� 's3:,:. y .�,t. • � .. . ��Y/� � CI1R OF SAINT PAUI., MINNESOTA APPLICATION FOR ON SALE IPT08ICATING LIQII B LICENSE � SUNDAY ON SALE INTOXICATING LIQUOR LI SE INTdRICATING CLUB LIQUOR LICENSE �` �' OFF SALE INTOICICATI1tG LIQ�OR LICEN ' � ON SALE MALT BEPERAGE LICENSE •-" " �� . • ON SALE WINE LICEHSE �;: ";��'`r+ -':; . .;f. :. , �=F. -;,, � , „t';: ;. Directions: THIS FORM M[TST BE FILLED OOT WITH ZRPEWItITEB OR BY NTING� >INK. ��"SOLE.° OWNER, BY EACH PARTNER, BY EACfl PERSON TiiHO HAS I T Ifi SS . w THE CORPORATION AND/OR ASSOCIATION IN WHICS THE NAML �OF L SE 6UE`D• � �� . TIiIS APPLICATION IS SUBJECT TO REVIEW BY THE PUBL`IC :. �1,F �. / � . 1) Applicatioa for (type of license) �� S/¢/� ��7 • Li c�v2 t.�� Cf,uS � 2) Located at (business address) �� s� S� ' r9��F� T��Z/9 STREET: Number Name Type Dirsction 3) Business Name /7'v�/�a+ �!'- P��lva d O� ��- /au � �i� C . .��, Corporation, Partnership or Sole Propr etorship 4) If business is incorporated, give date of incorporatioa � 1'9 ,`�/r 5) Doing Businees As /�a� GrJoOCY - ��YW�(/Giva�� Busine s Phone � 6) Mail to Address (if different than business address) . } :s ;� � 3 � �r�� ,� �z �3 .�u c1s�,� �� STREET: Number Name Type ir�ction � �� r < ��o�C�/� KZt �i'� � s's', � s ; Citq - State Zip Code � � 7) Your Name and Title 1�� G.,¢/,� , sr� /"�£ S • � � (First) (Middle) (Maiden) (Last) (Title) 3 .� 8) Homn Address ��C7/ ��/1 S o�J Phone� ��d - � �� STREET: Number Name Type Direction '�. � �S� •�4u / /�I �s-�� , ,� - City _ Stata Zip Code 9) Date of Bizth 9 `�' `�I Place of Bizth �,c� o �/� . _ (Month, Day, and Year) `:,,� .;_: � �� I �i`y},y\ '� � K"�� Y , � �['q•��C�� e . � � .. ��'��.: .s.� �`,, 1R:\�., . �.,.''+•��~�: . V�;��..'rM y�•� ,. 4: : � � '�f�� t�_. `N� � , :� /1 a .:�l.`K. `:.1` .1t,,: •1 `n��,, ... . # 4 �'�;' � f �Z �" Fr I �a � �' � � � � ;, � ,. �.r ; �� ... � � �9��' IO) Are you a citizen of the IInited States? � Native�_ Nat�ralized 11) Manied? /�� If answex is "yes", liat name aad addre�s of spouae. � ` �. 12) Save you ever been •comricted of anq�felony, crime, or violati n of any city �;` : . - ordinance other than traffic? YES NO _� � °'�"` Date of arrest , 19 Hhere �'` �'- Charge �x�� :.' .. Conviction Sentence �:=. ��° Date of arrest , 19 Where ^ Charge Conviction Sentence � 13) Liet the names and residences of threa persons within the Me ro Area of good E��„ moral charactar� not related to the applicaat or fiaancially interested ia the. premises or business, who may be referred to as to the appli¢ant`s character. � NAME _ � ADDRESS � _II � n ��4�� /o �u£S� �� -�I�`��s�•,� s�/'.au/ /1,/�v . �'��,cl� S ,��fZ � y`��' �� '/f,4,.1 �S� /%�u/_/�=�.'• � � }� C� .�; � o� G. �/�� G,��N� �,� F �. � � ,�,� �,��-r� , 14) List Iicenses which you curreatly hold, or formerly held, or may have an iaterest �;•�'s. , ,, �. �v/� ,�.,� / � �y 1 15) Have any of the licenses liated by you in No. 14 ever beea r�nvoked? Yes_ No If anaWar is "qes", list the dates and reasona I _ # .� � /� 1 �� . � 16) Are qou goiag to operate this business personallq? � If not, Who will - operate it? l�ame Homa Addresa ` ' � Phoae __ 'a , I �,�� ' w , , '.'``_ ��'.-� �. ��e., �. 4[. F Y�'i •�r �±.,-. . �l � V ,'. .. 1 4 �!'. P { . �Q,-� 17) Are you going to have a maaager or assistaat in this business3 �C� � If answer is "yes", give aame, hone address, hame phone, aad �ate of birth. Name Addresa I � Phonn • DOB 18) Iacluding your present business/employment, what basiness/�mp oyment have you followed for the past five years? Business/Emploqment Address � (l.l�,U S�( ��C4�v� vc ,D t ��r��'�C � �G �� ! f £/l s v ..c./ 5�.�/.Ir.c / �C�� / i C`�%i,� ' /'��'.,�Z,vA�c� %��OuJ/J� /�n'` - ,�/�5. JC�� c s�• �u /� /�(,v v 19) List all other officers of the corporation. NAME TITLE HOME ADDRESS HOME� BUSINESS (Office Held) P�� P�� Pa.�� /.�£ti�:5 �/ ss,� - �2� s . �8 �i .l��i�,�s� ..� G '- �7P� �y73s— �/��S ��r�/ o� �,v.0 . ; -- c . �7v y ,l�sh�c�t 1 s . ,� - �xs s�l �z 3-�z 7� � 20) If busiaess is partaership list partner(s) , address, home an� business phone � number. Name � Address (, � / Home Phone� Busiaess Phoae . Nffie Address s Some Phone Business Phone � 21) Liquor will be sert►ed in the follaaiag areas (rooms) ,/.2S� c�; ' ��'�E � � 22) Between what cross streets is busiaeas located? �Q��Fd2 f��z� Wtiich sida of street? �,l i S� - —� � 23) Are premises now occupied? /�d What Tppe B siness? � Ho�+ Long? • I .�� ,�� , � s � , . . . . �►r-�' , . 24) Closest 3.2 Place Church Schoolj � 25) Closest intoxicating liquor place. Oa Sale Of� Ssle . 26) You will be required to obtain a Retail Liquor Dealers Taz Stam�. (See Attached) � . ANY FALSIFICATION OF ANSWERS GIVEN OR MATEBIAL ! SIIBMITTID WILL RESULT IN DENIAL OF TfiIS APPLICATZO[�1 I hereby state under oath that I have answered alI of the above que�tions, and that the information contained hereia is true and correct to the best of my knowledge and belief. I hereby state further under oath that I have received no money or ot�er consfderation. by way of loan, gift, contributioa, or othezwise, other thaa already disclosed in the application which I herewith submitted. State of Minnesota) ) I Couaty of Ramsaq ) Subscribed and sworn to before me this / ��l6 j • S gnature of Appli ant Da e day of .�l , 19� i , , N ry Public �Ndr,�� "�Countq, IrII� Mp Commission ezpires /�— /��/ � :6.:.;:.:' sandxa uo�ssiwwo� �tW ;�i"n 1 A I i�^O_` >dla.'�P:7N y''��f�� I ; Vt^53`�hln—:fi?fld A�Yj<?W v r� � : , ..�lc..:.... .. � ��,::i.r Y?f�i2c��r � . .�.—� _—_� i a t. .. � � REV. 2/90 , I �� , . . f � . . �"�� CZTY OF SAINT PAOL, MINI�ESOTA APYLICATION FOR ON SALE INTO%ICATII�G LIQ R LICENSE � S�ITDAY ON SALE INTORICATING LIQUOR L CEIQSE INTORICATING CLUB LIQUOR LICENS OFF SALE INTOZICATING LIQUOR LICEI�SE "ON SALE MALT BEVERAGE LICENSE I ' ON SALE WINE LICENSE Directions: THIS FORM I�NST BE FILLED OUT WITH TYPEWRITER OR BY INTING IA INR BY THE SOLE OWNER, BY EACH PARTNER, BY EACH PERSON �iHO HAS INTE�ST IN EXCESS 4F Sz IN TSE CORPORATION AND/OR ASSOCIATION IN WHICH THE NAl� �OF 'k"8E LZCENSE WILL BE ISSUED. , THIS APPLICATION IS SUBJECT TO REVIEiJ BY TliE PUBLIC 1) Application for (type of license) �h Sa�2 �►1�`OXt�a�)n � t Uu�' ��A 2) Located at (business address) � 7 5 E a S�' S� s'}' . Ga 1�i er PI cz�t. s'�'- A�+�i � h'1� STREET: Number Name Type. Direction 3) Busines s Name ��I (�10 0 � � HO�� U100 d � �'�"'i PQ u.Q • ' �v1 G . orporatioa, Par nership or Sole Propr etorship 4) If business is incorporated. give date of iacorperation �� , 19 9 � �-IoII �ooa� Hol► u�o�d . — 5) Doing Busiaess As Busine a Phoae # 6) Mail to Address (if different than business address) . �0►�3 N�ds�, �oad , S�t.� � 40 STREET: Number Name Tppe irection �Do c� � �� S !2 �".' City . State Zip Code =�.,�.1�-4�.1v��,r. �u r t S h r i S 8 a n d a.p � C��e`� �c e.��v� a��ca r 7) Your Name and Title (First (Middle) (Maiden) (Laat) TiCle) 8) Home Addrnsa �U �oU� D.ZZ La�L �OG.a� Phone# �3�� '0� STREET: Number Naae Type Direc ion {!��r� 0 a-�f S� {Nl I� 5512 �J City State Zip Cade � 11 2 3 t 9 4-4 P' o h a , Y►�• S. � �n c�►a. 9) Date of Birth / / Ylace of Birth (Month, Daq, aad Year) _ I . , �-,s�� IO) Are you a citizen of the IInited States? ��S Native I Natnralized x , � 11 � 11) Married? `�� 5 If answar is "qes", list name and addr�ss of sp�se. C�'1 e ( C�M�S li ►1 � �N��vu-�— �QhQ A ( v`.� `'rr' I r 12) Have you ever beea•convicted of a�r•�felonq, crime, or violat�Con of any city ordinance other than traffic? YES NO �_ Date of arrest , 19 Where Charge � Conviction Sentence Date of arrest , 19 Where � Charge Conviction Sentnace � 13) Liat the names and residences of three persona within the M tro Area of good moral character, not related to the applicant or finaaciall interested in the premises or businesa, who may be referred to as to the appl cant's character. NAME ► ADDRESS so �,,��. E. �odti � u �- � ss s w�� ,�.�,� w -, s-r.Pa�, r� ,� �- 6 o r e� 6 b E�s fi � S��-�'��4 I�2 S�'.Pa wt 1� o b�d $, g q _ i > > : �.[.Y��G �7• �� he Iw� Il I lo �tM �r� �I1/'�.) 1`I��7�,.Pa1►�{� �J ��, � � 14) List licenses which yon currentlq hold, or formerly held, o� maq have aa iaterest �. ,�� 15) Have any oE the licenses Iisted by qou in No. 14 ever beea �revoked? Yes_ No If aaswer is "yes", liat ths datea and raasons ��f� i e 16) Are you going to operate this business personallq? �� ' If not, who vill � operate it? " Name �'�h v1��S �7�i� al S S t G Home Addresa � $�� `� ¢1��'I= Phone 6�`g � S�'-�a�, w� ru� SS 1�`f � � . `'�9/ �9 . 17) Are you going to have a manager or assistant ia this business2l �0 i � If answer is "yes", give name, home address, home phone, aad �ate of birth. Name Address Phone DOB 18) Includiag your present business/employment, what business/emp�oyment have you followed for the past five years? Business/Employment Address C�� A� C �+1�u$'M�� U�C�S � �DO �And VI P.w /mrP�h�l.L� �YVQqQ� �D g00oZ C�E�� N 1�� P Y�a n a w�.r,n �- C�M ah y 6�4 3 NU S� (-�oa.c�� 3 4 5�', Wv�d b�y� 1� r� - Cs�i s u «'a��' 3►�'1 �m ah -�, .t------,, G� h�t i N R A �'o I o 3� Aw� I q n u� �e� o � � ►'►� S5 12f 19) List alI other officers of the corporation. NAME TITLE HOME ADDRESS HOMFi BUSINESS (Office Held) PHOI�E PHONE D�rtni�s C7a�lass�'� P-y�►�� ' Iggl Je f �s� Sfi-��•..J G98- 6�gt 73�- u2yS Jeralcl I�e�ne(1� S.�we� � z'Joµ Pi Il sb+�y� h�r�hl . S79- oos�, 823-��71 T� � 2fl) If business is partnership list partner(s), address, home and business phone number. I Name �r � Address Home Phone Business Phone � Name Address Home Phone Business Phone 21) Liquor will be served in the following areas (rooms) u S r� `t L°w� ��-( 22) Between what cross streets is business located? �� r�� a Which side of street? �� T 23) Are premises now occupied? �� What Type B�usiness? How Long? �� q I . ' ��-�� i - 24) Closest 3.2 Place Church Schoo�. 25) Closest iatoxicating liquor place. Oa Sale O�f Sale � 26) You will be required to obtaia a Retail Liquor Dealers Tax Sta�p. (See Attached) ANY FALSIFICATION OF ANSWERS GIVEN OR MATERIALi SIIBMITTID WILL RESULT IN DENIAL OF TIiIS APPLICAT7�ON I hereby state under oath that I have answered alI of the above questions, and that the info=mation contained hezein is true and correct to the best o� my knowledge and belief. I hereby state further under oath that I have received no money or o�her consideration, by waq of Ioan, gift, contribution, or otherwise, other than already disclos�d in the application which I hezewith submitted. State oi Minnesota) i ) Couaty of Ramsey ) / r s ' 'aq ' Subscribed and sworn to before me this � • s � 7� � Sigaatu e of Appl'caat Date �� day of � , I9� � . Notarq Public County, MN My Co�ission expires q , �E A lA�M� fR�UM�l.irw� i � �x�' woM..�«ew..w,��a� � � RE9. 2/90 ''! �